Peter English #FBPE Profile picture
Public health Dr, recently retired. Interests in vaccination and health intelligence. Tweets may not even express my own views!
Peter English #FBPE Profile picture marafat Profile picture Ana Llamas Profile picture 3 added to My Authors
16 Oct
1/ It's hard to know the real reason for the decision to give 12-15-year-olds only a single dose of because the details of the discussion are not available. Hence the campaign for greater JCVI transparency.

@DrRCoull @cv_cev twitter.com/DrRCoull/statu…
2/ The purported reason for the decision, IIRC, is a concern about adverse reactions to the vaccine.

Myocarditis, in particular, seems to occur in an extremely small proportion of vaccine recipients.
3/ Post-vaccination cases seem to have a minor illness and make a full recovery, although some people are concerned there could be long term consequences.

Myocarditis is far more common after Covid-19 disease than after vaccination.
Read 9 tweets
14 Oct
1/ I couldn't find a link to the study in this BBC News report, but the report rehashes what we've known for a long time.

bbc.co.uk/news/health-58…

We know:
2/ PCR tests on throat swabs, done with good technique at the right time are only about 70% sensitive: 3/10 positive cases are missed.

PCR tests done late (eg a day or 2 after a positive lateral flow test) is even less sensitive.

Lateral flow tests are even less sensitive.
3/ Both types of test are extremely specific: fewer than 1% of people who do not have Covid-19 will get a false positive result.
Read 7 tweets
14 Oct
What an appalling interview from Sajid Javid starting a few minutes ago on @BBCr4today.

He is clearly incompetent, way out of his depth. I've seldom heard a minister say so many stupid things in a single interview.
@BBCr4today health inequalities are NOT caused by an unequal distribution of GPs.
@BBCr4today How, exactly, are you fighting the virus? Why are mask mandates not in place and rigorously enforced on public transport, in shops and other places, and in schools? Why is health and safety in schools and workplaces not ensuring good ventilation / air filtration?
Read 6 tweets
12 Oct
1/ . @jimalkhalili's Life Scientific on @BBCRadio4 this morning had a scientist (? @SirPaulNurse of @TheCrick ) saying:

"When [SARS-CoV-2 and the Covid-19 pandemic] arrived, we knew nothing about it."

Nonsense!

We knew a lot about Coronaviruses.
2/ We knew a lot about the immune system, how it interacts with pathogens, and how it can overreact to cause an acute (short term) overreaction (cytokine storms…); and about long-term autoimmune disease.

We knew a lot about treatments for autoimmune diseases.
3/ We knew a lot about vaccines and how they work. (Objections to sensible decisions - like extending the prime-boost interval - were based on the fallacy that "we know nothing…", and ignored decades of work on vaccination.)
Read 10 tweets
3 Oct
The tories claim to be the economically competent.

So why do they give visas to very high earners while deporting/preventing entry of people prepared to work for low wages?
1/
I don't know what happened to tweet 2 which I sent just after tweet 1… Will try again. It will be tweet 3, now.
2 /
That said, it pains me to agree with Johnson, but we have exploited low-paid workers for far too long.

Care and health care workers, pluckers and pickers, cleaners… particularly jobs typically done by women…
3/
Read 11 tweets
22 Sep
1/ Regarding infections in schools, a colleague has pointed out that it is Department for Education directives that require schools to stay open, not PHE advice.

I am aware of this.
2/ Before I retired in January a complaint was made against me by the education sector for refusing to change my advice that a school or section of a school should close because of an outbreak of Covid-19 that was putting staff, other students, and their families at risk.
3/ The complaint went nowhere - I was giving the right public health advice, no matter how awkward it was.
Read 7 tweets
21 Sep
Gross incompetence on behalf of BBC?

Bad legal advice?

Surely it wasn't impossible to make full vaccination a condition of employment eg on H&S grounds?

"Strictly chaos as 'third professional dancer refuses vaccine'" metro.co.uk/2021/09/21/str… via @MetroUK
@MetroUK who are the three vaccine refuseniks?

