Read on Twitter
My mantra has been : #COVID19: People who make bad decisions continue to make bad decisions.
Their latest = #carehomes
It's part of the "we're following the science" ritual. But are we? You don't need to dig much to say: I'm sorry, we ain't following the right scientists
Their latest = #carehomes
It's part of the "we're following the science" ritual. But are we? You don't need to dig much to say: I'm sorry, we ain't following the right scientists
I need a lot of tweets for the record. But if you want the short version it's this:
The scientists we need - the ones with feet-on-the-ground experience in slowing #COVID19, keeping care homes safe? Our Government has excluded them.
No, I'm not kidding.
let's get into it:
The scientists we need - the ones with feet-on-the-ground experience in slowing #COVID19, keeping care homes safe? Our Government has excluded them.
No, I'm not kidding.
let's get into it:
1/25I shout at the TV, again.
Our "Medical Advisor" had just said at UKGov's #coronavirus press conference, we had nothing to learn from "developing markets" in the strategy for #covid19
She helped. No real scientist could ever say that
I'll try to make this interesting
2/25I mean come on - how can this be "science".
We knew Jan 9th
We took no action until March 11th
Because we had a #HerdImmunityIsMurder plan
So we didn't order PPE, Tests, Ventilators
Didn't even put NHS on alert.
Scientists are cautious by nature. That's RECKLESS
3/25This will be easier to explain with you part of it.
Congrats. You're the NEW Minister for Care Homes ftom today and worried.
Do you
a) chew fingernails?
b) talk to a UK expert?
c) if there's no (b), maybe look globally?
Sitting in the wood-lined office you scribble
4/25Even a Tory minister can do it. People are dying - why wouldn't you?
There is one reason
That DAMN option (B). We should have people who know.
I'm not being arrogant or complacent.
The UK used to have the best Community Medicine scientists in the world.
No, honestly
5/25To question the science we have to "unbundle" what science is in question.
Without getting into too much detail, imagine if you're going to work with viruses you need to be good at 3 things.
1. Predication
2. Vaccination
3. Actually doing something about it. (OPTION B)
6/25Those ones in Green - they're OPTION B. But you're not getting #carehome insight. So you go digging.
You find that the World Health Organisation rushed out guidelines on this mid-March.
Hmm, that's a bit odd, why would it rush them? https://www.who.int/publications-detail/home-care-for-patients-with-suspected-novel-coronavirus-(ncov)-infection-presenting-with-mild-symptoms-and-management-of-contacts
7/25You notice WHO's first guidelines on #Covid19 care came out JANUARY 26th!! (all below)
It's good stuff. Better than ours. Much earlier too.
And they mention PPE, masks and contact tracing...?
https://apps.who.int/iris/bitstream/handle/10665/112656/9789241507134_eng.pdf?sequence=1
https://apps.who.int/iris/bitstream/handle/10665/112656/9789241507134_eng.pdf?sequence=1
https://apps.who.int/iris/handle/10665/272948
8/25You spot something.
They're NOT written about Covid-19
Is this why you didn't see them?
They were for MERS, re-rewritten for Jan 26th to serve for #COVID19
You know care home guidelines at the time were poor. So why didn't your predecessor issue these?
9/25It looks to you like the WHO took these same guidelines and republished them AGAIN on March 17th under "covid-19".
You're no virology professional but you can't find anything that would explain why they weren't issued either time.
It makes no sense
So you dig more.
10/25WHO doesn't explain its repackaging but you note 3 things
1. WHO mentions frequently that the document includes evidence from Covid19 cases - almost as if they're underlining it
2. Another big hint is that MERS guidance was an international collaboration. So what?
11/25It's weird. As you read, it's almost as if THEY'RE speaking to YOU
"Stop saying MERS isn't Covid-19, the guidelines are valid
& we've even included evidential links to C-19. Maybe do something about it before you have a massive care home problem? You used to be good!"
12/25There were 3 things:
You pull the WHO's tread - who were the international experts involved in the MERS study?
You find in a different time and place in 2013, one of the most important teams were
ASTONISHMENT
British.
