Thread by @SalWitcher

Dear @HumzaYousaf @DrGregorSmith @JasonLeitch @JohnHardenED Yesterday you published evidence you claim ‘clearly’ shows vaccines/new medicines mean there’s no need to retain the Highest Clinical Risk list, It’s far from clear to me. Please confirm my understanding 🧵

Evidence on vaccine efficacy consists of incomplete summaries of studies measuring different things using different methods, & includes studies that haven’t been peer reviewed. As you say “Many studies in this annotated bibliography will have several limitations”. Yes they do.

As for people added to the List by GPs – the 2nd biggest group, nearly 1/3 of people on the Highest Risk List, 50,778 people, it says: “Due to the range of conditions within this group, little research has been carried out on this specific group”. What there is looks dire.

In Jan 2022 this group had the highest Covid-related morality rates, along with people with cancers or rare diseases, x12 the non-risk population. They had the highest number of deaths, along with people with respiratory diseases.

But members of this this group are ineligible for antiviral treatment. Not that we’ve ever been told. A CMO letter to healthcare professionals on16/2 (I’ve seen), gave details of antiviral in/eligibility. No mention of this key info in his letter to Highest Risk List on 4/3. Why?

Members of this group are also not eligible for additional boosters or free Lateral Flow Tests. There is no way for GPs to add people to lists for these, even if, in their judgement, they remain at exceptionally high risk.

“Highest risk individuals have been advised to follow the same advice as the general population since August 2021.” True. For that long we’ve been told to do the same as everyone else without being given any evidence as to why our risk is now the same.

You state this is appropriate “unless otherwise stated by their GP and clinician”. So what are those people told by their GP they're still at very high risk supposed to do now? Why have you disempowered GPs from exercising their clinical judgement an access to treatments?

It’s back to “the pre-pandemic approach of individual clinical advice for those who may need to take extra precautions…just as they would have done before the pandemic to keep…safe from other viruses & disease”. But Covid isn’t any other virus & disease.

Covid can cause long-term - maybe permanent - damage to the brain, heart and just about any part of the body. People get repeatedly re-infected & damaged. Long Covid can strike down anyone, of any age. Not that you've provided any evidence of this

Even just on vaccine efficacy, next to no evidence is presented on how long protection lasts yet multiple studies show this wanes within a few months eg ukhsa.blog.gov.uk/2022/02/10/how… Are we to be canaries in the mine? No thanks.

Yes, it’s great that death rates are coming down. Maybe because those of us still at very high risk have remained stuck in our homes for 2+ years. But why have you stopped protecting the NHS? Hospitalisations still high as is staff absence due to infection.

Also true that “The availability and effectiveness of new treatments such as antivirals and monoclonal antibodies mean we are now able to take a different approach to supporting those at highest risk”. But only a limited few have access. Why?

A text yesterday says you’ll delete all personal data on people on the Highest Clinical Risk List. Does that mean you’ll stop monitoring the impact on us? Is this part of a strategy to make the ongoing impact of the pandemic invisible/ magic it into a giant elephant in the room?

Meanwhile legal requirements to protection were removed last week & our rights & freedoms replaced by reliance on other’s willingness to ‘protect the vulnerable’. It only takes one we meet who isn’t and we are totally screwed. That’s what makes us vulnerable not our clinical risk

Despite only focusing on vaccine efficacy (not even duration), safety also depends on #CleanAir – use of HEPA air filters, etc, data on efficacy of different types of mask, access to FFP2/3 masks & guidance on how to fit them properly.

It’s also about access to justice, to exercising rights we still ought to have under the Equality Act, health & safety, environmental standards and criminal law e.g. on reckless endangerment. See strategy for #InclusiveNewNormal

https://twitter.com/SalWitcher/status/1496035148965552130

@HumzaYousaf says “Our hope is that this will enable them [people on the Highest Risk List] to adapt to living with COVID and enjoy a better quality of life.” We don't need help to ‘adapt’. We need robust evidence & clearly joined-up policy. We have neither,

Until we do our quality of life will be severely impaired due to effective imprisonment in our homes & legitimate grounds for anxiety about safety. & if your concern is quality of life why are risks of imminent hospitalisation/death the only criteria for accessing antivirals etc?

“Clear communication on the change is needed to ensure individuals have a clear understanding of the reasons for retiring the Highest Risk List”. Indeed it is. I look forward to receiving it as we’ve not it this before & there’s nothing here to explain it.

Please tell me why I’m wrong. Please tell me you’ve not effectively sentenced us to indefinite imprisonment in our own homes. And if you have, please tell us why this is a ‘positive step forward’. I look forward to hearing from you, happy to discuss, yours sincerely, etc.