Dr Dan Goyal Profile picture
Feb 4, 2022 23 tweets 5 min read Read on X
1/ The “Omicron is mild narrative” is simply untrue and hugely harmful!

Scientists, doctors, experts and everyone else need to take responsibility for the harm done when minimising Covid - death and disability.

Thread 🧵
2/ There is no doubt that in the absence of boosters Omicron is a brutal infection for a significant number of people.

Still, for the majority it will pass without the need for medical care and recovery will be relatively uneventful. But some will have life-changing illness….
3/ There is no way of predicting who will get severe disease. The myth that Covid only affects older adults has been debunked in 2020.

All adults have the same increase in risk of death from Covid (figure).

But vaccines and access to healthcare change that risk.

[BMJ] Image
4/ Vaccines and access to healthcare make substantial reductions in deaths and disability…
Even with good booster cover Omicron can cause severe disease, death, disability, and can buckle a nation’s health service.

A good example is the U.K. where booster coverage reached 50%, yet a surge of Omicron admissions led to many patients dying due to delays in accessing care Image
6/ But good vaccine cover is a complete game changer. Individual risk with Covid falls dramatically and the impact on other health conditions also falls dramatically.
7/ Without vaccine cover and we are back to March 2020. Fail to boost the population and we are back in high risk territory.

It is on a knifes edge. And will be until we get pan-coronavirus vaccines and widespread availability of effective treatments.
8/ To talk about “Omicron is mild” or we can get “back to normal” fails to appreciate the fragility of the “decoupling” we have achieved between infection, admissions, death, and disability. People start thinking the disease itself is mild. This is wrong and dangerous!
9/ The US is a prime example where Death is being caused by misinformation.

A deeply polarised nation with a number of prominent politicians, scientists, physicians and influencers either denying Covid or trying to minimise it. Yet, the death toll is staggering: Image
10/ And much of this is due to the failure of getting the public to accept boosters.

Other wealthy nations achieved a surge in booster doses, the Uptake in the US has been very poor. Image
11/ And the consequence is a consistently higher death rate. More Americans are dying than in other wealthy nations. Image
12/ The U.K. is also now suffering from the “disease is mild” narrative effect on vaccine uptake.

Despite more than half not having had a booster, numbers of vaccines are falling Image
13/ Not helped by media outlets confidently reporting how mild Omicron was as early as the 1st of Dec, despite having no evidence to support such claims. Image
14/ And even more reliable sources fell into the “milder” narrative

bbc.co.uk/news/health-59…
15/ The truth was of course very different. Omicron is more severe than the original Covid, the one that had a 30% inpatient fatality rate and ground society to a halt. The difference, it is more infectious.
15/ What a responsible and fact-checked media should have reported is “a new variant has emerged but vaccines seem to provide protection”.

Indeed, “a new, more infectious variant has emerged, but vaccines seem to provide protection”.
But in fairness, the narrative from leadership was similar and several eminent scientists failed to put the less deaths into context.

Leaders should have been honest. “We can’t keep shutting down society, but we will do the best we can”. Instead, “milder” “we will cope” freedom
Some scientists have pushed the narrative further, despite knowing it has been vaccines and treatments that have made the difference not a lucky mutation to SARS2 or “natural evolutionary mildness”.

It creates the illusion of scientific discrepancy…a choice of what to believe
19/ In fact the vast vast majority of scientists are in complete agreement…even the “Omicron is milder” crowd.

▪️Omicron is a serious infectious disease!
▪️without vaccines Omicron would be devastating!
20/ There are a handful of scientists who have went down the rabbit hole of confirmation bias and giddy optimism or conspiracy.

Actual scientists fail when we don’t provide a united front over the basics and succinctly refute such unsubstantiated theories.
21/ Omicron is a serious infectious disease. It kills more than any other infection. Any sense it is “milder” is a slight of hand, achieved through years of research and clinical experience. For it’s true severity to show itself it need only complacency.
The issue of restrictions/protections/mitigations is separate to the key scientific facts. Offering our view on them is one thing, allowing our preference for more or less to interfere with the core narrative that Omicron is serious enough to get vaccinated is an entirely other.
22/ The “it’s mild” and “it’s over” argument is irrelevant at best and simply educated speculation at worst. And the harsh truth is that arguing it is mild and it is over actually costs lives.

