Dr Dan Goyal Profile picture
Feb 8 11 tweets 3 min read
Government and NHS Bosses waiting list plan has been released…

It is a sad read. Full of flowery language and an absence of substance.

You don’t even have to read between the lines to see what’s happening…

england.nhs.uk/coronavirus/wp…
To me it looks like: segregate elective care from urgent care and send the “easier” more profitable patients to the private sector and let NHS urgent care spiral.

The “hubs” are simply easier chunks for private take over. And effectively using public funds as start up capital.
The critical public need is in primary care and urgent care. This is where the majority of all disease is detected and managed.

But as we witness the biggest exodus of staff since records began, there is nothing for staff retention and no commitment to improve working conditions
The cursory sentence…

“We will make a more permanent contribution to the workforce if we can retain nurses by providing a positive experience and appropriate professional and pastoral support”

Is about as useless as a chocolate teapot and just offensive.
They talk of making innovations and current systems to work more efficiently, but they have no idea how to do this.

They talk about prioritising urgent cases. Not really sure what they think we do everyday under a severely rationed health system.
The tech solutions may well be profitable for the industry but without the staff to deliver the actual care, it’s just another system to log into that costs billions.

We need staff for wound care, rehab, and clinical care NOT not more tech to tell us how far behind we are!
As much as I know it will hurt Johnson/Sajid/Sunak, if they are serious about keeping society open during Covid and reducing the death and disability of extreme healthcare rationing, they have to treat the NHS and staff with respect.
Their dual agenda of letting Covid rip and allowing the NHS to fail so private companies can cherry pick the profitable cases, is only possible with lots of public suffering.
I predict a disaster! The targets will not be met, at least not meaningfully. And the tension in the NHS as managers are forced to try and deliver unrealistic goals with no additional meaningful resources will simply drive staff away…but not to the private sector, as hoped!
I for one want to know that:
▪️if I have a stroke, the ambulance gets to me in less than20 mins, not an hour.
▪️if I develop cancer that I don’t have to wait two months to be treated
▪️I want to be able to get emergencies dealt with quickly.

Nothing in this proposal will do this
Clearly the private sector do not have the capacity to take over the NHS workload - even elective care. This Gov Strategy does more to develop that private care capacity than it does to improve NHS capacity.

It’s bad for patients good for business.

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More from @danielgoyal

Feb 4
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
Read 23 tweets
Feb 2
It’s the question!
@Dr_D_Robertson has been asking it of our government for ages:

➡️ How many deaths do they consider “acceptable”?

Answer now seems to be: 250 deaths per day!
This makes Covid’s death toll the highest of any infectious disease:

4 X pneumonia deaths

60 X flu deaths
This means Covid is killing More than colon, breast and prostate cancer COMBINED.
Read 5 tweets
Feb 1
How lethal is Covid now?

A few scientists/statisticians have been comparing the ONS Covid survey with Flu modelling studies to compare infection fatality rates.

It is so important to understand how dangerous Covid is, but IMV, such comparisons are simply too inaccurate.
It is important to understand Covid risk:

1. We, the public, need to understand the risk so we can make a choice regarding masks, socialising and of course vaccination.

2. Policy-makers need to understand what impact Covid is likely to have on society and service provision.
The ONS survey has been an incredible resource. For those who don’t know, the ONS randomly samples thousands of U.K. citizens each week with PCR swabs. From this they can estimate the total number of Covid cases in the U.K.

It is effectively a weekly point prevalence study!
Read 16 tweets
Jan 31
If we are moving to a new phase in the pandemic - vaccines, treatments and an “acceptable” death toll - success will depend on:

1. The state of healthcare services
2. Trust in Leadership

Worrying for some countries…

🧵
Firstly, what is success:

1. Minimise death and disability from the virus
2. Minimise death and disability from other health conditions - maintain other services!
3. Protect livelihoods and mental health of the population.
Vaccines…
…have been hugely successful. we would be in a completely different, dystopian world without them. And even though their effects wane, the protection from severe disease holds on longer. And new vaccines will be even better, IMV.
Read 17 tweets
Jan 29
New Zealand have spent the majority of the last two years under less restrictions than the UK currently has in place (yes including freedom day!).
And here is Japan (for those arguing size, density, travel hub, etc…)
And here is somewhere closer to home….
Read 12 tweets
Jan 28
@profnfenton
I recently watched your explanatory video about Covid and the various problems with the data.
I think I followed your logic, but my concern relates to a few “big leaps” and the attempt to understand an illness I presume you have not seen very much of…
..if I can…
I appreciate the vulnerabilities in the data you have identified are genuine, but

1. Asymptomatic and non-infected are very different. The students were non-infected. Therefore the pick up rate of 36 false positives in the many thousands of samplings were well within <0.1%
2. The more likely reason for the initial spike in the data at the start of the vaccination roll-out is (IMV) more likely related to the genuine increased mortality associated with the overwhelmed hospitals. Excess home deaths have remained high throughout. And we see a…
Read 8 tweets

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