One of my dissertations was on the causes of the second world war.

I wrote it late, in a hurry, when I was young, naive, sleep deprived, and thought that it was ancient history.

But one aspect of what I wrote was what Germany looked like *from the outside*.
🧵 Here are six key views of Germany from other countries at the time that totally misread the situation.

Some of them might be relevant today.

Just imagine for a moment that you are infected with a virus that harms the lining of your arteries. The virus doesn't damage the artery walls in every part of your body to exactly the same degree. Some parts will be more damaged, some less.

At your next infection, will the parts of your artery wall that were more damaged first time round be more or less vulnerable to the virus? It's an interesting question, isn't it.

Will those damaged parts be better equipped the next time round?

I just want to do a very quick run through the latest up to date charts of rates of sickness absence in *young* doctors here.

Yeah. This is still *really* important, and I'll explain why in a moment. There are some really really important points before I get on to the graphs.

Let's play "Guess Where The Line Goes"

This one is "Retirement Due To Ill Health, NHS England".

It's a horrible thing to be playing games with, but I think it's less horrible to play 'Guess Where The Line Goes' than to ignore it altogether. A, B, C, or D?

The minimisers would have you believe that every bad health condition develops immediately, symptoms of it appear immediately, medical attention is found immediately, and the condition is diagnosed immediately.

The truth is very different. It can take years for conditions to develop after they have been triggered.

I've been kicking around the acronym cii.

Covid Infection Induced.

For example: cii cognitive dysfunction
cii memory impairment
cii executive dysfunction
cii brain fog
cii attention deficit
cii encephalopathy
cii encephalitis
cii seizures
cii new onset epilepsy
cii migraine
cii chronic daily headache
cii anosmia
cii hyposmia
cii ageusia
cii dysgeusia
cii tinnitus
cii hearing loss
cii vestibular dysfunction
cii dizziness
cii vertigo
cii sleep disturbance
cii insomnia
cii hypersomnia
cii circadian rhythm disruption
cii dysautonomia
cii postural orthostatic tachycardia syndrome
cii inappropriate sinus tachycardia
cii orthostatic hypotension
cii blood pressure instability
cii temperature dysregulation
cii sweating disorders
cii heat intolerance
cii exercise intolerance
cii post exertional symptom exacerbation
cii chronic fatigue
cii myalgic encephalomyelitis
cii post viral fatigue syndrome
cii severe deconditioning
cii sarcopenia
cii anxiety disorder
cii depressive disorder
cii mood instability
cii panic disorder
cii post traumatic stress disorder
cii myocarditis
cii pericarditis
cii myopericarditis
cii arrhythmia
cii atrial fibrillation
cii ventricular ectopy
cii heart failure
cii reduced ejection fraction
cii microvascular angina
cii endothelial dysfunction
cii vascular inflammation
cii arterial stiffness
cii thrombosis
cii pulmonary embolism
cii deep vein thrombosis
cii microclot disease
cii hypercoagulability
cii reduced lung capacity
cii restrictive lung disease
cii obstructive lung disease
cii pulmonary fibrosis
cii chronic cough
cii dyspnoea
cii hypoxia
cii impaired gas exchange
cii immune dysregulation
cii immune exhaustion
cii lymphopenia
cii neutrophil dysfunction
cii impaired interferon response
cii impaired opsonisation
cii reactivation of latent viruses
cii frequent infections
cii vaccine hyporesponsiveness
cii autoantibody production
cii autoimmune disease onset
cii autoimmune disease flare
cii sjogren’s syndrome
cii rheumatoid arthritis
cii systemic lupus erythematosus
cii vasculitis
cii antiphospholipid syndrome
cii autoimmune thyroid disease
cii type 1 diabetes
cii mast cell activation
cii histamine intolerance
cii anaphylactoid reactions
cii new food sensitivities
cii drug hypersensitivity
cii gastrointestinal dysmotility
cii gastroparesis
cii chronic nausea
cii chronic diarrhoea
cii constipation
cii abdominal pain
cii irritable bowel syndrome
cii inflammatory bowel disease flare
cii malabsorption
cii altered gut microbiome
cii liver injury
cii elevated transaminases
cii fatty liver disease progression
cii cholestasis
cii pancreatic dysfunction
cii pancreatitis
cii impaired insulin secretion
cii insulin resistance
cii new onset diabetes
cii kidney injury
cii chronic kidney disease progression
cii proteinuria
cii haematuria
cii bladder dysfunction
cii urinary frequency
cii urinary urgency
cii incontinence
cii sexual dysfunction
cii erectile dysfunction
cii menstrual irregularity
cii amenorrhoea
cii ovarian dysfunction
cii reduced fertility
cii endothelial barrier damage
cii blood brain barrier disruption
cii gut barrier permeability
cii vascular leak
cii musculoskeletal pain
cii myalgia
cii arthralgia
cii inflammatory arthritis
cii connective tissue fragility
cii skin disease
cii chilblain like lesions
cii vasculitic rash
cii urticaria
cii hair loss
cii eye disease
cii dry eye
cii uveitis
cii retinal vascular injury
cii visual disturbance
cii accelerated ageing
cii frailty
cii reduced physiological reserve
cii increased all cause mortality

