1/x 🧵***New data *** A double🧦 Lancet headline paper @TheCrick in London from @stcshepherd @TurajlicLab @DavidLVBauer. Results are ASTONISHING about whether we need to protect the #immunocompromised #forgotten500k. thelancet.com/journals/lance… & thelancet.com/journals/lance…. Pls RT.
2/x For those who you don't know. @TheCrick is one of our UK's leading research 👩‍🔬💪heavy weights with some of the best scientists in the country like @stcshepherd @TurajlicLab @DavidLVBauer. For them to be weighing into the national pandemic landscape is timely & important
3/x. Paper 1⃣ asked the question about cancer patients. They are very #immunocompromised, especially @bloodcancer_uk patients. @stcshepherd @TurajlicLab assessed ~200 cancer patients from their study and looked at immune response to omicron. A study and measure of "protection".
4/x Complex figure now. This is a violin plot as scientist say blue shapes look like violin. If violins are lifted up it's good. If they're low it is bad. It says post vaccines, 56% of @bloodcancer_uk have some neutralisation (protection against omicron), 44% do not. Not great.
5/x. What have @thecrick & @stcshepherd said about @bloodcancer_uk & coronavirus? 👇. i.e. further evidence that in patients who are immunocompromised, and more protection is required beyond vaccination. 🫢. Next paper answers "what might this be?" (no surprises). Paper 2 is good
6/x. Paper 2⃣ thread here . It asks does antibody therapy work? specifically #Sotrovimab and #evusheld. Important as it is another petri dish assay, but this time showing exciting findings. 🐛🪲🐞 They call their work ***URGENT***🧐. It 💯% is.
7/x. It was a lab petri-dish test- neutralising assays. How likely was antibody therapy to work. He's a very candid and honest scientist 👇. To date drugs like #evusheld and #sotrovimab work well in humans, but don't seem to work in a petri dish.
8/x. Why does he call his work ***URGENT***🧐? Because many countries are making irregular decisions based on neutralising petri-dish assays, like stopping patients get good treatment like #sotrovimab, or in the case of #evusheld not buying it at all (UK solely).
9/x. Results now and they are very colourful (though still easy to interpret). Flat lines= don't work, Downward waves=neutralises + works. Each result repeated 3 times, 12 times for certainty. The lines for Sotrovimab and Evusheld have shifted. They STILL WORK with higher dose👇
10/x. Intriguingly, the authors hold no punches here. There is one argument "that the only way to show treatment works when a new variant comes is for 50% of patients get a sugar injection- a trial". The BLIND RANDOMISERS argument. Here's what he says-👇
11/x. What's my take? COVID cases are surging, up by 50% in the last month and continuing to rise. For most it will be a mild disease, but if you don't have an immune response or are #immunocompromised, this can't be guaranteed. The crisis of #forgotten500k is now widely known
12/x. 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 & calling on us to notice. They are at higher risk of being hospitalised & more.
13/x. 32 countries are delivering additional levels of protection this winter to protect immunocompromised patients who have not responded to the coronavirus vaccine, using new therapies, not available in the UK- prophylactic antibody therapies with #evusheld
14/x. Their only protection if infected, #sotrovimab might be removed too. There is no urgency regarding the absence of #evusheld access this Winter. To give an “immune” system and "level up" protection compared to the population. UK patients have to wait till next summer.
15/x. @TheCrick has weighed into the debate providing timely science confirming what the world knows globally. We should be protecting the immunocompromised in the UK with the best antibody therapies and everyone is now asking for it to happen before soon- before Christmas.
16/x The UK clinical community has also sprung into action. Patients, 125 clinicians from 17 medical specialities & 4 nations are now online with 19 charities and patient groups. And so many MPs like @libdemdaisy who rallied so many MPs who are hearing first hand the mental and
17/x. physical health impact of delayed decision making that is not yet "up to date" with science. I expect that's natural, when science moves fast 🏎️. However, with all the evidence presented, all showing the same thing, will the UK move fast once again or remain indifferent? 🤷
18/x. Thanks must go to both groups for "TOUR DE FORCE" papers. From one of the leading UK research institutions. Thoroughly brilliant research demonstrating 1⃣ the issue & 2⃣ solutions served on a plate🍽️. Let's hope there is action + compromise in the run up to Xmas 🎄🤶.
19/x. My thoughts are with our #immunocompromised patients. Thank you to supporters. Tens of thousands of people are backing #forgotten500k campaign for their Winter plan and call for more protection for the #immunocompromised. Hopefully authors might answer Qs 🤞.

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More from @drlennardlee

Oct 11
1/x 🧵 This is a great read for those interested in the pandemic response for #immunocompromised who don't respond as well to COVID-19 vaccines- telegraph.co.uk/global-health/… from @Telegraph @katebingham2. Relevant to #immunocompromised
2/x #forgotten500k 👇 **Relevant paragraph** Image
3/x What's my take on the points? 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.
Read 9 tweets
Oct 10
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 Image
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" 💉 Image
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."😢 Image
Read 12 tweets
Sep 29
1/x ***New Research***. 🧵Relevant to the #immunocompromised with @bloodcancer_uk + #forgotten500k campaign. By a trusted lab in New York- Greenberger lab. Looking at immune responses to COVID vaccination. It is my new fav journal due to their colours! aacrjournals.org/bloodcancerdis…
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.
Read 17 tweets
Sep 27
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!😀
Read 4 tweets
Sep 23
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…
Read 25 tweets
Sep 21
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.
Read 18 tweets

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