1/ Recurrent self isolation for Omicron. This is a worry. @CMOIreland @DonnellyStephen @HSELive @merrionstreet. How often and for how long ? 2/ I think we had a good strategy that if vaccinated (and now indeed boosted), that we weren’t to be considered in need of self isolation as close contacts in the strictest sense and didn’t have to self isolate for days and days.

My concerns regarding recurring self- isolating as close contacts @DonnellyStephen @CMOIreland @HSELive 🧵 1/ So I’m assuming my interpretation is correct that a household must all self isolate for a minimum of 5 days for those that are fully vaccinated and boosted, and 10 days for those that aren’t if they have a case of COVID at home.

The risk of persistent lockdown and restrictions @DonnellyStephen @HSELive @CMOIreland @ronan_glynn @roinnslainte @MichealMartinTD @LeoVaradkar 1/ I’m worried about a cycle of events which may occur in the coming months. We have postponed reopening and the use of antigen testing until we “see how things unfold in other European countries regarding the delta variant” or while we “await more data”.

Perhaps I’m looking at things too simply for COVID, variants and re opening @DonnellyStephen @CMOIreland @ronan_glynn @HSELive @MichealMartinTD @LeoVaradkar 1/ It is a fact that when we or any country begins to lift restrictions that case numbers will increase. Cases of all viruses will increase in fact.

Maybe some balance and less sensationalism for the delta variant is needed @rtenews @GeorgeLeeRTE @DonnellyStephen @RiochtConor2 @sailorrooscout @CMOIreland 1/ Last nights RTÉ broadcast on the delta variant was in my humble opinion misleading and fear inducing. Presenting the data without context or balance was wrong.

We need to be rational with how we approach new COVID 19 variants @DonnellyStephen @CMOIreland @ronan_glynn @merrionstreet @HSELive @PatKennyNT @NTBreakfast #antigen 1/ We have a choice to make. We have to stop saying all public health choices around COVID are choices between life and death. That defeats the argument.

The cyber attack @HSELive @paulreiddublin @DonnellyStephen @NTBreakfast We have been at risk for years 1/ I fully applaud all my colleagues working in HSE hospitals who are working tirelessly to try and keep the show on the road without their IT systems. It must be incredibly difficult.

I am worried about the message @LeoVaradkar @MichealMartinTD @DonnellyStephen @CMOIreland @SamuelMcConkey1 @NewstalkFM 1/ There’s no doubting this lockdown has been the hardest. But people complied. Yes there was perhaps more traffic than April last year, but nothing is open. There are no gatherings.

The current Covid reality @DonnellyStephen @SusanMitchell_ @knutmoe @DrValerieMorris @MihaiVioreanu @FergalMcGoldri2 @asam100 @DrJohnCurran @stevemur67 @RiochtConor2 @higginsdavidw @DrBrianHiggins @ProfSuperJunior 1/ I am struggling to understand why there are those that deny Covid 19 as a problem. There’s too much noise at the moment. I absolutely encourage balanced debate, discussion of facts, pursuit of science, and avoidance of conspiracy theories.

My Covid thoughts
Regardless of ones stance on nphet, pcr issues, casedemic vs pandemic, here is what I think I can summarise from recent months @SusanMitchell_ @DonnellyStephen @RiochtConor2 @MihaiVioreanu @DrJohnCurran @Care2much18 @higginsdavidw @jlamber55605930 1/ Covid cases are increasing for two reasons. Firstly of course the resurgence of cases reflects greater amounts of people coming together. More socialising, bigger numbers of social contacts. But ..

