🧵 COVID-19 in the UK: We're so fucked

Today UK case numbers set a new pandemic record, a milestone so portentous that, despite having nothing to say and no plan to announce, Boris Johnson had to hold a briefing, even if it was only for the symbolism.
And it was.
1/25
Chris Whitty did his best to inject some vital reality into the briefing and the title of this 🧵 is an homage to his valiant efforts, too little and too late, but at least a true communication of some of the harsh realities we face.
2/25
But the bottom line is the govt is going to continue to do just about enough to defend against the charge that it is doing nothing. A case that it will fight on a technicality.

Btw, for those who might point to Plan B and the booster plan, I offer you this analogy.
3/25
There is a fire burning through a hospital. It's blazed through paeds and the ICUs and is heading towards the oxygen storage. On the other side of the hospital, outside A&E, a drunk man watches the inferno & tries to aim an unsteady stream of piss at it.
'Fuckin wet shoes'
4/25
We are in the midst of a dual pandemic, omicron on delta. The doubling time of omicron is less than 2 days. Boris wants to offer vaccinations to everyone possible by the end of December, because it's the offer of a job/jab that really counts, not getting the actual job/jab.
5/25
End of December is 8 doubling times away.
The two weeks it'll take for a booster to start being effective is 7 doubling times.
And this booster stunt is not going to help control the spread of a pandemic doubling every 2 days.
It's just continuing with vaccines only.
6/25
Part of the workforce is being diverted to deliver Boris's publicity stunt.
The services & the workforce have already been heavily depleted and are in crisis.
We are in a position where even emergency care may not be available
7/25
Stay healthy, drive safely, don't take up risky sports or DIY, because you don't know if your local healthcare service will have the capacity to look after you. Personal responsibility folks.

And that's not considering those who will need hospitalisation for COVID.
8/25
Because what is predicted by the people who have got pretty much every prediction right in this pandemic and by SAGE is that cases and hospitalisations (and consequently deaths) are going to be at a whole different level.
9/25
In the 'unprecedented' times of the 21 months of the pandemic, we are entering an unprecedented period. The exponential curves with omicron are terrifying.
It is infuriating to see the media and the govt 'acting' in response to record case numbers.
10/25
'Well we never thought the fire would get to the oxygen stores. It's why we didn't try and stop it. Now, let's all clap for Steve, who's still outside A&E. Oh he's passed out? Ok, let's move on.'

Because this was all completely expected and predicted.
11/25
Omicron is a bit of a gamechanger but not a massive one i.e this kind of scenario was going to happen with uncontrolled transmission. The Omicron-delta dual pandemic scenario is bad but it's not like things were going swimmingly before omicron.
12/25
@dgurdasani1 @chrischirp @trishgreenhalgh @fitterhappierAJ @ProfColinDavis @Dr_D_Robertson and so many others have been warning about this latest disaster (as well as all the previous ones) for ages. They've been telling us it was coming.
13/25
They've been telling us it's here.
All these people have been telling us for months (in 3 months we can say 'for 2 years') what we need to do, what risks we're taking, what costs we are incurring and what we will continue to incur.

And today we had a symbolic briefing.
14/25
We're here because of the failings and deliberate actions of our corrupt govt. Because of powerful vested interests and a complicit media.
15/25
But we're also here because of scientists and doctors who have been actively complicit and advocated for:
-herd immunity
-It'll become endemic
-Vaccines will be our way out
-Keep schools open, don't protect children
-Living with the virus
16/25
21 months in and these ideas have been proved wrong repeatedly.But it is the approaches they have continued to argue for that have won.
The advocates of these approaches won the war and they have the casualties to prove it.
17/25
One of the most terrible things they have done the idea of taking any reasonable steps to control the pandemic so toxic in the discourse, by attacking anyone who makes the very reasonable case to do so, that we end up again in yet another crisis within a crisis.
18/25
We're in a far worse position in December 2021 than we were in December 2020 and that's after nearly a year of vaccines. This didn't just happen, it was entirely expected and inevitable because it was made so.
19/25
We're heading to a position where a lockdown is inevitable. Inevitable in the sense that we won't be able to control the pandemic without imposing one. That doesn't mean we'll have one because the idea of lockdowns has been made so unthinkable.
20/25
So we've been set up. Opposition to any reasonable measures to control transmission (masks, mitigations in schools) means the pandemic will surge. Opposition to any stricter measures when this happens means that things will only get worse.
21/25
And we'll still have these talking heads in parliament, on the media, on Twitter talking about 'people being alarmist' and proclaiming themselves as militant COVID centrists.
And all these forces will try and keep us focused on right now and the next short term 'fix'.
22/25
But even with that, think about how we're going to manage the cases, hospitalisations and deaths over the next few weeks. I'm struggling to see how we will.
Of course we'll get through the next few weeks, mainly because time will continue to flow and we'll have no choice.
23/25
But it'll be like a Hollywood disaster movie with not much of the cast left by the (unlikely-to-be-feel-good) ending. All the minority cast members will have perished but for a token token survivor. The lead white guy will somehow be ok of course.
24/25
This is the alternative to controlling the pandemic, you can let it burn out.
There will be a helluva lot of ashes and they'll be the remains of someone's loved ones.
It's hard to believe that this is what some people are STILL actively pursuing.
25/25

