1/ I've just tweeted two twitter threads - from @dgurdasani1 and @DrEricDing - about "highly pathogenic avian influenza" (HPAI) virus spreading in cattle and on to humans.

This is a step along the path to epidemiologists' nightmare scenario.

There are many strains of influenza. @dgurdasani1 @DrEricDing 2/ Most strains mostly affect a single species. Bird strains generally transmit poorly to, or between, mammals.

But flu viruses mutate very quickly. Once established in another species, variants that can transmit better have an evolutionary advantage.

When I graduated in 1984, and became a junior doctor, I had to pay my GMC membership, professional indemnity insurance, and for ongoing professional exams and Royal College membership. Just as junior doctors do now. BUT…
1/ …But, as a junior doctor in the 1980s, I had no "student debt". Like nearly all my colleagues, I'd had a government grant to pay my fees and living expenses.

And I had free hospital accommodation for the first three years…
2/

@TedUrchin @acgrayling @RishiSunak @BorisJohnson As a doctor turned (unwillingly) civil servant, it was always drilled into me that all records must be kept - not least in case of a future enquiry. 1/ @TedUrchin @acgrayling @RishiSunak @BorisJohnson My bacon was once saved when Department of Health tried to blame HPA (and me specifically) for leaking something they'd announced to a meeting of 100s months earlier. 2/

@implausibleblog It pains me to defend Hancock, but…

We SHOULD have known, very early on, that it was at the very least highly plausible that people could be infectious before they became symptomatic. See
1/threadreaderapp.com/thread/1726558… @implausibleblog But the national experts in PHE stuck to the dogma that Covid-19 could not be transmitted by asymptomatic patients until months after we knew for certain that it could.
2/

@trishgreenhalgh And communicable disease experts like me were forced to

1 implement this insane policy
2 keep stum about how insane it was.

Do you wonder I'm glad to have retired, having been forced to betray all ethical principles by Jenny Harries? @trishgreenhalgh A number of people have accused me of behaving like a Nazi concentration camp guard and "just following orders". It's a bit more nuanced than that…

I was involved in the public health management of the first identified UK resident case of Covid-19 and, within weeks it was no longer true that "… said Bell, adding that nobody knew enough about the virus to begin with…"
bbc.co.uk/news/live/uk-p… What we did was to interview the first or "index" case, to obtain detailed information about the people he'd been in contact with, the restaurant, churches, and other venues he'd visited, and the nature of the contact he'd had with people.

Why are people so critical of ministers for wanting to "decide who should live or die" during the pandemic? 1/20theguardian.com/uk-news/2023/n… Why should politicians have been allowed to sit back and blame clinicians (as they inevitably would have done) for the cruel but unavoidable decisions necessary as a result of their gross under-resourcing of the NHS, 2/20

I'm going to discuss Covid-19, different forms of immunity, disease severity, long covid, and vaccination.

The interval between getting infected or exposed to an infectious agent such as a virus or bacteria is called the incubation period. 1/35 (For simplicity I will use "IA" to refer to the infectious agent - this is not a commonly used abbreviation. I may also refer to "pathogens", which are IAs which can cause illness.) 2/35

I am passionately anti-smoking. So you might be surprised to hear that I agree with Ian Dunt.

https://twitter.com/IanDunt/status/1709594419270238525

Dunt's headline might be a bit hyperbolic, but overall he's quite right.

I'll be interesting to see what the proposed legislation will say about vaping.

I've been blogging about this for years, eg inews.co.uk/opinion/rishi-…
peterenglish.blogspot.com/2015/12/appall…

1/ Why are covid-19 booster vaccines unavailable in the UK, other than to those meeting a tight, restrictive criteria?

A friend in Germany told me she was getting a seasonal Covid-19 vaccine booster. There, apparently, it's recommended for everybody over the age of 60. 2/ I think it's available in the same way as the flu vaccine: via pharmacies, for a small fee, on request. If I'm wrong, please let me know!