So what’s the next plan. The confusion continues. More questions. @SusanMitchell_ @CMOIreland @MihaiVioreanu @DrJohnCurran @Care2much18 @RiochtConor2 @CcoHse @jlamber55605930 @MlMcNamaraTD @SenatorMcDowell 1/ So Sweden has posted its data for all cause mortality up to Oct this year and it seems that the figures as as low as any other year, lower in fact

https://twitter.com/grahamneary/status/1321516693848469504?s=21

1/ Maybe we are detecting too many asymptomatic cases, people with non infectious viral remnants, and acknowledge a low case fatality rate. People suggest a #casedemic, yet we hear of a lot of European countries now struggling with hospitalised Covid patients

https://twitter.com/ohanloncmr/status/1320789726052405251

2/ I read one article which seems very convincing about the low risk of Covid 19. Other papers suggesting a far higher level of T-cell immunity. Data to suggest this coronavirus is no worse than seasonal flu. And that data seems very convincing

My Disappointment. @HSELive @DonnellyStephen @SusanMitchell_ @ciarakellydoc @merrionstreet
1/ Maybe it’s just Covid lockdowns and 2020 in general but there is at present a greater attention and focus on how we do things in Ireland 2/ How we build hospitals, how we build houses, how we care for the elderly and vulnerable. It’s disappointing how much our government focuses on smoke and mirrors. Deflection and delays. Right hand not knowing what the left hand is doing.

Some great points made in this paper and mirrors data from other countries. @HSELive @DonnellyStephen @merrionstreet Second waves mostly linked to transmission in young healthy people.

And So it begins again.
Lockdown part 2. @MlMcNamaraTD @ciarakellydoc @SusanMitchell_ @MichealMartinTD @jenoconnell
1/ I feel a genuine fear that much of the fabric of society will come apart in various shapes and forms in the coming weeks. 2/ There is already such anger, much of which I worry will not simply settle as the days pass. Obviously there is the shock of the much leaked news of the level 5 announcement.

We must look after all parts of the health needs despite COVID19 @HSELive @DonnellyStephen @SusanMitchell_ @ciarakellydoc

1/ It’s absolutely clear that we don’t have the ICU capacity we need in Ireland. This has been shown in multiple reports going back years. 2/ The numbers are less now than they were, and 20% of the current ICU beds in the public system remain closed. In the times of a pandemic, we have to ask why.
We have to also ask why in the last 7 months the capacity hasn’t been improved.

A sense of balance and a question of who is right ? @DonnellyStephen @ciarakellydoc @SusanMitchell_ @ronan_glynn @Care2much18 @ConorRiordan2 @FatEmperor 1/ Sometimes I wonder are the debates on twitter a reflection on how the wider population feel. Is there such a degree of anger and divergent opinions regarding Covid and our response? It seems to be one camp or another.

Facts or fiction. Some thoughts as we enter the winter months @DonnellyStephen @HSELive @roinnslainte @paulreiddublin @SusanMitchell_ @ciarakellydoc 1/ Why do we look for a winter plan every year . We know what’s coming. It comes every year. More acute admissions, the seasonal influenza outbreak, worsening of community acquired infections.

Questions I have on our healthcare crisis @HSELive @roinnslainte @DonnellyStephen @SusanMitchell_

1/ Ill admit I have questions. Questions wondering how it can be that our health service isn’t what our patients deserve. 2/ It’s a given that there aren’t enough beds in the public system. But there is extra capacity in the system. There are wards closed around the country due to staff shortages and/or renovations.

It’s not about us vs them @HSELive @DonnellyStephen @SusanMitchell_ @roinnslainte

1/ Infighting, anger, frustration, fear, bun fighting. Isn’t life too short for all this. Are we not potentially going down a road of missing the point. 2/ First we must acknowledge one thing, which is key to all of what we do. Whether one is a full time public consultant, a public/private mix, or full time private, there is only one constant that we are all striving for- the best care for the patient sitting in front of us.

The new takeover plan by @HSELive @roinnslainte. Some thoughts @SusanMitchell_ @DonnellyStephen @ciarakellydoc

1. So once again it starts. The narrative from the DOH and HSE that the public system can’t cope. And it’s hard to dispute that fact. The public system is broken 2. Brilliant capable and hard working colleagues working hard in a system that doesn’t function. We pour billions into the public health system every year, a budget that is increasing most years.