Thread by @CumminsNM, A thread on Public Health. Prior to #COVID19 there wasn't a great [...]

A thread on Public Health. Prior to #COVID19 there wasn't a great awareness among most people about #PublicHealth as a Medical Speciality. I don't mean any disrespect in saying that, it's an observation, not a criticism, from someone working in the field #Coronavirusireland 1/25

For the record, I work as a researcher (not a #PublicHealth clinician) so this is just my perspective #PublicHealthUL Originally a #scientist my research career began in #HealthBehaviour but my work now focuses on #EmergencyMedicine particularly #Prehospital Care #MyEMSday 2/25

I think a few definitions are in order here but I'll try not to be too much of a boring academic!

I've already mentioned #HealthBehaviour - this is basically any action that promotes health or prevents illness e.g. #Exercise #Diet #Vaccinations @PAfH_UL @PublicHealthUL 3/25

So what is the actual definition of #PublicHealth? It is the #science of protecting and improving the #health of #communities Public Health is often used interchangeably with #Epidemiology which is actually a subspeciality (or a #quantitative tool for action) #COVID19 4/25

#Epidemiology is the study and analysis of the distribution (frequency & pattern) and determinants of #disease. It is #scientific, systematic and data-driven #PublicHealthUL #COVID19 #Coronavirusireland 5/25

Like any good TV show we need a celeb right? So who is "famous" in #PublicHealth in Ireland? Ever heard of the #ScallyReport? Prof. Scally is a legend in the field

#CervicalCheck @GabrielScally @PhelanVicky 6/25

Much of #PublicHealth focuses on #prevention rather than cure so when it comes to funding etc it can be all too easy for policy makers to put it on the backburner #COVID19 #Coronavirusireland 7/25

After all there are more pressing issues at hand like our #EmergencyDepartments being overwhelmed right?

Wrong!

#PublicHealth is actually our first line of defence against issues like the #TrolleyCrisis

8/25

Much of #PublicHealth is about forward planning and future-proofing but in the case of a #pandemic like this one it's also very responsive. Decisions are made day-by-day based on the most up to date #COVID19 #research and statistics #FollowTheEvidence 9/25

#PublicHealth is a delicate balancing act and it's all about timing

#Shutdown too EARLY and #complacency and #CabinFever sets in #EmergencyFatigue (E.g. #Antilockdown protestors in the #USA) Implement #StayHome

too LATE and #COVID19 has already spread - it's tricky!

10/25

#PublicHealth is a delicate balancing act and it's all about timing #Shutdown too EARLY and #complacency and #CabinFever sets in #EmergencyFatigue (E.g. #Antilockdown protestors in the #USA) Implement #StayHome too LATE and #COVID19 has already spread - it's tricky! 10/25

For some reason, unlike other medical specialities #PublicHealth is a free-for-all and everyone has an opinion. Personally I don't think clinicians, who are leaders in their own fields, but who don't have expertise in #PublicHealth should be given sooooo much airtime 11/25

Specifically I mean with regard to commenting on #PublicHealth policy. Obviously it is appropriate for clinicians to discuss the impact of #COVID19 on their own patients & their field. But when it comes down to criticising #NPHET policy that's a different kettle of fish

12/25

I'll put it this way... Would it really be acceptable for a cardiologist to roundly criticise an oncologist about cancer care and policy on national TV? In that scenario would the cardiologist's expertise in the oncology field not be questioned?

#StayInYourLane 13/25

Everyone is entitled to their opinion but I don't think it's constructive to muddy the waters with opinions of non-experts in the media during a #Pandemic when there is already so much uncertainty re. #COVID19 We should be quelling public fear not inciting it! #MentalHealth 14/25

Also while I'm having a rant here

Non-experts contributing their own modelling graphs without being familiar with the intricacies of #epidemiology is really not helpful

#ArmchairEpidemiologist #PublicHealth 15/25

Also while I'm having a rant here Non-experts contributing their own modelling graphs without being familiar with the intricacies of #epidemiology is really not helpful #ArmchairEpidemiologist #PublicHealth 15/25

Ya really gotta love the #ArmchairEpidemiologist brigade

I've never been #Mansplained to as much in my entire life!

#DunningKrugerEffect 16/25 https://bit.ly/2RZI5vj

The Rise of COVID-19 Influencers and Armchair Epidemiologists - InsideHook

David Dunning, an emeritus professor at the University of Michigan, talks with InsideHook about armchair epidemiologists and coronavirus influencers.

https://bit.ly/2RZI5vj

On a more serious note our #PublicHealth experts are already looking to the future and the fall-out from the #COVID19 pandemic. Particularly with regard to #economic considerations 17/25

Sadly there will be widespread #PublicHealth implications of the #unemployment levels due to #COVID19 - increased rates of #poverty with all the associated knock-on effects #Healthcare #Housing #MentalHealth #Suicide #DrugAddiction #HealthBehaviour etc #CascadeEffect 18/25

So in terms of the day-to-day work of #PublicHealth professionals many people are familiar with their local #PublicHealthNurse (PHN) who do great work in the community!

E.g. Our PHN runs a fab Mother & Baby group which all of us #NewMammies really miss

#COVID19 19/25

While the concept of #ContactTracing is new to most people our #PublicHealth doctors actually do it every day for notifiable infectious diseases from the "less serious" such as #Measles & #STD right up to the scarier ones like #Smallpox! Also #FoodPoisoning

e.g. E. coli 20/25

So here's an excellent article about the work of our Irish #PublicHealth experts with a great explanation of the #ContactTracing process. 21/25 https://bit.ly/3bnyINx

Coronavirus: The inside story of Ireland’s contact tracing operation

Public servants are making 2,000 calls a day to monitor and tackle the spread of Covid-19

https://bit.ly/3bnyINx

One item of note throughout the article. In Ireland our #PublicHealth doctors at the very highest level are referred to as "Specialists" unlike other medical fields where the title of "Consultants" is officially in use 22/25

Not only do these #medical experts not receive recognition for their years of training by their title but for some reason it's also reflected in their salary! Specialists are paid less than consultants!

Why? @SimonHarrisTD #Discrimination #CareCantWait @ProfPayEquality 23/25

I personally know #PublicHealth doctors who are currently working long, hard shifts, missing their families & putting themselves at risk. They are absolutely #FrontlineHeroes & I hope they will be recognised as such so working conditions can improve for them post #COVID19 24/25

If you're interested in learning more about #PublicHealth I would highly recommend following these experts

@publichealthie @hpscireland @CMOIreland @ronan_glynn @GabrielScally @PublicHealthMW @marietcasey @PublicHealthUL @elmusharaf1 @NICU_doc_salone @nick_eichler 25/25

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