Dr Dan Goyal Profile picture
Medic | Researcher | Citizen. Corruption and disinformation are the greatest current threats to progress. Health updates & opinions.
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Jun 25 4 tweets 2 min read
I will say it again, if you do not want to wait an hour for an ambulance, 12 hours in A&E, days to see a GP, months for your cancer treatment to start, or years for your operation, job 1 is to pay NHS staff properly.

We will not stay under these pay and conditions! Since this Government came to power, doctors have taken a 4-9% pay cut, nurses a 7% pay cut. Image
Jun 23 22 tweets 4 min read
One of the first big questions with Covid was: would getting Covid provide lasting protection against getting Covid again?

Now we know that reinfection is sadly all too common, the next big question is: is getting reinfected a big deal?

Evidence suggests it can be... It was a big kick in the teeth when we realised Covid is quite good at escaping our immunity and that our immune response to Covid gets poorer over time.

The promise of enduring "Herd Immunity" was, it seems, premature and maybe now quite counter-productive.
Jun 20 7 tweets 2 min read
Should you worry about the new Covid wave?

It is a worrying time:

> Third wave this year

> Still killing more than any other infection

> With the pressures on the NHS it’s not a good time to get Sick.

> Long Covid increasingly more a worry

But we know Covid better… > We are much better at treating Covid, at least in the acute phase.

> We know just how safe and effective vaccines are at preventing severe disease and to some degree Long Covid

> ICUs are less overwhelmed with Covid and have expertise in managing the critical Covid patient
Jun 14 11 tweets 2 min read
I think this Covid wave may be more damaging than any previous wave over the last year.

Non-Covid pressures are greater
We have fewer staff
There is less NHS capacity
Vaccine uptake has plummetted
Immunity is waning
We have an impotent leadership
And a complicit media

1/10 Yes, we have much better outcomes in Covid, but that requires considerable effort and resources.

Anti-virals are available for some, but this requires assessment and a unique prescribing pathway.

Severe disease is less frequent but typically requires lengthy admissions.
Jun 10 21 tweets 5 min read
Some seem to think doctors, nurses and paramedics working in urgent care spend their day saving lives.

And we do, sometimes.

But actually, we spend most of our day saving organs - brain, heart, kidneys, etc - to prevent disability so people can make the most out of life.

🧵 There are occasions when we have to intervene urgently or someone will die then and there.
Sepsis, for example, needs prompt attention and antibiotics.
Asthma attacks, major heart attacks, brain haemorrhages, etc.., are all examples of when access to emergency care saves life.
Jun 7 13 tweets 4 min read
The current state of the NHS looks and feels really bad.

Really, really bad.

The volume of genuinely unwell patients is just overwhelming. Staff are utterly exhausted and dispirited.

There is some hope in Scotland and Wales, but... I can't fully explain it. Why are we seeing so many properly unwell patients?

The NHS gets busier every year. It is the success of new treatments or just better pathways for managing disease...people live longer but do require our input to do so. It's great. All age groups.
Jun 6 7 tweets 2 min read
Just to be clear, the long protracted and brutal lockdowns (that the public followed!) were a DIRECT consequence of Johnson’s mismanagement of the pandemic.

Had he supported the NHS and not given our pandemic crisis money to inexperienced private contractors we may have…. …avoided lockdowns altogether. But certainly had he followed the expert advice and acted sooner lockdowns would have been weeks versus the months they were.

He did not get this “Big Call” right…indeed, I can’t see a single Covid “Big Call” he got right..
May 31 5 tweets 1 min read
I joined Twitter last year to highlight the dangers of this Government’s pandemic strategy.

Healthcare rationing! That was and is the policy. “Take it on the chin”

We published our findings:

thelancet.com/journals/lanep… We found that the Government’s decision to choose private providers versus primary care (GPs) to provide community triage led to patients not receiving any clinical assessment at the point of diagnosis with Covid.
May 29 17 tweets 5 min read
Why are there so many trolls on Social Media?

Quite simply, they are effective...!

....so long as we play along, that is.


#disinformation A troll is someone (or a bot) whose purpose is to derail a tweet or tweeter.

Wiki: “…a troll is a person who posts inflammatory, insincere, digressive, extraneous, or off-topic messages…”

They want to distract, usually from uncomfortable truths.
May 29 12 tweets 3 min read
Why do doctors and nurses stay in the NHS?

It’s a fair question just now.
- unmanageable demands
- real world pay cut
- more abuse
- falling standards and moral injury
- better overseas opportunities…

But many of us want to stay…why?
1/12 Universal access is a monumental human development. Healthcare most consider as a human right. In many places access to healthcare is limited and dependent on your wealth or position. In this way medicine becomes more opaque and complicated.
May 26 4 tweets 1 min read
It makes for grim reading...but knowledge is power! And if we have learned anything these last two years, it's that burying your head in the sand won't help

Small changes matter...if Big Business see us change they will respond to that consumer demand

bylinetimes.com/2022/05/26/un-… The UN Report talks of 9 planetary boundaries,, relating to chemical pollution, climate change, freshwater use, air pollution, etc...

