Thread by @fascinatorfun

With COVID-19 we are not dealing solely with an acute infection with short-term clinical risks. Much is still unknown about long term implications so the precautionary principle would advocate for taking approaches that minimize this potential risk. mdpi.com/2076-0817/10/1…

“To this end public health policy should focus on significantly reducing community transmission alongside vaccine roll-out. Focusing on hospitalizations and deaths as the only outcomes is short-sighted.”

Relying on post-vaccine infection as an immune ‘booster’ may carry serious risk as such infections can result in increased disease severity [32].

The paper goes on to itemise known risks and why they should be taken seriously in order to reduce transmission

Viral evolution

Thus far the virus has continued to evolve to become fitter, more infectious

High levels of community transmission provide ++opportunities for this

VIRAL OR ANTIGENIC PERSISTENCE.

Possibly persisting in the human gut for up to 4 months, but there’s uncertainty if these particles are viable.

Autopsies suggest persistence of viral RNA.

We need to understand the implications and minimise risks meanwhile.

REINFECTION.

We know it happens but estimates vary from over 20% in one Indian study, far FAR more in an Iranian study, but PHE data puts the number far lower at c23k reinfections.

However community testing in wave one in the U.K. was minimal and the timescale relevant.

Whilst Governments hope that infection post vaccination will be milder and boost immunity there is also evidence in some that, despite previous infection and vaccination, subsequent infections can be severe.

There’s a lot we don’t know.

Prevalence should be reduced whilst we find out.

Another field of risk and uncertainty is IMMUNE DYSREGULATION