Lower the Baseline

UK healthcare systems may better manage the COVID-19 epidemic if we lower the baseline demands on our NHS. Group of UK doctors & public health professionals.

[Lower the Baseline @lower_baseline]

Nine days on from @bmj_latest opinion by @R_Hughes1 @sunilbhop @guppikb @abhopal_1 @AnyaGopfert we can't wait to share our next steps

https://t.co/LTzpdBRKp1

Meantime, look what individuals, health authorities, and governments around 🌎 are doing to #LowerTheBaseline 👇🏾👇🏾👇🏾

[Lower the Baseline @lower_baseline]

#COVID19 is overwhelming health systems – wondering how to protect our #NHS and staff on the frontline? Do we need these radical measures to #FlattenTheCurve & #ScaleUpCriticalCare? YES. And we may need much more 👇👇 (1/17)

[Rob Hughes @R_Hughes1]

@globalhlthtwit A few of us have suggested these sort of ‘emergency public health’ interventions for the UK and beyond too. Check out @lower_baseline.

[Clare Wenham @clarewenham]

Interesting ideas

[Rob Hughes @R_Hughes1]

@ProfKevinFenton @lower_baseline @20splentyforus Or how about emergency winter fuel payments to vulnerable older people?

Or emergency curbs on air pollution from wood burners and construction?

https://t.co/ceHOKw9fb3

[Rob Hughes @R_Hughes1]

@ProfKevinFenton @lower_baseline @20splentyforus Or controls to alcohol sales?

In 🇿🇦, albeit combined with curfew, this radically reduced trauma admissions 👇

[Rob Hughes @R_Hughes1]

@ProfKevinFenton @lower_baseline E.g. emergency speed restriction to @20splentyforus across London?

The only people who need to rush in lockdown are 🚑 🚓 🚒. And last lockdown saw big rise in speeding.

[Rob Hughes @R_Hughes1]

@ProfKevinFenton 🙁 I’m not sure if this has been considered yet, but alongside all the other measures might some “emergency public health” policies help to lower non-COVID demands on the NHS? See @lower_baseline 👇

[Lower the Baseline @lower_baseline]

@SadiqKhan - hospitals, especially critical care beds, are under immense pressure.

Please consider:
- emergency @20splentyforus across London
- ban wood burning except for those who have no other source of heating
- emergency winter fuel payments for vulnerable
- and more...

[Catherine Draper @DrCathD]

@R_Hughes1 South Africa is an example of where this is currently being done (plus 9pm-6am curfew) and had empty trauma units on New Years in many major health facilities. @profparry is a good person to follow on the science behind it!

[Rob Hughes @R_Hughes1]

worth noting that @harryrutter @guppikb @sunilbhop @ADMBriggs @abhopal_1 @AnyaGopfert I and others have been (largely unsucessfully) suggesting this for 9 months now... 🤷

https://t.co/fxw4vGRkmm

[Rob Hughes @R_Hughes1]

Isn't it time that we (belatedly) looked at some emergency public health interventions like 20mph speed limits in cities, and controls to alcohol sales to reduce the pressure on the NHS? @lower_baseline

[Lower the Baseline @lower_baseline]

@onisillos That said, the principle still stands. Right now, the cost/benefit on a whole host of public health interventions is very different to that a year ago.

[Lower the Baseline @lower_baseline]

Is anyone else feeling a sense of deja vu!?

Dear @PHE_uk @MattHancock @Jeremy_Hunt, this is still a viable way to relive some pressure on @NHSEngland.

Measures like a nationwide emergency @20splentyforus will help to reduce emergency admissions.

[space for gosforth @space4gosforth]

@NewCycling There have been some really shocking reports over the weekend. The @lower_baseline message from earlier this year about safe driving to help the NHS clearly needs repeating.

[Lower the Baseline @lower_baseline]

@onisillos That said, the principle still stands. Right now, the cost/benefit on a whole host of public health interventions is very different to that a year ago.

[Lower the Baseline @lower_baseline]

@onisillos Good question. I think some of the reasons are:
- tunnel vision (missed)
- not enough numbers, even rough modelled ones
- other measures started to work, and we failed to see the bigger - longer term - picture

Oh, and we were all doing this alongside other jobs etc.

[Lower the Baseline @lower_baseline]

South Africa implemented strict controls on alcohol too, and violence related admissions fell. These things require creativity and ambition, but can be done.

[Lower the Baseline @lower_baseline]

These are still relevant. Before they effectively eliminated #covid, @IOMGovernment implemented an island wide 40mph limit to protect their ITU beds.

[Lower the Baseline @lower_baseline]

What could Governments do?

- Reduce speed limits

- Unprecedented stop smoking for #COVID19 campaign - with FREE nicotine replacement therapies for all

- Extend winter fuel allowance for the >70 year olds

- TV-based home exercises

- Extend minimum unit alcohol pricing (5/17)

[Lower the Baseline @lower_baseline]

Please also look into this @IndependentSage @globalhlthtwit @devisridhar @theAliceRoberts. The cost/benefit ratios on lots of public health interventions are changed. We need to be creative.

[Lower the Baseline @lower_baseline]

Is anyone else feeling a sense of deja vu!?

Dear @PHE_uk @MattHancock @Jeremy_Hunt, this is still a viable way to relive some pressure on @NHSEngland.

Measures like a nationwide emergency @20splentyforus will help to reduce emergency admissions.

[Lower the Baseline @lower_baseline]

#COVID19 is overwhelming health systems – wondering how to protect our #NHS and staff on the frontline? Do we need these radical measures to #FlattenTheCurve & #ScaleUpCriticalCare? YES. And we may need much more 👇👇 (1/17)

[Lower the Baseline @lower_baseline]

@Dr_D_Robertson We agree.