People are dying because they believe it is mild. They don’t have to!

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More from @danielgoyal

Jun 19
NEW: SNP manifesto

This is the kind of manifesto many wanted Labour to deliver

The pitch is left of centre - socially progressive…

with a persistent argument about the harms of being tied to a broken Westminster

Protecting the NHS from privatisation is a key theme

🧵
Some highlights:

SNP taking a clear position on integrity in politics and the lack thereof in Westminster. Hard to argue against this Image
3. Some hard data comparing Scotland to England.

The SNP argues this is despite a stranglehold Westminster has on Scotland policy areas and the “power grab” of the current U.K. govt. Image
Read 12 tweets
Jun 17
Given some so called patriots want a French healthcare system, let’s take a look at it.

🧵

Summary: social insurance with 95% of people taking private healthcare to cover copays. Costs £40bn per year more. Less equitable than NHS, but can turn a profit
1/10
Akin to some other European countries, France uses a social insurance based model predominantly - where employer and employee pay a means-tested insurance premium

but unlike most EU countries the French people pay a surcharge on pretty much everything they access or use
This has led to 95% of the population taking out private insurance.

This is an insurance premium (on top of the social insurance premium) that is in part based on likelihood of needing health care - older people paying more.

Typical costs: Image
Read 13 tweets
Jun 14
Labour Manifesto - NHS

Some good policies but overall disappointing and a bit concerning.

A summary thread
1/x
1. There is the title: Build an NHS Fit for the Future

In one way, fair enough. Buildings are outdated and crumbling and IT is hopeless

But, Labour seems oblivious to the fact the NHS leads the world in medical and surgical care. The issue is merely access not tech upgrades. Image
2. "publicly owned and funded" is meaningless. Even the deranged health system of the U.S. has a publicly funded component - waiting lists are horrendous and access to treatment is very limited.

We want universal access to all available treatments - quite different! Image
Read 20 tweets
May 21
We are already in a two-tier healthcare system

Nuffield Trust reports this week on a massive increase in private provision

More worrying, a massive surge in people using their savings to access care

From the best health system to one of the worst in 14yrs!

Summary 🧵
The amount the NHS pays (this is our tax money) to the private sector has nearly doubled in five years…

From £1.66b to £3.1b

2/9 Image
This is catastrophic for the future of our health system

It’s based on political targets superseding clinical ones - Managers wanting to please whoever the latest Health Sec is versus prioritising clinical needs

Urgent and primary care should be priorities not GE fodder!
3/9
Read 10 tweets
Apr 29
I have no inherent obligation to work in the NHS

My obligation is to my patients, whoever they are and wherever they live.

But I want to work in the NHS…

Selfishly speaking, I appreciate not having to say no to treatments because a patient can’t afford it..

But…

🧵 1/6
After 14 yrs of Tory rule and a cowed and complicit NHS Leadership, patients are being denied treatment due to lack of resources. It is hard to witness, day in and day out.

The very principal of the NHS - access for all - no longer exists!

2/6
So do I blame any doctor seeking work elsewhere? Absolutely not. Better to survive and help patients than to be broken by a system that makes treating patients harder and harder, in a country increasingly polarised. Staying in the NHS now can be very damaging for staff.

3/6
Read 6 tweets
Apr 21
This is simply unbelievable.

The way the Tories go on about it you’d think we spend all our money on the sick and unemployed

But check out the stats!

We should be paying much more…

Near bottom for incapacity benefit Image
Bottom half for social spending

France spends 50% more

Germany 25% more Image
Spending on unemployment is actually just ridiculously low..

Bottom of the table

About TEN times less than other comparable nations Image
Read 5 tweets

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