Thread by @SGriffin_Lab

OK, joking aside, what does this 💩 mean?
This has vast implications for health, wealth, and wellbeing, IMHO.
Money first, with my vast economic expertise...🤪
So, from a brief web search, there's just shy of 6M people in the UK over 75.
~3.5M CV/CEV, plus others ≈ 10M eligible?

https://twitter.com/SGriffin_Lab/status/1755339391851983063

I'm sure @jneill @chrischirp @Kit_Yates_Maths @Dr_D_Robertson @_CatintheHat etc will correct my numbers!
So, old vax price of ~£10, new price £25 😕...so either £100M or £250M...NOT cheap, plus need to buy/maintain stocks, including mRNA cold chains etc, and task NHS onto it...

So, even this paired down, piecemeal, tokenistic, flu-crowbarring crap, discriminatory strategy costs a fair bit by the sounds of it...
You can imagine the response from the treasury and Chancellor on THAT one...🙄
But, THIS has been approved, sounds generous, doesn't it?!

But, we're talking between 4 and 10 Mone yachts here folks, and who knows how many landfills worth of dodgy "PPE" that's been wasted over the last 4-5 years...and of course, there's this minor issue to consider @carolvorders

https://twitter.com/SallyBourliakas/status/1755951426654654933?t=6Jl8_axR70mGHTLWj4HHdw&s=19

Upshot being of course, JCVI are being given a yearly budget for this that's apparently less than the daily accumulation of national debt...despite austerity, despite cuts, despite apparently being the party to trust with the economy?!
We could do with a red bus or two, eh?!

This is so incredibly shortsighted, it's beyond belief. We've already seen that uptake of the booster programme is diminished cf 2022, so we're actually talking less than the theoretical value above to deploy. Perhaps reinvest the excess in PH coms and silencing Bridgen et al?

Consider what might happen if our vulnerable populations aren't regularly protected vs SARS2 whilst it continues evolving.
This is NOT saying vax isn't brilliant, but we're asking way too much of a single intervention, and then denying access to >90% of the UK population!🤦‍♂️

As omicron/pi next become more and more divergent, even "fit and healthy people with strong immune muscles" (🤦‍♂️🤪) will find their ability to resist/survive infection/LC diminished bc of immune imprinting and poor/inconsistent immune stimulation following infection.

No. of vax per prevented hospitalisation/death IS part of the analysis, but these calculations are likely based upon current levels. if we stop boosting 40-75 y.o.s then I expect we will begin to see increased problems in this group. Also, uptake in offered cohorts is falling...

Whether the bespoke analysis takes this into account, who can say...
However, what clearly is NOT factored in here is ANY consideration of #LongCovid or associated longer term sequelae for which there is a VAST evidence base accumulating as well.
Adding this to austerity is BAD!

We keep hearing about vast numbers of people mysteriously vanishing from "the workforce". You'd hope this might grab the attention of folks who only consider humans in terms of cost/benefit, but seemingly not.
The reluctance to invest in preventative long-term plans is tangible.

The simple fact is that we have an odd combination of values at the moment, IMHO.
All accept that individual acute risk has been lessened for most, but by no means all 💔
However, this reduced risk is scaled by prevalence, it is not "just vulnerable" people getting very unwell...

Not only does prevalence in part reverse the reduced individual risk of acute disease, it means increased exposure, so any given level of waning becomes more consequential.
Then, add in #LongCovid, whilst more likely after severe disease individually, again scales by prevalence.

Prevalence also means that vulnerable people are more exposed, less likely to be able to interact with those "living" with this disease, and by far more discriminated against than they ever have been, except possibly autumn 2020 when the Sunak/GBD 💩 "policies" tore us apart.

There were nearly 2M people self-reporting long COVID when @ONS was told to stop counting, and there's no reason to think it's gone down by much.
BTW, those doubting this method, @VirusesImmunity and @PutrinoLab published in @Nature this was ~95% accurate based on biomarkers.

Vax reduces long and short C, of course, but MUCH better if recent.

The counter to widespread vax is usually cost (see above), individual risk of severe disease/death, and that the vaccine doesn't provide long lasting sterilising immunity, ie preventing transmission and disease.

Well, of course, individual risk is reduced, but there were ~17k cert deaths in 23 with COVID, underlying cause in 60-70%. That's down from ~90k in 2020, ~70k in 21, ~32k in 22. Obviously this is amazing, but vax is 95% effective at risk reduction, so why is the decline not more?

Here's a clue, it begins with P, and rhymes with malevolence...🙄
Also, these numbers don't include the mortality linked with #LongCovid or other sequelae...cardiovascular, neurological, metabolic, and so on...
Point is, the area under the curve counts, big time, still...

The 2nd point, not preventing transmission...well, no, it doesn't in the same way as a sterilising vax, but if you compare the inherent R0 of SARS2 with Rt, which is a function of susceptibles, we move from ~8-10 to ~1-2...in the absence of ANY mitigations, so go figure folks.

The other travesty of this misperception is that, UNLIKE flu, we aren't protecting our children from all of the above.
#LongCovidKids is very real💔, acute risk vs age is U-shaped
This abject public health misfire has recently been accepted for Zoster...it makes me incandescent.

There are myriad reasons to vax kids. My full version is below, but in brief:
⏬️risk from 1st SARS2 immune encounter.
⏬️risk of #LongCovidKids
⏬️susceptibles & transmission
⏬️time to one day reach stability
⏬️reinfection
⏬️type 1 diabetes etc.

https://twitter.com/TAPASNetwork/status/1726583671086338196?t=H5JSXO1BMugbekEzBkdcAw&s=19

Of course, continued repeated vaccines with the same modality, similar immunogens, limited availability, and considerable cost isn't necessarily the best long term plan.
Don't underestimate how lucky we are that the mRNA platform has worked as well as it has, imagine if not...

There is fantastic innovation in this area, but the UK has, unsurprisingly, disinvested in vax/therapeutics, even selling its trophy vax development centre to a private company. Words, including very rude ones, fail me.
There's a distinct "not for another 100 yrs" mentality...🙄

I mean, to fund existing, never mind new, vaccines, is admitting there's still concern, right?
Living with, just flu, scaled down response, lack of population mitigations despite #ClassAct etc., absorbing COVID into previous NHS budgets (more from less, for a change), endemic...

This is reverse Emporer's clothes, one bloody big elephant, but not even the main opposition call it out. School/work absence is somehow a mystery🤦‍♂️
Public health will always beat individual responsibility; mitigation, not restrictions; vax, not infection.
#VaccinesPlus
Simples.