Not in a small way. International experts
13/25But, if we're good at this, why do you have no community medicine?
Why is this all such a mess?
Are they important?
Could they help?
Good questions
Back in 2013, these heroes stopped a MERS epidemic in the UK. And YOU'VE never heard of them.
https://www.eurosurveillance.org/content/10.2807/ese.18.11.20427-en
14/25What did these mystery heroes do in 2013?
+Contact tracing - obsessively
+Airline and airport management ANYONE anywhere near the carrier on planes
+Non-NHS care & PPE management
+Massive community testing
That looks important to you, what happened? You read on.
15/25It started with 1 person visiting the Middle East
He came back, sick, almost died in hospital
That's when heroes got involved
The first person he infected then died
But this team obsessed about the detail
ANYONE who had contact was identified and traced
EVERYONE!
16/25In 2013 it took them a month, contacts of contacts of contacts!
They DIDN'T EVEN HAVE TESTS to start with.
Just good eyes, detailed casework, and an understanding of respiratory infection.
In the end, 200 were tracked down.
Only 3 died
These people knew their stuff!
17/25You pick up your list of scientific advisors, start checking them off
Epidemic
Clinical
Immunology
MicroBiology
Sociology
Psychology
Community/Public Health
You go just a little bit cold.
This looks like a lot of thinkers
But no doers
18/25Of course, you'd seen he Government advice from science, at least the bits the Secretary of State would share. Not the good behind the scenes stuff from Cabinet.
To the extent you could understand, it seemed excellent.
But for one thing. You couldn't judge omissions
19/25You go back to the list, you ask yourself, what does this Government group of scientists do well?
Predict viral danger and spread
Know how it's going to affect the NHS
Have some insights into likely behaviour of an unknown bug
And how people will react and behave
20/25What about "less well"?
Community management
Preventative testing and contact tracing
Border management
Non-NHS care
Community death statistics
You bring up the 2013 MERS list.
Crap
What, like
EVERYTHING
WE
ARE
DOING
WRONG?
Like a jigsaw, one piece missing
21/25To you and me, this is a Godsend. Lives saved.
As a Minister, you're aware enough to know that solutions that identify huge Government failings but are too late to solve aren't solutions at all.
The secretary will need a scapegoat.
OBS - You reach for your EU file
22/25Crap. They produced extensive documentation on exactly these issues
AND it's from the part of the EU that you've just been arguing you need to leave, even when everyone in medicine said you shouldn't.
#BREXIT always makes things worse
https://www.ecdc.europa.eu/sites/default/files/documents/Public-health-management-persons-contact-novel-coronavirus-cases-2020-03-31.pdf
23/25Reluctantly, because you need them, you reach for the selection process. It's a tough call but the rule is it's never the Government's fault.
The scientists do have a role in the selection process, good. BLAME
But RESPONSIBILITY IS DEPARTMENT OF HEALTH.
Crap!
24/25Crap, crap and double crap.
What to do now?
a) Hope to God you solve this before some numbskull on Twitter starts to pull it together?
b) Or we could do the right thing before more die? Admit it. maybe even get that team?
Damn option (B) - never gets picked
25/25I'd like to say this was a one-off - but it's an epidemic in UKGov - over and over again. The "No point looking elsewhere" virus
3 examples of many
Elderly Guidelines
https://twitter.com/atatimelikethis/status/1248593195962904576?s=20
Lockdown Exit
https://twitter.com/atatimelikethis/status/1248669563849527296?s=20
Viral Control https://twitter.com/atatimelikethis/status/1246392991524229123?s=20
I think when I wrote this there may have been some scepticism about us previously being world leading at viral control.
So from the horses mouth, so to speak - direct quote is at 1.30 but the whole commentary essentially reflects this thread. https://twitter.com/shady_inf0/status/1251887193754406913?s=20
So from the horses mouth, so to speak - direct quote is at 1.30 but the whole commentary essentially reflects this thread. https://twitter.com/shady_inf0/status/1251887193754406913?s=20
