Dr Dan Goyal Profile picture
Jan 25 9 tweets 3 min read
Some policy makers are using the “Flu” comparison to argue for doing less/nothing to control Covid.

Here I present an argument against such policies.

Understanding the risk of Covid is useful when deciding your own opinion about gov policy.

🧵

[FYI ⬇️ - Flu vs Covid]
Disclaimer: not a statistician. Clinical academic. This is my understanding of the current risks told plainly. Others better placed to comment further: @Kit_Yates_Maths @chrischirp @dgurdasani1 @JamesWard73 @jburnmurdoch @EricTopol @DrEricDing and others…
Risk to self: the actual risk of death from Omicron is less (vs Delta).

In crude terms, the risk of death from Flu is 0.05% (prob much less).

The current risk from Covid seems to be ~0.2% (vaccinated, confirm, ave)

This is a direct comparison. Real risk is very different.
In making your decision about what is acceptable, it is useful to think about your “walking about risk” is. That is, the real world risk.

Now, everyone will have different individual risk, but we know that high circulating virus means you have a higher chance of catching it…
Therefore your “walking about risk” is probably significantly higher than baseline Delta (Autumn) and much higher than the summer (suppression of Delta), just due to the higher risk of catching it.
But that is far from the whole story. An added risk (higher for some than Omicron) is the reduced access to healthcare.
By allowing Omicron to spread unmitigated the 15% additional inpatient burden, 1500-2000 daily admissions + all the primary care, ambulance and A&E time taken up by this NEW group of patients has led to a significantly more rationed healthcare service.
This is of course The Government’s choice. They have decided there is greater harm (albeit unquantified currently) in suppressing the virus than from the virus itself or the impact on healthcare provision.
Be clear, healthcare is always rationed, to some degree. But what we can see from the additional 15% inpatients and all the rest of the Covid pressures is that the restricted access to healthcare is really profound…

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More from @danielgoyal

Jan 25
How similar is Covid to Flu in the UK?

On an individual level, the risk of severe Covid-19 in a fully boosted adult is significantly lower with Omicron than Delta.

How close is that individual risk to the risk with Flu?

Short 🧵
I will provide some data and sources at the end, but the main points are:
1. Rate of death from Covid has dropped significantly over the last year. By about ten-fold.
Read 21 tweets
Jan 22
Despite the dramatic title, Mr Snowdon raises an important point: what happens when number-crunchers neglect human factors.

I fear though, Mr Snowdon has succumbed to the very criticism he levy’s against those arguing for stronger mitigations

Thread
This is not a criticism of the many astute and invaluable statisticians. More a challenge to basic assumptions.

Indeed, often the distance and objectivity is appreciated.
But It is a pattern that seems to be emerging from economists and statisticians, that somehow the resistance of the PM to further mitigations was in some way a success.

While the economic argument seems absent, focus on healthcare numbers seems popular and problematic.
Read 19 tweets
Jan 16
Oh my, Johnson must be getting desperate. His tactic for holding onto power now seems to be “talking up” his success in managing the pandemic.

Some things to bear in mind as the battle for the narrative continues…
While we can get distracted by the ‘with’ or ‘from’ Covid argument, here is the excess death data…one of the good overall measures for how a nation responded to the pandemic.

Ireland, Germany and France had about half as many excess deaths as the UK.
We averaged between 500 to 1000 extra deaths at home per week, throughout the pandemic.

Note, only a fraction were Covid.
Read 11 tweets
Jan 14
Covid update from the UK frontline.

Things are looking different at the “front door”

Here’s how…
Context:
▪️Scotland
▪️Non-city
▪️High vax rate + high booster rate
▪️Respectful people: masks, distancing, isolating when needed.
▪️Care homes still protected
I compare this wave with the last delta wave July ‘21 to Nov ‘21 - so called, Delta baseline.

Just my experience of the patients I see.

Our rates have been about 3 X higher than our delta baseline.
Read 11 tweets
Jan 10
Back on the frontline the damage caused by 'letting it rip' is all too apparent. "Broken" seems to be the word of the day - both for staff and NHS.
As the battle for the Omicron narrative begins, hearing the word 'coping' now stings a bit too much...'success' a swell of anger...
Lots of Covid today. New outpatient treatments (someone has to administer them); loads of patients not well, but with some effort can be managed at home; the inpatients, and the odd escalation to Level 2 care..
It's a lot of work in the middle of our usual brutal winter caseloads
Being on the senior medical team is tough. Lots of compromising, and spreading too little way too thinly. Sleepless nights and little left to give for the family. I feel for the patients more...although many don't realise. I feel also for the juniors and med students...
Read 8 tweets
Jan 9
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

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