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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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
Hancock: "there was no way we could allow the NHS to become overwhelmed"
Except, the NHS WAS overwhelmed
Here is what NHS staff said about that time - Pls read whole 🧵
"Heartbreaking"
"Horrific"
"It broke my soul"
"We cried, we came home exhausted. We were overwhelmed"
1/16
"Overnight we were told that all “safe working rules” were gone. There was no choice, we were forced to do it"
"It felt like a death sentence. It felt out of control"
"We were put on wards with no senior support, sometimes makeshift ... with little of the right equipment"
2/16
"Terrifying. A huge sense of duty ... but also terror. We were unprepared & ovt clearly had no plan"
"We had patients on wards on 19 litres of oxygen - this would never happen under normal circumstances - they’d have come to Intensive Care but we didn’t have the space"
TLDR: modest August wave with flatlining hospital admissions, but expect a bigger wave later this autumn 1/12
Hospital admissions with Covid in England are still quite flat for 3rd week in a row and at a level below previous troughs.
Number of people with covid in critical care & primaril yin hospital because of Covid also flat & low.
Deaths ⬆️, from case rises few weeks ago 2/12
However, Zoe symptom tracker app estimating significant increases recently. Very hard to know how reliable Zoe trends are, given far fewer people reporting, but it's worth bearing in mind.
THREAD: Various new or expanded cancer screening programmes have been announced recently and coverage has been overwhelmingly on the pros. But there are cons too.
First a screening recap : a relatively simple test that flags potential cause for concern. If flagged, you are offered more, gold standard, testing, often in a hospital (e.g. MRI scans, blood tests, other diagnostic procs). If those +Ve too, you are offered cancer treatment. 2/24
The benefits are clear: If you have undiagnosed serious cancer, screening can save your life if it leads to earlier treatment.
In this case massively beneficial to you *and* to NHS which can save on longer, more expensive treatment from later diagnosis 3/24