..if we breach too many...

"the increasing probability of civilisational collapse"

"without radical change, that’s where the world is heading."
May 23 16 tweets 5 min read
I know everyone is fed up of Covid, but this is IMPORTANT.

The ONS (UK Gov) have compared:

COVID versus The FLU

And the results are quite staggering.

TLDR; Covid much more risky than Flu; Younger people higher increase in risk than older.

Share pls.
[40-59yrs ⬇️] This is important info if you are weighing up whether to get a booster or whether to wear a mask on the underground, etc...

And it should make us all think twice before going out and about if we have or may have Covid.

It does not mean we need to bring restrictions back!
May 23 8 tweets 2 min read
Sometimes it’s difficult for experts to admit they were wrong.

Covid wasn’t a mild infection, and “taking it on the chin” led to a lot of death and disability.

SARS2 is a very high impact virus. We should have acted sooner and should be doing more, but…

We’re kind of stuck
🧵 There are of course just bad scientists and crooked advisers. Those who tell the boss whatever they want to hear. They find the arguments to support the bosses position.

IME, they are actually rare.

As much as we may like to believe in “evil” scientists, most believe in truth.
May 20 11 tweets 2 min read
We have received our national update on Monkeypox.

The risk to the General population from Monkeypox remains low.

But the risk for frontline workers is not insignificant.

Frontline staff are more likely to encounter it pre-diagnosis, so I will be taking some precautions… National recommendation is to manage patients with possible, probable or confirmed Monkeypox in negative pressure rooms. And use HCID (High Consequence Infectious Disease) level PPE.

Direct or close prolonged contact most risky.
May 20 14 tweets 3 min read
Have we learned from the pandemic?

Some of us seemed to have… Many of us are more grateful for those family members who survived - both illness and death.

Some have had some sort of realisation after losing loved ones or near misses, choosing to drop a day at work to have more time with their family, or just deciding to be present more.
May 19 23 tweets 5 min read
This week in Covid, those leaders pummelled and defeated by SARS2 begin trying to re-write history.

They, yet again, forget that pesky thing called science!

#TheWeekInCovid - a weekly "slightly" sarcastic summary of the pandemonium caused by the pandemic.
🧵 1. A new analysis from WHO that estimated around 20million Covid deaths have occurred worldwide was ceased upon by anti-public health commentators, as on initial inspection it seemed to paint a less damning picture. On closer inspection, it didn’t.
May 18 12 tweets 4 min read
Despite all the arrogance of the West, we got Covid wrong. We are still getting Covid wrong.

Time to look East, at those thriving while "Living with Covid"

Japan: no lockdowns, no excess mortality, better economic performance, and more socialising...
🧵 Image This, albeit a bit "cheesy" promotional video from Japan, shows how they have actually reduced all cause mortality.

Key points...

Japan's new normal via @YouTube
May 18 25 tweets 5 min read
It's hard trying to raise awareness of governments' failure to manage the pandemic properly.

It shouldn't be, but it is.

Why, and why keep going:

1. There is a small but powerful minority who want the public to forget about Covid, even if that means more death and disability. Consumer confidence is hit hard when people are constantly reminded of Covid by masks and notices and the need to self-isolate. And when money is on the table we see co-ordinated disinformation campaigns and tactics (some nasty) to suppress those who are raising concerns.
May 15 11 tweets 2 min read
Johnson’s dismantling of the NHS - the public bear witness!

It may seem that all is going to plan, for Johnson. The NHS is in a spiral, the public are not happy with it, and the government are poised to send the private sector in for the rescue.
1/11 According to the recent King’s Fund poll however, the public are not as gullible as Johnson and his party think they are.

May 6 10 tweets 2 min read
Astonishingly, folk are still asking:

“but what can we do about it”

…when confronted with the fact we are letting Covid kill more people than any other infection.

It’s two years now.

So let’s start with the simple stuff:

Don’t spread it around! If you get Covid, don’t spread it around. I know, we are starting really basic.

If you have Covid - an airborne virus - then self-isolate.

Some genuinely can’t. But this is a very small minority of the country.

Remember self-isolation remains mandated in most HIC countries.
May 4 6 tweets 2 min read
I don’t have a political allegiance. Voted for pretty much all parties except the Tories.

In Scotland I am voting SNP. There are great independents here and I love the Greens, but The SNP is the best way for us to get some protection from the madness in Westminster, IMO. I am disappointed with the Scottish governments response to Covid. I think they did better than Johnson’s unhinged cabinet, but that is a low bar to set. I wish they had stood up stronger and emulated excellence not mediocrity.

But, I appreciated Sturgeons clear focus during…