Can 2022 be the year we learn from our mistakes?

We are entitled to make mistakes, given how new Covid is.

But stubbornness and ego have no place in pandemic management.

On that note: Covid admissions rising in many places.

Here’s New York: Image
And here is London:

@chrischirp Image
Denmark, France and the wider US… Image
And here is South Africa nearly two weeks ago…

(Note: last week is never complete, as is current week). Image
And there was clear signal that admissions were rising at the start of December. Image
There was plenty of time to prepare for Omicron.
Even just improved social protections - such as the devolved nations have now put in - would have helped.

For the economy of the nation - not just an elite few - and to save lives a short circuit breaker would have worked.
We remain about 4 weeks behind South Africa!

…they remain with 10-fold higher Covid inpatients than their previous Delta baseline.
They of course mitigated against the wave. And still within two weeks jumped:

Gauteng…
Dec 5th:
1.5k admitted
115 in ICU
29 Ventilated

Dec 19th:
3.4K admitted
285 in ICU
110 ventilated
We must predict this will get worse. And if we don’t take action the ensuing healthcare rationing that we have suffered for nearly 2 years will reach new dizzying heights.

Act now! Or damage health and economy of the nation.

Get your house in order @Conservatives

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More from @danielgoyal

23 Dec 21
New: UK Omicron studies suggest certain populations (e.g. fully vaccinated) may have a reduced disease severity vs Delta.

Hope though, that Omicron is “mild” enough to avoid increased Covid admissions and further rationing of non-Covid care for UK is, unfortunately, diminishing.
According to several early studies on Omicron severity: in previously exposed (vaccines +\- infection) populations, hospital attendance may be reduced by around 25% and admission by around 40%.

[The Imperial investigators advise these numbers may change as the wave progresses.]
On an individual risk level, so long as you are up to date with your vaccines it is great news. Your risk of serious disease appears significantly lower. Even for those unable to take vaccines, there may be a reduced severity.
Read 8 tweets
22 Dec 21
❗️Massive…Omicron Disease Severity Study just released in pre-print.

Huge thanks to our South African Colleagues who must have worked through the night to complete this so soon.

Some thoughts on it…
[summary last two tweets]
A good study.
✅ Only reported on cases that had an outcome
✅ Controlled for age, co-morbidity, etc…
✅ Used quite solid proxy for Omicron

✅ admitted limitations -
❌low numbers,
❌no raw data on morbidity or mortality
The most important limitation the investigators highlighted, was the likely difference in vaccine/immune status. Around 50% of the target adult population had at least one vaccine by the time Omicron hit. It was less than half of this at the start of October.
Read 12 tweets
20 Dec 21
The signal from today’s South Africa Covid-19 data is that #Omicron is still causing serious disease.

ICU admissions have more than doubled and MV (ventilation) have tripled since 5th Dec.
Gauteng…
Dec 5th:
1.5k admitted
115 in ICU
29 Ventilated

Dec 19th:
3.4K admitted
285 in ICU
110 ventilated
Vaccination reduces the chance of severe disease. Get boosted.

But some will still require hospital admission, some ICU, and some will need ventilated.

And with the NHS struggling, I remind: mortality rate depends on access to healthcare. Wishful thinking is not good enough.
Read 4 tweets
17 Dec 21
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 12 tweets
15 Dec 21
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.
Read 8 tweets
12 Dec 21
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

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