Thread by @dgurdasani1

It's important to understand that this wave is going to be different from previous waves in many ways. Every wave so far in the UK, the govt has acted late- when the NHS was already quite overwhelmed. This time doing this will be far far more dangerous- here's why. Thread

We know that there is a lag between cases & hospitalisations rising. This means that even if we act to curb spread today, hospitalisations and deaths will continue to rise for 2-3 weeks because those who will be hospitalised and die in the next 2-3 wks have already been infected.

So every time the govt has taken action, with the NHS severely strained, the situation has continued to get worse for 2-3 weeks in terms of hospitalisations and deaths before getting better. Which means strain on the NHS continues to rise for a period even after we act.

Somehow the NHS managed despite massive pressures (at huge cost to many HCWs), and thankfully we haven't seen the sort of O2 shortages, and large numbers of people dying due to lack of ventilators like some other countries did despite late action by govt.

his time the situation is different, and I'm not sure the govt understands this. The rate of rise with omicron is vastly different from any variant we've seen before- a doubling time of <2 days.

No one knows how long this doubling is sustainable, but this means that by the time we see the impact of cases today in terms of hospitalisations and deaths, several doubling times would've likely passed.

this means by the time hospitalisation rises are felt and acted upon, during the 2-3 wk lag, cases may be several fold higher (no one can actually predict this currently because we've never been here before).

This means once again that hosp will continue to rise after we act, but the rise may be far greater and steeper than anything we've seen before, and NHS utilisation will increase much more steeply even after we act than we've seen ever before due to delay.

The recent SPI-M-O report also makes this clear- if you're acting by the time the NHS is already overwhelmed, it's going to be far far too late.

Yes, boosters will almost certainly help, but everything is telling us that early action is even more important when the rate of spread is so high. Any underreaction or late reaction has the potential for severe damage to public health and the NHS. Much more than before.

I think govt may think they got away with late action before (with huge costs to public health) so they can act late once again, but things are very different this time round, and they need to be aware that the costs of acting late this time will be far more devastating.