"What is the cost of lies?

It is not that we will mistake them for the truth.

The real danger is that if we hear enough lies, then we will no longer recognise the truth at all."

The first words spoken in HBO's Chernobyl but somehow strangely relevant right now.

The Vice President who built his political identity on a fabricated story about immigrants eating pets in an Ohio city of 60,000 people, then watched bomb threats shut that city down for weeks, is now very concerned about the quality of American political discourse. Noted. The debate he wants to have freely and openly is the one where nobody brings receipts.

We are so fucked. And I don't mean Ukraine.

@sib313 @Frank9478968518 @mancunianmedic @hannahmary31 @MFAminGP @DrSteveTaylor @HSJnews @parthaskar Longer LOS
Higher Morbidity
Higher mortality
More nurses needed to staff the corridor 1:6
12 hour breaches need meals and further care

@higherutleyI@sib313d@Frank9478968518 @DrJoFranklinh@mancunianmedicy@MFAminGPn@DrSteveTaylor @HSJnewsf@parthaskarst seen in the whole picture, which seems to be rarely used when cuts and efficiencies are planned, or a certain type of manager comes in who wants to be seen to ‘make a change’ for career progression reasons.

@mancunianmedic @hannahmary31 @MFAminGP @DrSteveTaylor @HSJnews @sib313 @parthaskar Been banging this drum for a decade+. If the silo perspective is maintained, any local gains in productivity are to be absorbed/void by the broader issues. Perhaps the focus ought to be on function rather than org silo?
Nice thread BTW and agree.

@MaryBowdenMDhis graph has a fundamental methodological problem.

It labels its outcome “sudden cardiac death,” yet includes death certificates mentioning atrial fibrillation, cardiac murmurs, cardiac arrest, unspecified circulatory symptoms, and ill-defined causes of death. Those are not interchangeable diagnoses of sudden cardiac death.

It also reports deviations from a modeled baseline, not independently verified, population-adjusted incidence rates.

And where is the vaccination-status linkage? Without it, how can the graph distinguish vaccination from infection, changing death certification, or other factors?

Vaccine-associated myocarditis is real and deserves serious investigation. But converting a heterogeneous collection of death-certificate codes into a seven-sigma claim of vaccine-associated cardiac mortality is not sound epidemiology.

Large population-based studies examining vaccination and mortality directly have not demonstrated the widespread increase this graph implies.

The statistical presentation may be impressive. The causal evidence is not.

"My daughter caught measles when she was seven. I remember not feeling particularly alarmed about it.

Then one morning she said, 'I feel all sleepy,' and she went into a coma. In an hour, she was unconscious. In twelve hours she was dead."

Roald Dahl on his daughter Olivia

@DrKellyVictoryn@SecKennedyu are misrepresenting the evidence — WHO claims no such thing — you are simply referring to two case reports in 2022 that are among many papers on their website that raises the possibility — but later studies failed to show any increased risk of MS after COVID vaccines.

Sorry but the scientific evidence doesn’t support most of your repeated narratives, and you are still making unsubstantiated claims misrepresenting evidence that earn the labels some make on you.

You are playing for a captive audience but any objective person who considers the available evidence themselves can see through your claims.

This is exactly how anti-vaxxers manufacture misinformation.

They take one tiny grain of truth, wrap it in an enormous wad of complete bullshit, and inject it straight into the veins of a conspiracy-addicted audience hungry for anything that confirms their beliefs.

Here’s the awarded its 2027-2028 COVID vaccine contract to a protein-based vaccine, instead of the mRNA vaccine it’s primarily using for the current and prior seasons.

Now here’s the bullshit:

The claim that Sweden is abandoning mRNA technology because of autoimmune reactions, uncontrolled spike protein production, serious adverse effects, and deaths.

What none of these anti-vaxxers will bother to read are the actual Swedish announcements and procurement documents.

They say NOTHING of the sort.

ALL of the bullshit you see on screen comes from the Dutch anti-vaccine website that took one legitimate fact, wrapped it in its own anti-mRNA propaganda, and packaged it for an audience of science deniers eager to swallow it whole.

So what did Sweden actually do?

It conducted a competitive procurement process that evaluated vaccines based on price and quality, specifically refrigerated shelf life. Those are the documented evaluation criteria, with absolutely no finding that mRNA vaccines were dangerous or responsible for the medical disasters alleged in this article.

