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Dr Dan Goyal

@danielgoyal

9 Jan

How will the pandemic end?

To appreciate the magnitude of lunacy behind the UK, US, and some other nations pandemic strategy, it is helpful to try and “game out” how the pandemic will “end”.

Here are some scenarios…

1. Waves of new variants with increasing immune tolerance to SARS-CoV-2.

Only someone very brave or very foolish would bet against more variants. As the population develops immunity to one variant the conditions become favourable for another to take hold.

We don’t know what such variants may look like. They may be more severe or less severe, they may cause more illness in the young or less, they may be more responsive to vaccines or less. No doubt, on this path uncertainty remains high.

Read 18 tweets

Dr Dan Goyal

@danielgoyal

6 Jan

@chrischirp

"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).

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:

Read 12 tweets

Dr Dan Goyal

@danielgoyal

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]

@NHSConfed

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

Dr Dan Goyal

@danielgoyal

5 Jan

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…

Read 11 tweets

Dr Dan Goyal

@danielgoyal

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:

@chrischirp

And here is London:

@chrischirp

Denmark, France and the wider US…

Read 9 tweets

Dr Dan Goyal

@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

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