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A thread on Public Health. Prior to #COVID19 there wasn& #39;t a great awareness among most people about #PublicHealth as a Medical Speciality. I don& #39;t mean any disrespect in saying that, it& #39;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& #39;ll try not to be too much of a boring academic! 
https://abs.twimg.com/emoji/v2/... draggable="false" alt="🙈" title="See-no-evil monkey" aria-label="Emoji: See-no-evil monkey"> I& #39;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 https://abs.twimg.com/emoji/v2/... draggable="false" alt="👏🏻" title="Clapping hands sign (light skin tone)" aria-label="Emoji: Clapping hands sign (light skin tone)">https://abs.twimg.com/emoji/v2/... draggable="false" alt="❤" title="Red heart" aria-label="Emoji: Red heart">https://abs.twimg.com/emoji/v2/... draggable="false" alt="💪🏻" title="Flexed biceps (light skin tone)" aria-label="Emoji: Flexed biceps (light skin tone)"> #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?https://abs.twimg.com/emoji/v2/... draggable="false" alt="🤷🏻♀️" title="Woman shrugging (light skin tone)" aria-label="Emoji: Woman shrugging (light skin tone)"> Wrong! https://abs.twimg.com/emoji/v2/... draggable="false" alt="🤦🏻♀️" title="Woman facepalming (light skin tone)" aria-label="Emoji: Woman facepalming (light skin tone)"> #PublicHealth is actually our first line of defence against issues like the #TrolleyCrisis https://abs.twimg.com/emoji/v2/... draggable="false" alt="🏥" title="Hospital" aria-label="Emoji: Hospital"> 8/25
Much of #PublicHealth is about forward planning and future-proofing but in the case of a #pandemic like this one it& #39;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& #39;s all about timing https://abs.twimg.com/emoji/v2/... draggable="false" alt="⏳" title="Hourglass with flowing sand" aria-label="Emoji: Hourglass with flowing sand"> #Shutdown too EARLY and #complacency and #CabinFever sets in #EmergencyFatigue (E.g. #Antilockdown protestors in the #USA) Implement #StayHome https://abs.twimg.com/hashflags... draggable="false" alt=""> too LATE and #COVID19 has already spread - it& #39;s tricky! https://abs.twimg.com/emoji/v2/... draggable="false" alt="🤔" title="Thinking face" aria-label="Emoji: Thinking face"> 10/25
#Shutdown too EARLY and #complacency and #CabinFever sets in #EmergencyFatigue (E.g. #Antilockdown protestors in the #USA) Implement #StayHome https://abs.twimg.com/hashflags... draggable="false" alt=""> too LATE and #COVID19 has already spread - it& #39;s tricky! https://abs.twimg.com/emoji/v2/... draggable="false" alt="🤔" title="Thinking face" aria-label="Emoji: Thinking face"> 10/25" title=" #PublicHealth is a delicate balancing act and it& #39;s all about timing https://abs.twimg.com/emoji/v2/... draggable="false" alt="⏳" title="Hourglass with flowing sand" aria-label="Emoji: Hourglass with flowing sand"> #Shutdown too EARLY and #complacency and #CabinFever sets in #EmergencyFatigue (E.g. #Antilockdown protestors in the #USA) Implement #StayHome https://abs.twimg.com/hashflags... draggable="false" alt=""> too LATE and #COVID19 has already spread - it& #39;s tricky! https://abs.twimg.com/emoji/v2/... draggable="false" alt="🤔" title="Thinking face" aria-label="Emoji: Thinking face"> 10/25" class="img-responsive" style="max-width:100%;"/>
For some reason, unlike other medical specialities #PublicHealth is a free-for-all and everyone has an opinion. Personally I don& #39;t think clinicians, who are leaders in their own fields, but who don& #39;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& #39;s a different kettle of fish https://abs.twimg.com/emoji/v2/... draggable="false" alt="🐟" title="Fish" aria-label="Emoji: Fish"> 12/25
I& #39;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& #39;s expertise in the oncology field not be questioned? https://abs.twimg.com/emoji/v2/... draggable="false" alt="🤔" title="Thinking face" aria-label="Emoji: Thinking face"> #StayInYourLane 13/25
