THREAD: I keep being asked when we can go "back to normal" or "like it was before". My personal thoughts:
We've added a new disease to our population, more infectious and more severe than flu.
The world pre 2020 no longer exists - we may want it to, but it just doesn't. 1/13
Vaccines are amazing but do wane - esp vs sympomatic infection. Immunity from infection wanes too.
Surely Omicron has proven that high levels of antibodies in your population are no guarantee against v high levels of illness & disruption. 2/13
We *could* act as we used to & accept millions of people getting sick once or twice a year. Yearly education, business disruption. And gradually, a slightly sicker pop'n. That seems to be the current plan in UK and e.g. US.
But that's NOT the *old normal* - it's worse 3/13
We *can't* go back - but we *can* go forward *if* we accept we need some adaptations - driven by what we have *learned*.
Learning:
1. Outdoors is pretty safe - so let's invest research and funding into making indoor air as much like the outdoors as possible 4/13
It's *not* easy, but it *is* possible - we did it with clean water, electricity infrastructure, CFCs, telephone and broadband...
The best thing about cleaner indoor air is it works against *any* airborne disease and also reduces e.g. allergies. 5/13
2. Vaccinate the world as soon as possible - and keep working towards vaccines that are longer lasting and more variant proof.
3. Invest in global infrastructure to support surveillance of new variants of Covid *and* other new infectious diseases. There will be more. 6/13
4. Add permanent surveillance of Covid infection rates in UK to existing programmes for flu, measles etc in public health
5. Invest in understanding & treating longer term clinical impacts of Covid, inc organ damage & Long Covid + treatments (eg antivirals) for acute phase. 7/13
6. We need to urgently increase funding and staffing for NHS if it is expected to cope with regular Covid surges *and* existing backlogs *and* years of understaffing and not enough money.
This includes *supporting* existing staff to stay..! 8/13
7. There *will* still be future surges. We need to have a plan to deal with these surges - as we do for other diseases.
A plan which is supported by the rapid outbreak identification & rapid understanding of virulence & transmission we've learned to do so well in the UK! 9/13
The plan might include (temp) reintroduction of large scale testing (inc better tests?), high quality masks in indoor spaces and - *if & only if* there is a serious threat from e.g. a new variant (or disease!) - further measures, such as targeted test, trace & isolate.
10/13
A plan should *not* mean long national lockdowns, which represent a failure of public health systems.
In fact, refusing to do the *learning* in "learning to live with Covid" is the biggest risk for such future lockdowns. 11/13
8. We also need to invest massively in reducing inequalities: in health, in housing, in workplaces, in sick pay, in education - this will make us more resilient to future outbreaks and reduce ill health and death - from Covid & everything else!
Both nationally & globally 12/13
Fundamentally, world is different now. Acting as if it isn't, which UK seems determined to do, may feel good in short term but will result in a new normal worse than the old one.
I prefer for us to build a new normal that's *better* than frequent sickness & disruption. 13/13
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THREAD: Given tomorrow's election, I've been thinking about our nation's (poor) health, the wider determinants of health and how these have worsened and what it means for policy....
TLDR: worrying only about NHS & social care is missing the point
let's dive in... 1/25
The UK has a health problem. After steady gains in life expectancy for decades, it flatlined during the austerity years and fell for the first time this century with the Covid pandemic.
The number of people out of work for long term sickness is near record levels. 2/25
There are huge inequalities between rich & poor. Boys born in the most deprived areas can expect to die almost 10 years earlier than their peers in the least deprived areas.
Even worse, they can expect to spend 18 fewer years of their life in good health (52 vs 70 years) 3/25
As ever, I am getting lots of pushback.
Here is a compilation of the European countries I've found with recent wastewater data. Some are going up a bit, some down a bit, some are flat, none are anywhere near previous peaks.
I can't see anything here to be panic anyone. 1/3
I can't find the dashboard for Spain, but others saying it is in a wave. Perhaps it is. England has just had one - the last data we had (a couple of weeks ago from Bob Hawkins) looked as if our wave had peaked.
So, I'm not seeing reason to think things are terrible here! 2/3
Yes there are new variants growing right now. They are not growing faster than JN.1 grew in December and that wave did not end up as bad as feared.
Clearly it remains true that Covid is NOT a seasonal disease (unlike Flu and RSV)
3/3
Quick thread on the Astra Zeneca (AZ) covid vaccine since it's been in the news today.
TLDR there isn't a new "smoking gun", the AZ vax was one of first and cheapest, it saved millions of lives globally, there are better vax out there now, adapted to new variants 1/9
the AZ vaccine was one of the first approved at the end of 2020, cheaper than Pfizer, and - importantly - easier to administer in lower resource settings as it didn't require super low temperatures for storage 2/9
In most countries it was first rolled out in older adults. As it was rolled out in younger adults, a *very rare*, serious, side effect was noticed - it could cause deadly blood clots
This was spotted quickly and studied. Vax monitoring did its job. 3/9
A short thread on why this is not a scary chart and why all the evidence suggests that there is not much Covid around right now. 1/6
the above chart is recorded covid hospital admissions / reported covid cases. It is close to 100% now *because basically only hospitals can report cases since Feb 2024*
It is to do with changes in case reporting and NOT hospital testing
2/6
The UKHSA have now published their modelled estimates of what percentage of English population has Covid. And as of a week ago it's high (4.3%) and rising.
It's highest in London, South East and East & in young and middle aged adults.
The main thing is it's going up and fast, so prevalence will already by significantly higher now than it was last week. 3/7
Short thread on what I said on Channel 4 news tonight.
1. Did I find Hancock a sympathetic witness?
A: I find it hard to have sympathy for someone who repeatedly claimed to have thrown protective ring around care homes, while discharging covid+ patients into them.
1/5
There were *28,000* excess deaths in care homes Apr-May 2020.
Harries thought it was "clinically reasonable" not to treat covid +ve residents in hospital. Even it was, it was NOT reasonable to return them somewhere they could infect so many other very vulnerable people. 2/5
2. Did I think scientists bear blame for not emphasising asymptomatic transmission?
A: No, because they very clearly did advise there could be asymptomic transmission before March 2020 - sources in next tweet. 3/5