Thread by @dgurdasani1

Today's briefing appears to be an exercise in doing the bare minimum while seeming to signal that our response is in someway proportionate to the potential threat. Let's be clear- this response doesn't even go far enough to deal with delta, far from dealing with anything beyond🧵

Let's remember we're entering a period of uncertainty and high *potential* threat with our NHS already under unsustainable pressure (something that doesn't seem to have been discussed at all during the briefing)! Ambulances are on black alert with emergency services struggling.

We've been having excess deaths and very high transmission for months, and are currently at 50K cases or so a day, and rising, esp in children. This has been accompanied by huge rises in self-reported long COVID in young people- something not addressed at all in the briefing.

We currently have >3% of health and social care workers suffering with long COVID, higher than any other occupation, with massive understaffing, underresourcing, and reduced bed capacity in hospitals and critical care - being made worse by COVID-19.

We are in a crisis. Even without omicron. There is literally no slack in this system. I seriously worry about what would happen if anything were to make the current situation - where people are already dying in the backs of ambulances - any worse.

While it is absolutely essential to slow the import and spread of omicron, it's critically important what we do with this time we're gaining, given the crisis we're already in. Here's what we should be doing:

1. Slow import as much as possible: Comprehensive managed border quarantines across all countries (this variant is no doubt widespread) and screening. Effective, test, trace, isolate, including backward and forward contact tracing + isolation with *adequate support*.

2. Slow spread of both omicron and delta - we cannot face this threat at current hospital capacity and strain on HCWs and NHS. So:
- mask mandates - high grade masks provided by govt in all indoor settings & outdoor crowded settings
-ventilation
-work from home where possible

-contain spread in schools: mask mandates like in most other European countries, and ventilation + HEPA air purifiers, bubbles
-caps on large gatherings
-isolation of all contacts
-speed up boosters & give earlier
-2nd doses for 12-15 yr olds
-extend vaccination to 5-11 yr olds

3. Prepare healthcare capacity:
The best way to do this is contain transmission with delta now, to avert the current crisis and create at least some slack in a system that's already functioning in a way that's likely unsafe because it's overwhelmed.

Plan and prepare for further pressure on the NHS, if this does arise - including emergency planning.
I'm so dispirited by how slow our response has been to every aspect of the pandemic. Mask mandates should've never been removed. Vaccine roll-out to children massively delayed.

As other countries take serious steps to prepare for a new variant that poses a high potential threat, we are essentially just telling people to wear masks in shops and on transport (which should've been happening anyway!), and considering giving boosters earlier. That's it.

Yes, we have single PCR tests after people enter (which of course won't catch many cases, especially infections during travel), and travel restrictions from a few countries in Africa (despite omicron clearly being far more widespread).

Worth remembering our policies are well behind most of Europe, where high-grade mask mandates are already in place in many countries, much stronger mitigations in schools, many countries with higher vaccination rates, and much higher coverage for children than us.

And one can rely on vaccines and say 'it'll be much better than before because of vaccines', but also remember, we have an NHS and healthcare force that's been devastated by 19 months of being hung out to dry - with many suffering from long COVID or PTSD.

Our human resource, which is our most important resource, is struggling, because of what looks like never-ending exhaustion, illness & trauma. Teaching staff, health & social care workers, other frontline staff. We are entering winter with much less resilience than before.

And a vaccine-only approach hasn't worked in any country so far, even in those with much higher vaccination rates than us. And we've already lost >15,000 lives to this approach since 'freedom day'. How many more deaths, and chronic illness are we willing to tolerate?

One might say things will be a lot better with boosters, and potentially children being vaccinated. But this takes time, and it makes perfect sense to use effective public health measures like high-grade masks, ventilation in the meantime to contain spread.

And for those who think all of this is alarmist, we went through this with delta. And we responded too late. When there is a potential threat, it's important to respond early, in line with its potential, until we understand more. That's not alarmist. It's basic pandemic response

Always better to take precautions, and scale back if the threat turns out to be at a lower level than anticipated, than to under react, which is what we've done since the beginning of the pandemic.