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More from @HZiauddeen

14 Dec
Update:
So, the flesh eating bacterium, having done a number on the first leg, is now quite literally ploughing through leg No.2 (I know, I am shocked as you are).
It's probably getting pretty critical now.
What's that you say?
N=2 is just one better than N=1?
(1/6)
Yes, that is strictly true but I don't think you're going to be able to increase sample size much further.
You could add in a trial arm I suppose...
But I do think we have enough to be going on here, you may not (literally), but we do.
2/6
I see your point that leg 2 is not quite so bad as leg 1 but that is just the lag.
You don't agree? I see, you think that leg 2 has acquired some immunity so is fighting back better.
Well, your hope and optimism gladden my cynical heart but I do think-
3/6
Read 6 tweets
11 Dec
🧵 Research study: Psychotic experiences in borderline personality disorder (BPD)

Psychotic experiences are common in BPD but are under researched and often dismissed. We are looking to better understand these experiences and how they might arise.
tinyurl.com/rnjs8xs7
(1/4)
BPD is associated with a huge amount of suffering and it is one of the most stigmatised psychiatric conditions. For research it is important to use established diagnoses but we are very mindful of the issues with the diagnosis as discussed 👇
(2/4)
The study will involve a brief screening session to determine if you are eligible to take part. If eligible, you will be sent a link to fill out a set of questionnaires and some computer based tasks that will take ~ 1.5 hours. You will be paid £20 for your time.
(3/4)
Read 4 tweets
11 Dec
🧵 The problematic diagnosis of Borderline Personality Disorder (BPD)

BPD (aka EUPD, emotionally unstable PD) is arguably the most stigmatised diagnosis (Dx) in MHservices and in the general hospital.

This 🧵is going to cover some of the problems with this Dx.
(1/51)
Many of the people (predominantly women) given this diagnosis are survivors of complex trauma, who continue to experience recurrent trauma in mental health and physical health services, as well as in other areas of their lives (a frequent & painful legacy of trauma).
(2/51)
Despite this being fairly well known, in reality the trauma and suffering often receive little consideration, and the Dx is heavily stigmatised, leads to frequent dismissal and EXCLUSION from care, and even frank discrimination, with far too many people taking their lives.
(3/51)
Read 55 tweets
4 Dec
🧵On complicated grief: losing someone who should have been close but wasn’t

For those of us who've lost people who should have been loved ones but didn’t really love one,
Who’ve lost parents, siblings, (sometimes children), and spouses, who were uncaring, and abusive.
(1/25)
Grief is the pain of the void left in life where someone used to be.
The void is the great discontinuity, the point where they will no longer be part of the unfolding story of your life, the point where your shared story ends, from when there will be no new memories.
(2/25)
All they were part of, all that they helped in making the world feel better and safer, in making you know you mattered, all of it ends at the void. The enormity of the void is overwhelming, and in the early stages of grief, it can be hard to see a future beyond the void.
(3/25)
Read 25 tweets
4 Dec
RTing this for 2 reasons:
1. I think this is the only way in which we might get a sensible pandemic strategy (I'm not hopeful).
2. The lovely replies from pronoun warriors.

Neither of these is a compelling reason to read this little thread but 1 possibly narrowly beats 2.
1/6
We've learnt a lot about Omicron since I wrote the original thread and none of it is remotely reassuring. In the thread below I wrote about how this is what was expected and predicted especially by people who know about virus and immunology.
2/6
My worry is that a massive change of direction will be required to deal with the combined delta and Omicron pandemics. This is not going to be controlled by minimal interventions and continuing otherwise as before.
3/6
Read 6 tweets
4 Dec
🧵Ostensibly about necrotising fasciitis:

A flesh-eating bacterium is eating through your leg. This is a new experience. You have never seen bits of your leg disappearing like this. And the pain, well that's something else. And the smell, oh boy the smell.
1/8
This is not looking too good but we don't know how it's going to go. Perhaps you should sit & watch carefully to figure out what's going to happen next. What can you infer from the mysterious ways in which the bacterium moves?
2/8
Perhaps it's important to adopt the right attitude, one of caution but not rushing of to action. Perhaps fortitude may cause the bacterium to think again if this is perhaps the wisest strategy to pursue.
Read the entrails carefully (but quickly lest they become your own).
3/8
Read 8 tweets

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