If the BBC won't replace them now, the public should know, so we can vote them off ASAP.
@MetroUK is there anything that would prevent it being a condition of employment that Strictly Come Dancing #SCD competitors are fully vaccinated?
@AdamWagner1 @BarristerSecret @davidallengreen
Read 4 tweets
5 Sep
Maybe the JCVI decision does make sense. Thread.

I've revisited their terms of reference. They're all about cost-effectiveness.

gov.uk/government/gro…
They appear to have framed the benefits of vaccinating 12-15-yos exclusively in terms of the short term healthcare costs that would be avoided.

They appear not to have considered the wider benefits to children's.

Such as a reduction in disruption to education.
Such as distress when parents or grandparents get ill, can't work/earn due to Long Covid, or die.

Or the harm to the 1 in 7 children who get Long Covid, or the minority with permanent organ damage.
Read 13 tweets
30 Aug
We know SARS-CoV-2 can infect the brain.

So can measles, which occasionally causes SSPE - a progressive and invariably fatal brain disease, which typically becomes apparent years after measles infection. en.wikipedia.org/wiki/Subacute_…
About a century ago something - almost certainly virus - caused an epidemic of encephalitis lethargica. en.wikipedia.org/wiki/Encephali…

How do we know that SARS-CoV-2 won't do something similar, possibly years after infection?

The answer is that we don't. It might do this.
That's one reason why I worry so much about the "children aren't at risk" messaging. It will be years before we will be able to say this with confidence.
Read 4 tweets
21 Aug
1/ Like so many of us, I have been watching, aghast, as evil forces take over Afghanistan, and wondering "how can this be happening?"

It's not my area of expertise.

I think it's a proxy war.
2/ I think many of the Taliban fighters (and financial backers) are not Afghans, but extremists from other countries, who want to impose a misogynistic, illiberal culture on Afghanistan (initially). Probably ultimately on the world; but Afghanistan is weak and susceptible.
3/ But what do I know?

I hear people saying - "we cannot, indefinitely, hold the line with our military - eventually the local government must do this, and we must withdraw. We cannot continue to lose our own people's lives, and pay the vast costs."
Read 34 tweets
11 Aug
1/ Are we still at the point [genuine question] where a dose of Covid vaccine given in eg UK or USA deprives somebody in a poorer country from a dose?

And if so - is that because we haven't done enough to ramp up production?

What should be our priority now?
2/ Should we be boosting production in Africa, Asia, South America, and elsewhere?
3/ Will there come a point where the argument that we shouldn't vaccinate [lower risk groups] in rich countries until higher risk groups in poorer countries have been vaccinated becomes irrelevant, because there's enough manufacturing capacity everywhere?
Read 4 tweets
28 Jul
I was just told "my son went to the Latitude festival, and he and all the people he went with have Covid".

This begs so many questions!
Transmission is predominantly airborne, and mainly occurs when aerosolised respiratory droplets can accumulate, and you spend enough time in the space to breathe in an infectious dose.

That's what most of us believe.
An anecdote like this suggests so many hypotheses that could be tested by investigating transmission patterns at events like Latitude.

Who are the people the son went with? What did they do together? Can you identify clusters or chains of transmission?
Read 10 tweets
27 Jul
1/ There's been a lot of talk about Covid-19 becoming "endemic".

Which means it circulates normally.

It doesn't mean "trivial" or unimportant.

(Long thread.)
2/ (A version of this thread is available at my blog: peterenglish.blogspot.com/2021/07/will-c… .)
3/ Polio was endemic in many countries in the mid-twentieth century. Smallpox ditto, for a much longer period. Both caused death and disability.

Populations which had been exposed to them had lower mortality rates; but that didn't mean the disease was trivial.
Read 51 tweets
27 Jul
Chirr App is a powerful Twitter thread maker. It splits text automatically using an intelligent algorithm that makes your threads easy to read.

You can also control where to split your text using the special character sequence below 👇
Thousands of people came to write Twitter threads but stayed for amazing features like:

📅 Scheduler that allows posting great content consistently.

⚡ Blitz that allows you to reply to your audience distraction-free.

📈 Analytics that helps you to know what works the best.
The Editor is free to use, but if you want more - for just $4/mo you can unlock tons of mighty features.

