Thread by @karamballes

🧵Latest SAGE advice to UK government

➡️SAGE minutes
➡️SPI
➡️Future evolution of SARS-COV-2

In summary, this doesn't support details coming out about the Government's "living with covid" plans

2/ To start with, future evolution of the virus document and the discussion of this in the SAGE meeting

Possible scenarios

3/ All scenarios assume we reach stable reoccurring patterns over a 2-10 year period

Immune escape of future variants and waning immunity will be important factors

Possible to end up with more than one variant co-circulating

4/ Viral variant characteristics are not necessarily predictive of each other, eg higher transmissibility doesn't mean its going to be less severe

Unlike what others claim this isn't a given!

5/ Surveillance, vaccines, therapeutics and testing will have a large impact on outcomes

This does not support scrapping ONS surveillance and cutting back massively on testing

"Waves will be worse if detected late"

How quickly can gov ramp back up testing once dismantled?

6/ Warns against extensive use of antivirals, these need to mainly be held back in case of lower vaccine effectiveness

We don't have the supplies yet for mass use but when we do, gov saying antivirals means high transmission can be sustained is either disingenuous or that...

7/ they plan on risking our fall back plan in the case of a dangerous variant

If a dangerous variant does arrive then it looks like UK gov is going to be leaving us very vulnerable and underprepared

8/ SAGE discussing the Virus Evolution paper

High confidence variants less susceptible to current vaccines will emerge

"No reason future dominant variants should be similarly or less severe than Omicron"

SAGE don't think it's just going to turn into the flu or a cold

9/ Another note that antivirals need to be used in a way to reduce the risk of resistance emergence

"We now have antivirals, dont worry about masks, ventilation, filtration etc"= bollocks excuse for letting it rip

10/ SAGE minutes: Current situation

As @chrischirp has pointed out tracking of cases vs ONS infection survey aren't tracking as they have in the past

Cases in over 60s increasing in some regions

BA2 growing, highest in NI, could explain their higher and increasing positivity

11/ Suggests behavioural changes have had a big impact on current case rate, lots of ppl still being cautious

This wouldn't have happened without SAGE's warnings in Dec, bet @spectator won't point this out in their next "SAGE was wrong article"

12/ Continued high rates of hospitalisations in under fives, action point is to further assess the data for small children

Future waves could have sharper peaks due to reduced testing, importance of testing is said repeatedly

13/ SAGE minutes: Social and Behavioural changes impacts of lifting restrictions

Removing access to free testing and isolation will cause CEV increased anxiety, and will disproportionately impact the more vulnerable ppl in society

14/ Government must tackle presenteeism, providing support for workers to stay off when I'll is recommended.

Messaging must be clear and consistent to encourage encourage ppl

Vulnerable ppl should continue with protective measures

15/ SPI paper

Removing restrictions requires mitigations against harms to disadvantaged and vulnerable, these groups are likely to be disproportionately impacted by removal of testing

Good evidence for improving sick pay and access to it

16/ NHS advicr for years has been to stay at home if you have flu like symptoms, this advice has been ignored and there are concerns the same will happen with Covid, not staying at home likely to cause more outbreaks, deaths and increased morbidity

16/ As in the SAGE meeting SPI-B say Gov messaging should stress importance of general public understanding how their behaviour can impact the vulnerable

Concerns of attacks on those seeking to protect themselves
Concerns for marginalised communities

17/ Also slide in tweet 15 does say that this is likely to lead to increased outbreaks in schools, so more disruption and sickness for us, so choosing more disruption to education to keep the CRG happy

Main priority?

18/ messed up the thread, one slide here⬇️

https://twitter.com/karamballes/status/1492672076779560962?t=GrasW3ajg4-GvPjQLndUWg&s=19

19/ Basically saying that if gov scraps requirements it should continue to recommend voluntary adherence to continue reducing risk

Provide a toolkit for reducing risk, cut out central control and trust local decision making, so NO to DfE emailing heads to micromanage

20/ More advice on the need for clearer messaging

21/ Long term communication considerations

More needs to be done about informing the public of long term health consequences

Support for all the wider harms of the pandemic including grief needs to be considered by health professionals

22/ Slightly different to other SAGE papers, reads as though its retrospective, rather than looking through policy choices the only scenarios are virus evolution, the rest feels like trying to mitigate against policy decisions already made

23/ One thing is clear, it's not SAGEs advice the UK government is listening to.

Attendees

One final addition, it looks like the UK government is embracing the Great Barrington Declaration, this author Sunetra Gupta's current view on the Pandemic

Herd immunity apparently now means constant reinfection

https://twitter.com/karamballes/status/1484262007591378949?t=mHB1pVtqBAzTYrQCsrt2eg&s=19