Funnelling all “available” NHS staff to vaccinate is a poor strategy.

Appropriate response is to:
1. Mitigate properly
2. Redeploy to frontline to treat the sick.
3. Then boost when able.

To avoid a few weeks of sharp restrictions a lot of people will suffer unnecessarily.
1. Letting #Omicron spread without capacity to treat the sick is not a sound public health strategy. Nor is it sound clinical prioritisation or appropriate critical incident triaging. It may temporarily appease those who have little idea of the consequences.
2. Our first duty is to treat the sick. It is pandemic management 101. Find them, isolate them, treat them. Do it well and the threat lessens.
No doubt vaccines lessen the threat, but mortality still depends heavily on access to treatment, as the UK and US have shown previously.
3. And with a 2-week lag in vaccine protection and a 25% immune escape rate, and unknown duration of action, vaccine alone will not prevent many preventable deaths - Covid, non-Covid, old and young. And will not get us off this traumatic merry-go-round.
4. The right move now (with the state of the UK’s infrastructure) is to have short, sharp restrictions. Use the time to strengthen the healthcare service and make offices, schools, venues, etc…less hospitable to airborne viruses.
And yes, buy time to boost.
5. With the NHS 9% over safe capacity levels, people dying in ambulances, longest 12-hour A&E wait ever, longest waiting lists, GPs depleted, staff sickness only worsening,…and now more Covid, staff should be deployed where patient risk is greater: front door and primary care
6. We need an increased basic care capacity. We need to triage effectively and protect staff. This can permit other essential care to continue and society to tolerate surges in infections better.

Putting all staff to vaccinate does not provide the protection the public now needs

• • •

Missing some Tweet in this thread? You can try to force a refresh
 

Keep Current with Dr Dan Goyal

Dr Dan Goyal Profile picture

Stay in touch and get notified when new unrolls are available from this author!

Read all threads

This Thread may be Removed Anytime!

PDF

Twitter may remove this content at anytime! Save it as PDF for later use!

Try unrolling a thread yourself!

how to unroll video
  1. Follow @ThreadReaderApp to mention us!

  2. From a Twitter thread mention us with a keyword "unroll"
@threadreaderapp unroll

Practice here first or read more on our help page!

More from @danielgoyal

17 Dec
There is a real concern that some decision-makers BELIEVE Covid-19 is only a ‘bit’ worse than Flu. This justifies less effort to treat or prevent Covid.

It is so important to dispel this absolutely wrong comparison.

🧵 1/8
RT pls.
#CareForCovid
Let’s use the UK as an example:
Flu directly causes around 4 deaths per day.
Bacterial pneumonia around 55 deaths per day.
Currently Covid-19 causes around 120 deaths per day.

Source: ONS.
Some agencies and scientists report flu and pneumonia together. This leads to the confusing estimate that “Flu and Pneumonia” causes 20k deaths per year. Covid around 40-60k.
Some interpret this as “well Covid is only twice as bad as flu”.
This is entirely wrong!!!
Read 11 tweets
12 Dec
Preventing lockdown…
Our gov have had one eye on herd immunity since The start. This shaped policy and provision.
It must now change if we are to suppress Omicron - avoid lockdowns - and protect the public.

Mistakes are forgivable; failing to learn from them is not.

RT pls
Herd immunity leads to an attempt to minimise casualties NOT suppress infection.

Omicron is set to overwhelm healthcare providers. This will lead to higher mortality from Covid and Non-Covid disease.

Two things can stop it:
▪️Suppression of cases
▪️Optimising Care Capacity
1. Find the Sick!
Cough, Fever and loss of taste/smell account for less than 50% of presentations in early disease.

We must add “cold/flu-like symptoms” as reasons to test and isolate. It may be test and release is possible. But to avoid lockdown, we must catch more cases early
Read 12 tweets
10 Dec
I’m sure @dgurdasani1 will correct me if wrong, but the message isn’t that Covid is inevitable or we must eliminate it.

We will get better at treating it and perhaps tolerating it (immune wise).

But to pursue a vaccine only strategy when herd immunity is not assured is wrong.
Deepti and others have IMO been right: the least global impact would be (and is) to eliminate SARS-CoV2.

The world has not been united enough, at least not yet, to achieve this. And our leaders have lacked the vision to even consider it.
Perhaps it raises important questions about our processes and systems, if we have the power to prevent an infectious disease with a similar mortality as Endemic Malaria from becoming established and have chosen not to.
Read 4 tweets
10 Dec
Take Two:
"The Omicron Variant!"
Can we do better this time round?
Here are three animations born from the belief that we can!
🙏🏼 @VickiGSP

[Pls Share - if we can improve care for Covid, then we can save lives and reduce the hardship of restrictions]

1. The problem...
A lack of clinical follow-up costs lives and resources...

...but we can stay vigilant to signs of deterioration.

2. The Individual Solution
Early Intervention saves lives and resources, and frees up capacity for non-Covid illnesses...

...the more capacity we have to intervene early the safer society is!

3. The Healthcare Provider Solution...
Read 4 tweets
7 Dec
Starting to get a bit annoyed about this...

Let us be clear:

If we are forced into heavier social restrictions (e.g. circuit breakers/lockdowns) the BLAME sits more with those who supported Mass Infection, and NOT on those who tried to stop the spread.

Rant 1/5
If you are one of the toddler-adults who have refused to wear a mask to protect others...its on you!
If you are one of those who promoted unmitigated Mass Infection of a novel pathogen...its on you!
Read 6 tweets
5 Dec
Thanks @jburnmurdoch for clear update.
Clinical concerns:
At an individual level we are still not clear on threat level.
At a societal level, the numbers are very worrying. And the government should be panicking.
The rate of hospital admission seems very high with #Omicron.
1/5
A number of countries do not have the additional hospital capacity to manage yet another surge.
The US and UK (and others) are (IMV) in a very poor position to manage #Omicron.
In the UK and US the ongoing Covid-19 wave is TRIPLING the healthcare burden of 'normal' pneumonia.
Access to care for both Covid and Non-Covid diseases are already limited and this lack of capacity is causing death and disability.

[Table = 'extra deaths from any cause'] Image
Read 6 tweets

Did Thread Reader help you today?

Support us! We are indie developers!


This site is made by just two indie developers on a laptop doing marketing, support and development! Read more about the story.

Become a Premium Member ($3/month or $30/year) and get exclusive features!

Become Premium

Too expensive? Make a small donation by buying us coffee ($5) or help with server cost ($10)

Donate via Paypal

Or Donate anonymously using crypto!

Ethereum

0xfe58350B80634f60Fa6Dc149a72b4DFbc17D341E copy

Bitcoin

3ATGMxNzCUFzxpMCHL5sWSt4DVtS8UqXpi copy

Thank you for your support!

Follow Us on Twitter!

:(