And here’s the particularly revealing part:

Sweden’s official procurement system STILL lists Pfizer and Moderna as qualified suppliers for future COVID vaccine contracts.

Sweden is also using Pfizer’s mRNA vaccine for its current vaccination campaign.

So where exactly did the claims about autoimmune disease, uncontrollable spike proteins, and widespread vaccine injuries come from?

The anti-vaccine website. Not Sweden.

And that’s how this misinformation machine works.

Start with a fact. Bury it under a mountain of bullshit. Present the whole package as an official revelation.

Then watch thousands of people share it without ever checking what the original source actually said.

They don’t need the story to be true. They just need their audience to believe it.

Besides being nakedly racist and bigoted, this is just hilariously wrong on all levels.

I mean, Omar Yaghi won the Nobel Prize in Chemistry last year, and he won the Wolf Prize in 2018. And that's just one example.

He also said Arabs don't produce any literature. Last year's winner of the National Book Award was Lebanese writer and painter Rabih Alameddine. The winner in non-fiction? Egyptian-American journalist Omar El Akkad.

Mendel's narrative that Ukraine has "rejected" easy peace deals or bears responsibility for the war’s continuation and destruction is disinformation. Here's why:

1. The Istanbul Talks (April 2022)

Claim:

Ukraine was offered a favorable deal in Istanbul to keep its territory (minus Crimea/Donbas) in exchange for neutrality and army reduction, but Zelenskyy unilaterally declined.

Rebuttal:

Demilitarization as a Trap: Russia’s Istanbul demand for a drastically reduced Ukrainian military (capping forces at levels that would leave Ukraine defenseless) was designed to make future invasion effortless. Accepting demilitarization without ironclad security guarantees was an invitation to total conquest down the road.

The Guarantee Catch: Russia demanded a veto over any future collective security response if Ukraine were attacked again. Under Moscow's terms, if Russia invaded a second time, Russia itself would have to agree before any external power could legally intervene to assist Ukraine.

Bucha and Russian War Crimes: The Istanbul talks collapsed primarily due to the discovery of mass atrocities in Bucha, Irpin, and Izium as Russian troops retreated from Kyiv. Russian war crimes demonstrated that "agreements" with Moscow meant surrendering Ukrainian citizens to occupation, torture, and mass graves.

No Real Russian Commitment: Russia never offered a binding, full withdrawal from Kherson, Zaporizhzhia, or Kharkiv during those early talks; Moscow was attempting to consolidate military control while stalling for time after its initial push on Kyiv failed.

2. Late 2022 & The Kherson Liberation

Claim:

After Russian forces withdrew from Kherson city, Ukraine refused a potential ceasefire brokered or suggested by the US to continue the war.

Rebuttal:

Operational Momentum: In late 2022, Ukraine had just scored major strategic victories in Kharkiv and Kherson. Accepting a premature ceasefire would have allowed a severely weakened, retreating Russian military time to entrench, dig extensive defensive lines (which they later did with the Surovikin Line), rearm, and forcibly draft hundreds of thousands of mobilized troops.

Freezing the Conflict Benefits the Aggressor: A ceasefire without Russian withdrawal simply converts temporary frontline positions into de facto borders. Ukraine’s experience from 2014 to 2022 (Minsk I & II) proved that a frozen conflict only gives Russia time to prepare its next offense.

US Policy Alignment: The claim that Zelenskyy single-handedly "persuaded" the US to force Ukraine to fight ignores the fundamental principle repeatedly articulated by international law and Western coalition strategy: "Nothing about Ukraine without Ukraine."

3. Early 2023 "Back-Channel Deal"

Claim:

A deal was on the table to return to pre-February 2022 borders in exchange for neutrality and recognizing Crimea as Russian, but Ukrainian leadership turned it down.

Rebuttal:

Unsubstantiated Fantasy: There is zero official evidence that Vladimir Putin ever agreed to abandon Russia's illegally annexed "four new regions" (Kherson, Zaporizhzhia, Donetsk, Luhansk), which Moscow formally incorporated into the Russian Constitution in September 2022.