Edit tweets, reply with a thread, add tweets to a thread a much more!

Give it a try: getchirrapp.com
Read 4 tweets
21 Jul
They dismiss PIMS-TS/MIS-C as uncommon and not proven to be caused by Covid-19. (I am comfortable with this.)
7/
They then, similarly, dismiss "Long Covid" in children. Given (the clue's in the name) that it will take time for sequelae, and their duration, to become apparent; and the increasing evidence base on this, this seems an extremely brave decision (as Sir Humphrey would say).
8/
They then briefly mention "indirect health benefits" (not infecting your parents and becoming an orphan etc) and dismiss them as not significant.

Another very brave decision. Where is the modelling?
9/
Read 19 tweets
21 Jul
That JCVI statement in more detail.

gov.uk/government/pub…

It's clear that their top priority was "reductions in hospitalisations and deaths in the population".
1/ Image
They move on to considering vaccine safety - but say, in effect, there's not enough data.

But many other countries have been vaccinated children without significant safety signals. Image
They explain why they recommend vaccination of 12-17yos with certain conditions increasing their risk (and suggest there will be more detail to follow).

And recommend vaccinating those who are household contacts of immunosuppressed.
3/ ImageImage
Read 6 tweets
18 Jul
It has been announced that JCVI has recommended, or likely to recommend, that only at-risk adolescents be offered the vaccine. I suspect that they considered in their modelling only the direct costs to the health service of acute disease.
1/3
I would be particularly interested to see their workings on:

* The benefits to children of ending the pandemic and inevitable restrictions sooner;

* The harms from the secondary cases from the children, especially if teachers, parents or carers are infected;
2/3
* The effect of Covid-19 (directly or through self-isolation etc) on loss of school;

* And , crucially, given the growing evidence, the long term consequences on the children and adolescents of “Long Covid”.
3/3
Read 4 tweets
7 Jul
Doing trace and isolate properly is hugely resource intensive. Ideally you work out where they caught it and identify others potentially infected by the same source, and identify all the contacts that could become secondary cases and try to persuade them to isolate…
1/6
It took all of our resources in Surrey and Sussex for over a week to cope with one case in Feb 2020 There are few shortcuts, despite all we've learned (although there are a few more people to do the work).
2/6
It might be manageable if the number of new cases per day (in England) were in the very low hundreds - ideally less than 100.
3/6
Read 7 tweets
6 Jul
I think Hancock was eliminated for this reason.

The notorious video had obviously been kept back to be released when the moment was "right" for the conspirators.
1/7
It's all very Shakespearean, Caesar, knifed by senators at the base of the Curia in Pompeii.

And who stands to gain the most from this? (Putin?)
2/7
It seems all too convenient that, just when the government decided to let the disease rip to appease its ERG/CRG backbenchers, a new health secretary was appointed.
3/7
Read 7 tweets
3 Jul
I just referred to this #LBD film in an LBC interview.

I compared the Delta variant to the Spanish Armada gathering on the horizon; and said the PM, far from channelling Churchill, channelled Nelson, turning the blind eye to the telescope and declaring "I see no ships".
1/9
I pointed out that people who are vulnerable cannot rely on protection from vaccination. miamiherald.com/news/coronavir…
2/9
They have to rely on others to protect them. The most effective and least intrusive measure is mask wearing in enclosed public spaces, where ventilation is poor. (The less volume of air per person, the greater the risk.) Such as public transport.
3/9
Read 14 tweets
20 Jun
"Pandemic preparedness: UK government kept coronavirus modelling secret" @bmj_latest doi.org/10.1136/bmj.n1…
@DrMQureshi
Why was it @PHE_UK that said publication would "damage national security"? Is such a decision a PHE responsibility (I doubt it)?
1/8
Unless it reveals details of plans to counter bioterrorism or warfare that potential attackers would not guess and would help them, how could publishing reports on pandemic / epidemic preparedness exercises possibly damage national security?
2/8
This seems completely implausible.

Just like the identical claims that delayed (until protests forced publication ofthe reports on the impact of Covid-19 on BAME people last year.
3/8
Read 10 tweets