Everyone is entitled to their opinion but I don& #39;t think it& #39;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& #39;m having a rant here https://abs.twimg.com/emoji/v2/... draggable="false" alt="😜" title="Winking face with tongue" aria-label="Emoji: Winking face with tongue">Non-experts contributing their own modelling graphs without being familiar with the intricacies of #epidemiology is really not helpful https://abs.twimg.com/emoji/v2/... draggable="false" alt="🤦🏻♀️" title="Woman facepalming (light skin tone)" aria-label="Emoji: Woman facepalming (light skin tone)"> #ArmchairEpidemiologist #PublicHealth 15/25
Non-experts contributing their own modelling graphs without being familiar with the intricacies of #epidemiology is really not helpful https://abs.twimg.com/emoji/v2/... draggable="false" alt="🤦🏻♀️" title="Woman facepalming (light skin tone)" aria-label="Emoji: Woman facepalming (light skin tone)"> #ArmchairEpidemiologist #PublicHealth 15/25" title="Also while I& #39;m having a rant here https://abs.twimg.com/emoji/v2/... draggable="false" alt="😜" title="Winking face with tongue" aria-label="Emoji: Winking face with tongue">Non-experts contributing their own modelling graphs without being familiar with the intricacies of #epidemiology is really not helpful https://abs.twimg.com/emoji/v2/... draggable="false" alt="🤦🏻♀️" title="Woman facepalming (light skin tone)" aria-label="Emoji: Woman facepalming (light skin tone)"> #ArmchairEpidemiologist #PublicHealth 15/25" class="img-responsive" style="max-width:100%;"/>
Ya really gotta love the #ArmchairEpidemiologist brigade https://abs.twimg.com/emoji/v2/... draggable="false" alt="🙈" title="See-no-evil monkey" aria-label="Emoji: See-no-evil monkey"> I& #39;ve never been #Mansplained to as much in my entire life! https://abs.twimg.com/emoji/v2/... draggable="false" alt="😂" title="Face with tears of joy" aria-label="Emoji: Face with tears of joy"> #DunningKrugerEffect 16/25 https://bit.ly/2RZI5vj ">https://bit.ly/2RZI5vj&q...
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! https://abs.twimg.com/emoji/v2/... draggable="false" alt="👏🏻" title="Clapping hands sign (light skin tone)" aria-label="Emoji: Clapping hands sign (light skin tone)">https://abs.twimg.com/emoji/v2/... draggable="false" alt="❤" title="Red heart" aria-label="Emoji: Red heart">https://abs.twimg.com/emoji/v2/... draggable="false" alt="💪🏻" title="Flexed biceps (light skin tone)" aria-label="Emoji: Flexed biceps (light skin tone)"> E.g. Our PHN runs a fab Mother & Baby group which all of us #NewMammies really miss https://abs.twimg.com/emoji/v2/... draggable="false" alt="🙁" title="Slightly frowning face" aria-label="Emoji: Slightly frowning face"> #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 https://abs.twimg.com/emoji/v2/... draggable="false" alt="🤮" title="Face vomiting" aria-label="Emoji: Face vomiting"> e.g. E. coli 20/25
So here& #39;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 ">https://bit.ly/3bnyINx&q...
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& #39;s also reflected in their salary! Specialists are paid less than consultants! https://abs.twimg.com/emoji/v2/... draggable="false" alt="💶" title="Banknote with euro sign" aria-label="Emoji: Banknote with euro sign"> 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& #39;re interested in learning more about #PublicHealth I would highly recommend following these experts https://abs.twimg.com/emoji/v2/... draggable="false" alt="👏🏻" title="Clapping hands sign (light skin tone)" aria-label="Emoji: Clapping hands sign (light skin tone)">https://abs.twimg.com/emoji/v2/... draggable="false" alt="❤" title="Red heart" aria-label="Emoji: Red heart">https://abs.twimg.com/emoji/v2/... draggable="false" alt="💪🏻" title="Flexed biceps (light skin tone)" aria-label="Emoji: Flexed biceps (light skin tone)"> @publichealthie @hpscireland @CMOIreland @ronan_glynn @GabrielScally @PublicHealthMW @marietcasey @PublicHealthUL @elmusharaf1 @NICU_doc_salone @nick_eichler 25/25