Constitutional Reality in Moscow: Following Russia’s formal annexation decree in late 2022, Putin repeatedly insisted that the "new territorial realities" were non-negotiable. Reverting to pre-2022 lines was explicitly ruled out by the Kremlin's public and private declarations.

Rewarding Aggression: Surrendering Crimea formally would validate Russia's aggressive land grabs, violate international law regarding territorial integrity, and leave the Black Sea permanent security threat unaddressed.

4. The July 2024 Energy Ceasefire & Kursk

Claim:

Ukraine disrupted an energy ceasefire mediated via the Middle East by launching the Kursk operation.

Rebuttal:

Asymmetric Warfare and Strategic Initiative: The Kursk offensive was a tactical and strategic necessity designed to relieve pressure on the Eastern front in Donetsk, force Russia to reallocate troops to its own border, create a territorial bargaining chip, and demonstrate that Russia’s border was vulnerable.

Russian Destruction of Energy Grids: Russia began its systematic campaign to destroy Ukraine’s energy infrastructure in the fall of 2022—long before Kursk. Moscow’s attacks on civilian infrastructure were designed to freeze the civilian population into submission, not to negotiate a genuine energy truce in good faith.

Leverage for Peace: A state defending itself against an existential threat cannot rely on unratified, informal promises while its eastern territory is being taken day by day.

5. Blaming the Victim for Destruction and "Degradation"

Claim:

Because Ukraine did not accept Russia's terms, Ukrainian leadership is responsible for the destruction of the country, casualties, and degradation of the state.

Rebuttal:

Shifting Moral and Legal Guilt: Every dead Ukrainian, ruined power plant, and displaced refugee is the direct legal and moral responsibility of the aggressor - the Russian Federation - which launched an illegal, unprovoked full-scale war of conquest. Blaming Ukraine for defending its territory is classical victim-blaming.

Capitulation vs. Survival: Capitulation does not stop human suffering; it merely converts battlefield fighting into mass repression, occupation terror, forced Russification, conscription of Ukrainians into the Russian military, and the elimination of the Ukrainian nation-state.

Summary

The premise of Mendel's narrative rests on the false assumption that Vladimir Putin was acting as a rational actor offering genuine peace in good faith.

Throughout the conflict, Russia’s fundamental goal has remained unchanged: the total political control or subjugation of Ukraine. Ceasefire proposals offered by Moscow under terms of demilitarization and territorial concession are not paths to peace; they are operational pauses designed to secure Russian gains and set up the next phase of conquest. Defending sovereignty against an existential threat is not a choice made out of stubbornness - it is a necessity for survival.

@sib313 @DrSteveTaylor spot on. Key is knowing the REAL reason for delays, have digital tools to mitigate and/or address, but also ensuring that the remainder of the path or patients journey remains clear of other bottlenecks... without the unnecessary bunfights & manual overheads historically endured.

@sib313 @DrSteveTaylor However, reduction in beds causes capacity & flow issues with the back pressure likely felt in A&E + Amb waits and electives = 0sumGame. Which mirrors the issue in addressing symptoms rather than underlying causes.

@sib313 @DrSteveTaylor Assumptions like this - shifting focus onto cost cutting rather than delivering svc are likely to result in RP2PP in that beds & staff are sunk costs. Reducing bed count doesn't reduce cost unless you get rid of them, but does allows staff to cope better with lower bed vol.

@sib313 Don't join NATO and there's a ~23% (3/13) chance of being invaded.

@chadnagleesq The "tyrannical, destructive COVID-19 pandemic policies that included lockdowns, mask mandates, social distancing, and the ruination of countless businesses and livelihoods" happened when Trump was president. They were all gone within 5 months of Biden taking office.

RT @BoveFromAbove: Why the hell would you want to bring back an inferior measuring system that hasn’t been taught in schools for over 50 ye…

@AlexTaylorNews @BrexitBuster I’ve posted this as a reply elsewhere but its worth sharing again x.com/timcast/status…

@AlexTaylorNews Can we bring back typhoid and children chimney sweeps too? Oh and perhaps repeal the Catholic Emancipation Act? They are indeed off their tits

Beds … with the lowest number of hospital beds the NHS continues to cut them

The premise an empty bed cost £. They don’t, they provide flexibility, opportunity to admit someone while another bed is being emptied. Blocked A&E cancelled operations!

NHSE 5000 more permanent beds