
https://abs.twimg.com/emoji/v2/... draggable="false" alt="π΄" title="Older man" aria-label="Emoji: Older man">

https://abs.twimg.com/emoji/v2/... draggable="false" alt="π΅" title="Older woman" aria-label="Emoji: Older woman">

https://abs.twimg.com/emoji/v2/... draggable="false" alt="π" title="Lock" aria-label="Emoji: Lock">1/18
One of a series older parents, relatives, friends &
#Coronavirus.
THEY SHOULD BE IN QUARANTINE - READ ON
3 reasons to talk about this:
1. A critical group, yet quarantine rules are all over the place
2. They will suffer most if we get lockdown exit wrong...

https://abs.twimg.com/emoji/v2/... draggable="false" alt="π΄" title="Older man" aria-label="Emoji: Older man">

https://abs.twimg.com/emoji/v2/... draggable="false" alt="π΅" title="Older woman" aria-label="Emoji: Older woman">

https://abs.twimg.com/emoji/v2/... draggable="false" alt="π" title="Lock" aria-label="Emoji: Lock">2/18
3. The support network for older people, often family reliant, has been particularly disrupted
Disclaimer - I&
#39;ve done some pro bono work on
#covidγΌ19 for the wonderful people at
http://wisetribes.com">
http://wisetribes.com who got me aware of issue 3. If there&
#39;s some overlap that&
#39;s why.

https://abs.twimg.com/emoji/v2/... draggable="false" alt="π΄" title="Older man" aria-label="Emoji: Older man">

https://abs.twimg.com/emoji/v2/... draggable="false" alt="π΅" title="Older woman" aria-label="Emoji: Older woman">

https://abs.twimg.com/emoji/v2/... draggable="false" alt="π" title="Lock" aria-label="Emoji: Lock">3/18
So let&
#39;s get into it.
TOPIC - QUARANTINE RULES
I hoped that all older people were in quarantine.
http://wisetribes.com">
http://wisetribes.com helped me understand they&
#39;re not.
The reason is once again UKGov being too slow and IMHO too cautious with their advice. CONSISTENTly so.

https://abs.twimg.com/emoji/v2/... draggable="false" alt="π΄" title="Older man" aria-label="Emoji: Older man">

https://abs.twimg.com/emoji/v2/... draggable="false" alt="π΅" title="Older woman" aria-label="Emoji: Older woman">

https://abs.twimg.com/emoji/v2/... draggable="false" alt="π" title="Lock" aria-label="Emoji: Lock">4/18
I&
#39;m not going to contradict UKGov advice, I&
#39;m going to suggest applying it tighter.
IF YOU ARE 60 OR OLDER you should make every effort to QUARANTINE - that means NO FACE TO FACE contact, applying Shield Rules.

https://abs.twimg.com/emoji/v2/... draggable="false" alt="β¬" title="Down-pointing double triangle" aria-label="Emoji: Down-pointing double triangle">
https://www.gov.uk/government/publications/guidance-on-shielding-and-protecting-extremely-vulnerable-persons-from-covid-19">https://www.gov.uk/governmen...

https://abs.twimg.com/emoji/v2/... draggable="false" alt="π΄" title="Older man" aria-label="Emoji: Older man">

https://abs.twimg.com/emoji/v2/... draggable="false" alt="π΅" title="Older woman" aria-label="Emoji: Older woman">

https://abs.twimg.com/emoji/v2/... draggable="false" alt="π" title="Lock" aria-label="Emoji: Lock">5/18
The next tweets justify this statement because once that&
#39;s done, there&
#39;s guidance for the rest.
You may not know what UKGov advice is. Recently they upgraded it to say, "People 70 or older should be particularly stringent in applying Social Distancing"
Clear as mud

https://abs.twimg.com/emoji/v2/... draggable="false" alt="π΄" title="Older man" aria-label="Emoji: Older man">

https://abs.twimg.com/emoji/v2/... draggable="false" alt="π΅" title="Older woman" aria-label="Emoji: Older woman">

https://abs.twimg.com/emoji/v2/... draggable="false" alt="π" title="Lock" aria-label="Emoji: Lock">6/18
The issues with UkGov guidance:
1. For weeks they forgot to follow up guidance to older people
2. "Particularly Stringent" is undefined, does it mean washing hands for 10 more seconds? or outside even less than "absolutely necessary (HOW?)"
3. Asia/Aus BEST PRACTICE

https://abs.twimg.com/emoji/v2/... draggable="false" alt="π΄" title="Older man" aria-label="Emoji: Older man">

https://abs.twimg.com/emoji/v2/... draggable="false" alt="π΅" title="Older woman" aria-label="Emoji: Older woman">

https://abs.twimg.com/emoji/v2/... draggable="false" alt="π" title="Lock" aria-label="Emoji: Lock">7/18
1. FORGETTING OLDER PEOPLE (AND CHRONIC CONDITIONS)
I don&
#39;t know why UKGov forgot to follow up on advice but I do know the implications. In the first hurried weeks of social distancing, older people were not the focus. Subsequent advice got much less publicity.