I think we've let the damage that covid infections do to *linings* slip into the background of all the other problems that covid infections cause.

I think this may be a *big* problem. Across all of these, the pattern is the same: structural cell loss is followed by repair that restores structural continuity but not precision of purpose.

It's worth remembering that the UK's end to covid restrictions was built on:
Most kids here never getting vaccinated.
Opening early to get an economic advantage.
Allowing hard intense repeat waves of Covid to rip through.
Getting rid of the weak.
Not much long covid. Nothing scientific.
Just denial, cruelty, wishful thinking, and greed.

Let's run the checklist as it stands at the start of 2026. Altered innate immunity: check

People seem to have forgotten that, in the years before effective HIV treatments existed, many people lived and worked quite normally with HIV for a *long* time. Sometimes close to a decade. Think of Freddie Mercury, still recording albums.

Magic Johnson, playing elite professional basketball right up until he retired, and only then disclosing his HIV status.

There's something else very important about the @jonstewart video.

"You go 'are you sick' and they say 'I don't want to talk about it'.

When Jon Stewart asks why you're wearing a mask, TALK ABOUT IT.

Say one of these easy things.
Pick one, learn it: I wear a mask because Covid is airborne.

oh ffs, honestly, how do these people not know that covid infection makes you vulnerable to shingles.
Here's the exact mechanism: Shingles is your old chickenpox infection (VZV), once sitting dormant in nerve tissue, now waking up when cell-mediated immunity dips.

It feels worth saying that, over the last year, I've seen a growing number of people whose energy, vitality, and enthusiasm are visibly draining month by month.

They're just looking physically and mentally shattered, sliding into a strange exhausted apathy. In my work, I've always encountered people struggling this way.

But in small numbers.

Checking back in on the state of polyomavirus infections.

These are viruses that almost all of us carry for life.
In healthy people they usually sit quietly in the background doing nothing much... ... but in people with weakened immune systems they can cause kidney damage, urinary tract disease, neurological problems and serious complications after transplants...

Ten words you need to know to understand how we can be entering the seventh year of the covid pandemic. 1
Covvabarator
A public health figure who sides with the virus over the people.

Covid infections make people more vulnerable to other infections.

Here's what the Cleveland Clinic say about Brucellosis:
"Brucellosis is an uncommon bacterial infection that comes on slowly and can last for a long time. It can look like a lot of other illnesses, so it’s important to see a healthcare provider to get properly diagnosed and treated. Brucellosis usually isn’t serious, but it can infect your bones and organs, so it’s important to keep a close eye on your symptoms."

Less uncommon now, apparently. Meanwhile... listeria continues its rampant ascent.

You've heard about lots of people having cancer scares recently, haven't you?

I certainly have.
I work supporting people with exactly this kind of situation. I was specifically thinking today about cancer scares that have turned out to *not be malignant cancer*, *yet*.

Ok... so this is going to be an extremely weird thread...
If you're squeamish or sensitive, *stop reading*. You know that you have mites living in the hair follicles of your eyelashes and eyebrows, right?

The ones pictured in the tweet above - and another similar species.

The UKHSA have started publishing this goldmine again - but this year it's even more valuable *because they've reset it to a period when testing was consistent*.

This is very important and it shows yet again:
Covid infection makes you vulnerable to other infection. So... in the weekly flu and covid surveillance report (that also covers other respiratory infections too), they publish these two charts.

Most people just don't understand the immune system, its different components, how covid weakens it, and what that leaves you vulnerable to. We tend to imagine immunity as a single light switch.
On or off.

Maybe on a dimmer switch.
Strong or weak.

Five simple facts about masks: 1
FFP2+/N95+ masks filter out fine aerosols.
They're built to capture tiny airborne particles that surgical masks simply don’t catch.