I've already been waiting 6 years for something very simple in outpatients!

if we had not closed half our or general and acute beds
if we did not have the 2nd lowest bed base per 1000 in the OECD
if those beds were not full of people waiting community services but fit to leave
if we had not decimated public health, primary care and community nursing
no crisis to see

On the 12th day of Xmas my true love gave to me: 12 drummers drumming, 11 pipers piping, 10 lords-a-leaping, 9 ladies dancing, 8 maids-a-milking, 7 swans-a-swimming, 6 geese-a-laying, 5 GOLD RINGS, 4 calling birds, 3 French hens, 2 turtle doves, and a partridge in a pear tree. What's for dessert?

19. Put it this way, countries in SE Asia have embraced this philosophy for good reasons, as
@globalhlthtwit.bsky.social
rightly points out, relentlessly.
They coped with SARS1, SARS2, avian flu, Nipah, etc...they know their onions! Just compare the death rates, folks.
20. Immunity debt, no.

18. Needless to say, the Healthcare/NHS IPC refusal to act against airborne infections is a nonsense. People would be less upset if you admitted your mistake, apologised, and took action now.
Reintroducing mask mandates, too late, wrong masks, and piecemeal just compounds this.

17. Think "Swiss Cheese" - no single measure is enough on its own, no single person will effect change at scale. BUT, individual acts can have both good and bad consequences.
Balance risk, vax status, time spent, ventilation, the activity in question, and who else is there...

16. What we need is information regarding risk (ventilation ratings, prevalence, etc) and to drop the ridiculous persecution of those who act to both protect themselves and others.
This is a trivial act, a minor inconvenience, you don't know who you're sitting next to on the bus.

14. The narrative that "masks don't work" not only denies physics, but is clearly biased towards fatalism, individualism, and libertarianism. How convenient to have something you don't like rubbished by "experts"...I mean, come on folks...
15. We don't mostly need "mandates"...

11. Airborne viruses include, but are not limited to: SARS2, influenza, RSV, measles virus, M-Pox (likely)...
12. Yes, virus particles are smaller than mask pore sizes, but aerosol particles are NOT.
13. Masks aren't sieves, they r multi-layered & chemically/physically optimised.

9. Respirator (FFP2/3) masks, well fitted, DO protect the wearer as well as exerting source control. Surgical masks and, to a very limited extent, "face coverings" will restrict/protect from droplet-borne viruses.
10. Airborne transmission means FFP2/3 masks are gold standard.

7. Specifically, mask RCTs are inherently flawed, source control must be considered alongside protection.
8. RCTs can't account for complex behaviour.
8. Meta-analyses & systematic reviews are defined by their selection criteria, study weighting, and evidence hierarchy/idolatry.

6. Masks are key NPIs, all the more critical due to lack of clean air.
7. Respecting the impact of infection on fellow human beings and awareness of NHS capacity is not "panic".
8. Awareness that millions of vulnerable folks don't have reasonable adjustments is also not "panic".

2. COVID now adds to disease burden in an unpredictable, perennial way.
3. We maddeningly restrict access to vaccines without considering the wider and long-term costs of disease.
4. Nothing has been done nationally to improve indoor air quality.
5. Vaccines and NPIs synergise.