https://abs.twimg.com/emoji/v2/... draggable="false" alt="π΄" title="Older man" aria-label="Emoji: Older man">

https://abs.twimg.com/emoji/v2/... draggable="false" alt="π΅" title="Older woman" aria-label="Emoji: Older woman">

https://abs.twimg.com/emoji/v2/... draggable="false" alt="π" title="Lock" aria-label="Emoji: Lock">8/18
And there was another disrupting effect. The Media initially set an expectation that only old people needed to worry about C-19. So when younger people and kids started dying that got blanket coverage.
68% of 70 and older pass away in UK Intensive Care

https://abs.twimg.com/emoji/v2/... draggable="false" alt="π΄" title="Older man" aria-label="Emoji: Older man">

https://abs.twimg.com/emoji/v2/... draggable="false" alt="π΅" title="Older woman" aria-label="Emoji: Older woman">

https://abs.twimg.com/emoji/v2/... draggable="false" alt="π" title="Lock" aria-label="Emoji: Lock">9/18
Excluding any additional vulnerabilities the average fatality by age is:
50s: 1.3%
60s 4.6%
70s 9.8%
80s 18.0%

https://abs.twimg.com/emoji/v2/... draggable="false" alt="π΄" title="Older man" aria-label="Emoji: Older man">

https://abs.twimg.com/emoji/v2/... draggable="false" alt="π΅" title="Older woman" aria-label="Emoji: Older woman">

https://abs.twimg.com/emoji/v2/... draggable="false" alt="π" title="Lock" aria-label="Emoji: Lock">10/18
Plot this and see there&
#39;s another less talked about exponential of
#coronavirus #COVIDγΌ19. I&
#39;ve added the much-discussed 1918 flu data to show just how much Covid-19 affects Older People. It was correctly reported. it&
#39;s a LOT worse.
You see why over 60s data too?

https://abs.twimg.com/emoji/v2/... draggable="false" alt="π΄" title="Older man" aria-label="Emoji: Older man">

https://abs.twimg.com/emoji/v2/... draggable="false" alt="π΅" title="Older woman" aria-label="Emoji: Older woman">

https://abs.twimg.com/emoji/v2/... draggable="false" alt="π" title="Lock" aria-label="Emoji: Lock">11/18
2. PARTICULARLY STRINGENT SOCIAL DISTANCING
So what do you think that means? Here&
#39;s Google page 1
1. China level tracking
2. Do it a lot
3. Definitely quarantine
4. Definitely not quarantine
5. Work from home
6. Almost quarantine
7. NHS 404 error
Who could know?

https://abs.twimg.com/emoji/v2/... draggable="false" alt="π΄" title="Older man" aria-label="Emoji: Older man">

https://abs.twimg.com/emoji/v2/... draggable="false" alt="π΅" title="Older woman" aria-label="Emoji: Older woman">

https://abs.twimg.com/emoji/v2/... draggable="false" alt="π" title="Lock" aria-label="Emoji: Lock">12/18
IMHO ambiguity kills. My parents were quarantined from early March using the SHIELD rules above. Read them, and there&
#39;s a practical guide with downloadable reminders

https://abs.twimg.com/emoji/v2/... draggable="false" alt="β¬" title="Down-pointing double triangle" aria-label="Emoji: Down-pointing double triangle">
Don&
#39;t go out
Don&
#39;t open the door
Someone else delivers food
Decontaminate
https://www.wisetribes.com/post/staying-home-safe-mum-and-dad-parents">https://www.wisetribes.com/post/stay...

