1. Keep perspective.
Covid-19 is not the flu. It carries a significantly greater mortality. But, equally, the overall mortality rate is likely to be somewhere between about 0.5 to 0.05% (variance between countries). The odds are most definitely in your favour.
Whether it is this variant or another or it is another pandemic, we should be ready. Individually we can prepare now so when it arrives we can continue with our lives, less anxious, less consumed.
3. Mitigate any risk factors.
Some are at greater risk than others. Still - perspective -, even if you have many risk factors, the odds remain in your favour.
A number of risks can be modified…
4. Get better control of any co-morbidities.
Better control of diabetes, hypertension, asthma, COPD, heart disease, obesity, substance misuse, kidney disease, and many others are all likely to help. We have got very good at optimising disease control.
5. Get #CovidFit
Most of us carry extra weight. And many of us feel we are not nearly as fit as we could be. Does it matter if fighting Covid-19?
It really does. Being fitter helps when we fight the infection and also during recovery. So, for most: lots of veg and stay active.
6. Mental Health.
Also, pay attention to your mental health. As you prepare and once you are prepared, enjoy your life. Let whatever was at its centre before the pandemic return to its centre. Enjoy family and friends, and stay connected.
7. Prevent infection
Infection is not inevitable.
Delaying infection also has its advantages: 1) it avoids getting unwell when hospitals are overwhelmed and 2) more treatments are coming.
Masks work. A well-fitted mask significantly reduces the risk of getting infected.
8. Vaccination
I am no vaccine expert. I am reasonably informed and have seen the bad end and mild end of Covid-19. I have also seen some of the side-effects. I choose to get it. Even more so in countries where access to healthcare is limited…BEST CHANCE of protecting yourself.
9. Early intervention
If you do get Covid, it is usually mild. But you must seek help if you get worse or are worried. Shortness of breath with Covid-19 means you need URGENT medical care. Get a pulse oximeter. Thread explains more.
Please don’t wait until you are very unwell before contacting your healthcare provider. You may think you are saving healthcare resources but you are not. Waiting neither helps you nor healthcare services…it is much harder to recover someone who presents late.
10. Protect each other.
Avoid others if you have cold or flu-like symptoms.
Mask-up.
You can use home test kits before meeting others.
Try and avoid crowded events.
You can form your own social bubbles.
And advocate for improved ventilation in places of work/education.
Finally,
None of this is particularly difficult. You are not being asked to fight in a war or send your kids away or ration food. Covid-19 is killing more people per month than WW2 did. Let’s pull together, protect each other, and by doing so allow us to remain free and healthy.
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Nuffield Trust reports this week on a massive increase in private provision
More worrying, a massive surge in people using their savings to access care
From the best health system to one of the worst in 14yrs!
Summary 🧵
The amount the NHS pays (this is our tax money) to the private sector has nearly doubled in five years…
From £1.66b to £3.1b
2/9
This is catastrophic for the future of our health system
It’s based on political targets superseding clinical ones - Managers wanting to please whoever the latest Health Sec is versus prioritising clinical needs
Urgent and primary care should be priorities not GE fodder!
3/9
My obligation is to my patients, whoever they are and wherever they live.
But I want to work in the NHS…
Selfishly speaking, I appreciate not having to say no to treatments because a patient can’t afford it..
But…
🧵 1/6
After 14 yrs of Tory rule and a cowed and complicit NHS Leadership, patients are being denied treatment due to lack of resources. It is hard to witness, day in and day out.
The very principal of the NHS - access for all - no longer exists!
2/6
So do I blame any doctor seeking work elsewhere? Absolutely not. Better to survive and help patients than to be broken by a system that makes treating patients harder and harder, in a country increasingly polarised. Staying in the NHS now can be very damaging for staff.
3/6
The top down diktats ignorant to what’s actually happening on the frontline
And the kick in the teeth: there was no need for such chaos…we had plenty of warning!
1/n
You may be asking why only testing if travel history?
There were limited tests available, even though we had months of warning
It should have been a clinical call who gets tested not a management call
And remember at the time the UK was downgrading PPE, we were an international outlier. WHO never changed the advice. Even in poorer nations, medical staff were still kitted out in FFP3. Germany, France, Spain, Norway,…never downgraded.
It’s been a brutal winter for most of us in the NHS.
Now I’ve a got a few weeks off I’m reflecting on medicine in the NHS in 2024
🧵
To be clear, as a general medicine consultant in the NHS we get an unselected patient group. We see all sorts from sepsis to heart attacks to strokes to cancer to drug overdoses to alcohol withdrawal…I will see most of them from admission in A&E through to discharge or death.
My impression
Medicine is way more advanced than it was when I qualified in 2001. For example, we used to have two or three medications to treat heart failure and most patients with heart failure died in three years.
The Covid Inquiry has been asking questions about whether Lockdown could have been avoided. Some (like Sunak/Johnson) have interpreted this as suggesting we shouldn’t have locked down. It’s the entirely wrong interpretation and not the question the Inquiry is asking…
1/14
It is true that some countries didn’t lockdown and did far better than the U.K. But it was not the presence or absence of lockdown that determined the outcome. It was the presence or absence of an effective pandemic response executed early and well that determined outcomes
Lockdowns are ultimately a failure of basic pandemic management - isolating cases, tracing contacts, infection controls, treating the sick, etc.. A last ditched, heavy handed measure when you have completely lost control of the outbreak.