1/ The evacuation of the Bibby Stockholm as a result of finding Legionella bacteria in the water is surprising only inasmuch as it highlights - once again - the recklessness of the Home Office.

news.sky.com/story/asylum-s… 2/ As a retired Consultant in Communicable Disease Control, this is no surprise to me.

1/ I keep hearing that ministers have a "right to privacy", so their WhatsApp messages should not be shared.

This is a desperate attempt to conceal important information from the Covid Enquiry.

It is nonsense. 2/ Ministers and public officials have official communication channels to use for official business.

If they choose to use the same channels for their personal, private, business, they forfeit the right to keep those personal communications from other officials.

1/ One of my friends is a neurologist who has been very concerned about the harms caused to a few people by nitrous oxide ("laughing gas"). 2/ As he is a friend, and a political activist with whom I agree on many things, I have been sad that I could not support him on his desire for new legislation to ban nitrous oxide.

1/ I'm not sure I want the BBC to be "impartial".

I'm in favour of partiality, in particular -

*In favour of truth
*In favour of decency
*In favour of kindness
*In favour of humanity

#IStandWithGaryLineker 2/ People working in the news should have a positive duty to point out lies; but where the lies come from ministers or other government representatives, the BBC has an extremely poor record at calling them out.

1/ Of course, voter fraud is potentially an issue. But, in the UK at least, it seems to be a very small problem.

The tories have proposed a solution which is a sledgehammer to crack a nut, and will be far worse than the current situation.
theconversation.com/six-reasons-br… 2/ Sadly, @UKLabour appear not to oppose the bill.

https://twitter.com/LordRennard/status/1602722213878177794

Many of us will remember the immense problems there were with some recent votes - particularly, for example, for EU citizens who were entitled to vote prior to Brexit.

Thread by @alexhallhall on Thread Reader App threadreaderapp.com/thread/1570407…

The Queen's death has led me to a far more republican position than I held previously.

1/9 I have always been aware that selecting a head of state the way we do it in the UK - and remember, the Queen believed that God had appointed her - is bizarre.

2/9

1/ I have been married for 35 years, and my wife, Doro (@Fifino9) died this morning.

Long, raw thread…

In 2010, Doro found a lump in her breast. Lumpectomy, chemo, radiotherapy, hormone treatments (and consequent spotting and endometrial cancer scare) followed. 2/ At about the time of the original diagnosis, Public Health England blighted our lives, falsely blaming me for errors over the Godstone Farm E coli outbreak, damaging my reputation, and putting my career on hold for five years, for more senior people's mistakes.

1/ I am a recently retired consultant in communicable disease control (CCDC). Since I've retired, I don't see the internal briefings sent around by UKHSA.

I am not an expert on Monkeypox. 2/ (If you listen to @BunkerPod podcast player.fm/1BQFsru you may have heard Dr Hammer @cc_martell recently - she is an expert on the virus.

1/ Short 🧵 on #Beergate.

It's something of a cliché that many news organisations, asked if it's raining, will ask "experts" to come and give opposing opinions, when a proper journalist would open the window. 2/ Throughout #Beergate, many news organisations are piling in, speculating about the potential consequences for Labour/Starner. Generating enough hot air to ward off the energy problems for weeks.

1/ "Investigation continues into mysterious rise in cases of hepatitis in children"

Adenovirus is common and often trivial or asymptomatic.

You would expect a proportion ("E") of children in any random sample to test positive for it.

f7td5.app.goo.gl/Rqsjia 2/ What proportion of the children with hepatitis are observed ("O") to test positive?

Unless O/E>1, there's no reason to suspect an association, let alone a causal association.

1/ So, the governments policies re discharge to care homes was unlawful.

BBC News - Covid: Discharging hospital patients to care homes 'unlawful'
bbc.co.uk/news/uk-englan…

No surprise there, then. 2/ What about the policies that were clearly designed to ensure all children were infected in school?