How wrong is Johnson’s (and other leadership’s) inaction?

Almost beyond comprehension.

They have abandoned the public and frontline staff. AND make absolutely no mistake about it, they have accepted avoidable deaths and disability of thousands.

1/n
Johnson’s view that we can ride out the next few weeks is based on a complete disconnect from reality.

Firstly, we have not even reached the peak in the UK. The pressures will only worsen.
The two years of profound healthcare rationing that we have endured will only worsen

thelancet.com/journals/lanep…
Secondly, while the peak may come in a matter of weeks, what the plateau and baseline will be remains unknown.

What we do know from South Africa is that for the last five weeks they have maintained a 10-fold higher number of admissions.
And mortality remains X 6.
And Johnson does not have the “luxury” of surplus healthcare capacity to absorb these new, additional pressures. He has done nothing to retain or recruit staff, so capacity will remain unachievable. Other care will have to be curtailed further which means non-Covid morbidity ⬆️
And what we know is that delayed time to first response (ambulances) and 12-hour waits in A&E increase mortality. Healthcare outcomes are almost certainly declining in the UK and risk to public is considerably higher (everyone, not just the vulnerable).

rcem.ac.uk/new-report-rev…
The strategy of neither strengthening the Frontline nor reducing the number of cases is utterly absurd. It should not occur in any nation, least of all a wealthy country.
And in response to @emilymorganitv question: yes, others will and are being refused care due to XS Covid cases. Perhaps more accurately, due to the lack of strengthening of frontline services over the last two years and next to no mitigations.
I am struggling to find signs of reassurance. Yes, individual Covid risk for many is much lower now than last year. Risk from non-Covid conditions…I’m not so sure.

Excess death in the UK is shamefully high! (1/3 non-covid)

And pls do not think this is normal!
But as many of my colleagues have said here, our duty is not to Government. We work for you. We will provide the best care we can, and still this will be better than in many parts of the world.
I suggest though, you take up the issue of Accepting healthcare rationing as a major part of This Government’s pandemic strategy with the man in charge. And perhaps suggest OUR tax money go to the frontline not “commercial partners”.

We can do so much better!!!

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More from @danielgoyal

6 Jan
"Living with Covid" means different things in different countries.

Lets look at Singapore...

@chrischirp @ChrisCEOHopson @Kit_Yates_Maths @jburnmurdoch @DrGregorSmith @devisridhar @theAliceRoberts @doctor_oxford @DrEricDing @Dr2NisreenAlwan
Singapore has performed well.
About the size of Scotland (pop 5m.), they have suffered 800 deaths.
They began with a 3 month Lockdown, which they used to significantly increase care capacity.
They have 5000 additional Covid Care Beds and opened 900 Public Health Clinics (GP-led). Image
Apart from brief periods, routine care has continued relatively unaffected by Covid. GP's and private hospitals have been financially supported to provide routine care, while GP's and government hospitals tackled Covid.
This is reflected in their low excess mortality rate: Image
Read 12 tweets
6 Jan
NHS Confederation steps up!

Some good news this morning. NHS chiefs have called for more resources to the frontline and called out Johnson’s rhetoric of “riding it out”.

Concerns grow that millions of patients will suffer unless action is taken…

[Reported in the Guardian]
While still not publicly requesting proper PPE for front-facing staff nor directly asking for an immediate pay rise, @NHSConfed have openly challenged the PM’s reassurance that the NHS is not overwhelmed.
States:

“The government now needs to do all it can to mobilise more staff and other resources for the NHS to get through this extremely challenging period.”

Calling for reducing staff isolation to 5 days is IMO desperate and possibly counterproductive measure to staff frontline
Read 6 tweets
1 Jan
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
Read 9 tweets
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

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