1/x 🧵Thank you to @bmj_latest for an excellent article doi.org/10.1136/bmj.o2… by @Garethiacobucci "Evusheld: Government is urged to expedite covid antibody treatment for vulnerable patients". It highlights ongoing clinical pressure to protect the #immunocompromised. Pls RT
2/x What's the issue......"With covid-19 cases rising 📈 and winter approaching, immunocompromised patients are frustrated at the government’s 🏦 inaction on rolling out the preventive drug" 💉
3/x "The UK government has been urged to re-examine its decision not to purchase a new covid-19 antibody drug for clinically extremely vulnerable people, amid warnings that these patients face renewed risk from the disease this winter."😢
4/x "Evusheld was approved for use in the UK in March 2022 by the Medicines and Regularly Healthcare Products Agency after trial results showed that it reduced the risk of developing symptomatic covid-19 by 77%, with protection lasting at least six months after a single dose."
5/x "Evusheld is submitted for approval by the National Institute of Health and Care Excellence. But, because this process is not due to conclude until well into 2023, clinicians & patients have warned that people who could potentially benefit will miss out this winter."
6/x What's my take? Well, there are inconsistency between the government’s policy on covid vaccines and its approach to antibody treatments. The window 🪟 for protecting very vulnerable patents this winter was rapidly closing...
7/x Why does this matter? There are half a million immunocompromised people in the UK. Many are still shielding, still in isolation, still unable to work, see friends or hug loved ones. They are #forgotten500k, unheard and calling on us to notice.
8/x Thanks to patients, clinicians @AlexRichter3@ProfBMT, the clinical community has also sprung into action. Patients, 125 clinicians from 17 medical specialities & 4 nations are united in asking for action and potentially the missing decision maker.
9/x Thanks to @libdemdaisy, there is now a parliamentary debate on 12th of October at 11am. whatson.parliament.uk/event/cal39847. We hear MPs are being swamped by emails from patients and their doctors asking for action on to protect the immunocompromised
10/x And in a unusual twist, patient groups and their 19 charities are now asking relatives, grandchildren and grandparents to sit in parliament square on their behalf. The aim is to get DHSC civil servants to notice them and give them protection. I've not seen patient power like
11/x this before. UK patients wish to have the same protection as available in France, US and 32 other countries. There are half a million immunocompromised people in the UK. Many are still shielding, still in isolation, still unable to work, see friends or hug loved ones 😢
12/x They #forgotten500k unheard & calling on us to notice. So many people left behind. From the comments 👇- patients/clinicians are grateful for people like @Garethiacobucci for going the extra mile to share the story & plight for protection +🤞 for a good outcome before xmas.
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2/x. It was done as many blood cancer🩸patients have no detectable immune response following coronavirus vaccination 💉. It is accepted that if you don’t respond to a vaccination, you aren’t as well protected from COVID-19. This answers the counter-argument- is this okay?
3/x. In 505 patients with B-cell malignancies, in a real world setting. This is a new form of study scientists use nowadays (vs a randomised study-RCT, where 50% of people get a sugar injection). RCT are generally not thought to be acceptable. They looked at patient's blood.
1/x 🧵I was humbled by #immunocompromised patients for a surprise gift as we try to "surface" the #forgotten500k issue. Nice surprise before my busy NHS clinic. Our clinical leads didn't plan to be here and are glad to support the coronavirus Winter plan/pilot call #evusheld.
2/x I believe that calls for action/help from patient groups + charities are important + need acknowledgement. If people are in difficult positions, still shielding after 2.5 years 😢🏠, the best we can do is try & carefully evaluate. I am glad they trust us/me to speak for them.
3/x. Thanks as ever to the @APPG_VGP for starting this patient action campaign. I don't know if we will get their pilot by Winter, for some patients to benefit, but if they do, I know they can count on our doctors and the 125 across 17 specialities to support!😀
1/x 🧵What happens when a diverse group of patients at risk from COVID-19 try to ask what they need? In this case, #immunocompromised & their small ask for protection from COVID-19 with #evusheld. This is my honest assessment as a UK NHS doctor. 👨⚕️🏥. Pls RT.
2/x What's the background? In this case the group affected from COVID-19 are both young + old. They are #immunocompromised. They may have cancer, blood cancer, transplant, autoimmune disease or immunosuppressants. A patient group hasn't linked them before. 🧑💻👩⚖️👨🍳👨🌾
3/x. The pandemic brought them together, because many of them were checking if they had an immune response to coronavirus vaccine, the best form of protection from COVID-19 and they found they had low/absent immune responses. 🙄. itv.com/news/2022-08-1…
1/x 🧵This is an important issue that many clinicians are worried about & I am glad to have been put forwards to talk on behalf of the @APPG_VGP, its 19 patient charities and the National Clinical Expert group which pulls representation from 17 medical specialities & 4 nations...
2/x What's the background? We are living with coronavirus and most of us have high levels of protection from our vaccination 👍😃. However, not everyone gets high levels of protection. If you have a weakened immune response, your protection may not be as quite as high....
3/x. People with a weakened immune response are #immunocompromised & it can affect the young and old. It can happen because you have a cancer or blood cancer, a transplant, an autoimmune condition or because of drugs you receive from your doctor. 🧑⚕️💊😷. There are 500,000 people.
1/x. 🧵With HEALTH policy, there should be transparency + solid evidence that standard process was followed. RACI- RESPONSIBILITY 📝 1️⃣who made decisions, 2️⃣who was the clinical teams advising 3️⃣who was providing scientific input. ACCOUNTABILITY 🎖. With a decision of this
2/x magnitude affecting so many #immunocompromised people, normally very eminent & respected medical physicians would have been involved 👨🏼⚕️👩🏽⚕️🧑🏻⚕️. CONSULTATION🎪- stakeholder dialogue across 4 nations, across the specialities 🏥treating these groups
3/x. Finally INFORMED GROUPS🧑🏻. They are normally key 🔑 and informed as part of the process. For participation and to minimise potential distress. 🙁. They need to understand the nuances why and why not and that decisions were not “predecided”. It had to be “fair” at the time.
2/x What's the background? With winter coming and the high transmissibility of omicron, across the Northern hemisphere, countries are moving to protect their immunocompromised. These are people who may have lower levels of protection from vaccination.
3/x This paper looked at 6 antibodies against variants -Delta, BA2, BA.4 and BA.5 isolates. This was important as vaccines provide lower levels of protection against these variants, & it was unclear if antibodies maintain or lose protection too. ❓❓❓