https://abs.twimg.com/emoji/v2/... draggable="false" alt="π΄" title="Older man" aria-label="Emoji: Older man">

https://abs.twimg.com/emoji/v2/... draggable="false" alt="π΅" title="Older woman" aria-label="Emoji: Older woman">

https://abs.twimg.com/emoji/v2/... draggable="false" alt="π" title="Lock" aria-label="Emoji: Lock">13/18
I can&
#39;t think why we wouldn&
#39;t simply tell the 60s and above to quarantine - what are we protecting?
Over 60s still in employment who can&
#39;t work from home?
More pressure on supermarket delivery slots?
Societal Fear?
Those horses have bolted
Save political face?

https://abs.twimg.com/emoji/v2/... draggable="false" alt="π΄" title="Older man" aria-label="Emoji: Older man">

https://abs.twimg.com/emoji/v2/... draggable="false" alt="π΅" title="Older woman" aria-label="Emoji: Older woman">

https://abs.twimg.com/emoji/v2/... draggable="false" alt="π" title="Lock" aria-label="Emoji: Lock">14/18
3. ASIAN COUNTRIES KNOW BETTER
Of all the criticisms that will be made of UKGov in the future, high on the list will be institutional behaviours that refused to look at or listen to best practice from Asia / Australia in dealing with MERS and SARS

https://abs.twimg.com/emoji/v2/... draggable="false" alt="π΄" title="Older man" aria-label="Emoji: Older man">

https://abs.twimg.com/emoji/v2/... draggable="false" alt="π΅" title="Older woman" aria-label="Emoji: Older woman">

https://abs.twimg.com/emoji/v2/... draggable="false" alt="π" title="Lock" aria-label="Emoji: Lock">15/18
I can&
#39;t even call this institutional racism, because in common with the rest of Aisa, Australia concludes 60 and above
They even identified minority vulnerable communities more affected - something we haven&
#39;t started to do (big fuss coming).
https://www.health.gov.au/sites/default/files/documents/2020/03/coronavirus-covid-19-information-for-older-australians_1.pdf">https://www.health.gov.au/sites/def...

https://abs.twimg.com/emoji/v2/... draggable="false" alt="π΄" title="Older man" aria-label="Emoji: Older man">

https://abs.twimg.com/emoji/v2/... draggable="false" alt="π΅" title="Older woman" aria-label="Emoji: Older woman">

https://abs.twimg.com/emoji/v2/... draggable="false" alt="π" title="Lock" aria-label="Emoji: Lock">16/18
So that concludes the 3 reasons, why I (and other virologists and all of Asia, and most experience medics in this area) think the UKGov advice fails on age range, and on strict no face to face quarantine advice.
For clarity of guidance, do this:

https://abs.twimg.com/emoji/v2/... draggable="false" alt="π΄" title="Older man" aria-label="Emoji: Older man">

https://abs.twimg.com/emoji/v2/... draggable="false" alt="π΅" title="Older woman" aria-label="Emoji: Older woman">

https://abs.twimg.com/emoji/v2/... draggable="false" alt="π" title="Lock" aria-label="Emoji: Lock">17/18
Five important caveats.
1. Very elderly people may be unable to cope in complete isolation, you can modify by following shield hygiene guidelines
2. Same for Care
3. Same for those living alone
4. Cost
5. They live with you already
Happy to take questions on those.

https://abs.twimg.com/emoji/v2/... draggable="false" alt="π΄" title="Older man" aria-label="Emoji: Older man">

https://abs.twimg.com/emoji/v2/... draggable="false" alt="π΅" title="Older woman" aria-label="Emoji: Older woman">

https://abs.twimg.com/emoji/v2/... draggable="false" alt="π" title="Lock" aria-label="Emoji: Lock">18/18
At the start, I said this was one of a series. I plan also to cover:
Lockdown planning - also an unnecessary shambles and a refusal to learn from Asia
Family network planning - in case we have another one
Practicalities at home
Pls reply with any additions
Thanks to everyone who answered the poll that selected this topic, and particularly to
@AlisonKMurray @SusanChubb1 for great suggestions.
I&
#39;ll add future threads in this series next as I complete them.
Always forget!

https://abs.twimg.com/emoji/v2/... draggable="false" alt="π΄" title="Older man" aria-label="Emoji: Older man">Older men

https://abs.twimg.com/emoji/v2/... draggable="false" alt="π΅" title="Older woman" aria-label="Emoji: Older woman">Older women

https://abs.twimg.com/emoji/v2/... draggable="false" alt="π" title="Lock" aria-label="Emoji: Lock">Safely locked into quarantine.
Tip: mention @twtextapp on a Twitter thread with the keyword βunrollβ to get a link to it.