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Jan 24, 2020 13 tweets 10 min read Read on X
New pre-print by myself & @mandl:

Early basic reproduction number estimates for #nCoV2019 range from 2.0 to 3.3 (based off of publicly reported confirmed cases through 1/22/20 & subject to change) [ssrn.com/abstract=35246…].

Short explainer & several caveats in the thread below.
@mandl The basic reproduction number (R_0) is a measure of transmissibility that aims to describe the average number of people a new case *in a fully susceptible population* will infect. (Most of the time, this number isn’t actualized thanks to interventions as simple as hand-washing.)
@mandl Today, the @WHO reported their own estimates (though I haven't seen the methods yet), which were R_0 = 1.4 to 2.5. Their estimates are within the bounds of those we obtained on 1/18/20 (as shown in Panel B of the figure above); our estimates skew slightly higher by 1/22/20.
@mandl @WHO (There are many possible reasons for this slight difference, but I can't say for sure until I've seen the methods used by WHO researchers. Needless to say, the overlap should be encouraging given that we used public data and [I assume] they had access to more info than we did!)
@mandl @WHO For the related #SARS-Coronavirus, estimates for R_0 range from 2-5, so our early estimates for #nCoV2019 (though very preliminary) shouldn’t come as too much of a surprise. That said, they’re likely to fluctuate (perhaps considerably so) as more data (and info) become available.
@mandl @WHO The model we’ve used for our R_0 estimate is phenomenological, which means that it doesn’t aim to *explain* what’s happening on the ground but rather to *describe* it. This is a good option in information-scarce situations, like at the start of a novel viral outbreak (AKA now).
@mandl @WHO However, *because* we’re at the start of a novel viral outbreak, there are a number of critical assumptions we had to make to run the model. The first is that human-to-human transmission is happening in a meaningful way, which the WHO has already suggested (and the data agree).
@mandl @WHO The second is that the average time between two consecutive #novelcoronavirus cases in a chain of transmission – the serial interval – is similar to the related #MERS-CoV & #SARS-CoV. (We made this assumption because we don't know what the serial interval for #nCoV2019 is yet.)
@mandl @WHO The third is that the cumulative case count data that have been made publicly available so far are reasonably accurate. Thankfully if this assumption is wrong, we can easily recalibrate the model to reassess the situation... Which is exactly what we intend to do moving ahead.
@mandl @WHO As more information becomes available, we fully intend to report changes to our estimates as publicly and transparently as possible. This early in an outbreak, preliminary estimates like ours may be useful for decision-making but should be considered fluid and ever-shifting.
@mandl @WHO I bet I’ll have more thoughts later, which I’ll add to this thread. However, for now: please be advised that this work is a *pre-print*. This means that it has not yet undergone peer review and as a result, our findings should be treated as provisional. Thank y'all! [/fin]
As promised, I’m back! Overnight, @C_Althaus and his team shared their own R_0 estimates using stochastic simulations (which is a method very different from ours). With this in mind especially, I’m very encouraged that our results are so similar. This is open science at work.
Another day, another update to this thread! Yet another R_0 estimate is out (with yet another set of methods), yielding mean results (~2.6) similar to those reported by both our team and Christian’s team. Useful summary thread too. Work by @MRC_Outbreak, including @neil_ferguson.

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More from @maiamajumder

Feb 20, 2022
I wish we were monitoring (and reporting on) statistics about Long COVID the way we are about deaths.

Death isn't the only clinically relevant outcome of COVID, and our public health surveillance systems need to reflect that.
I know this is a challenging task—but taking into account existing (patient-centered) definitions of Long COVID, point estimates of its prevalence, & risk factors for its emergence, I think it should be possible to produce (spatiotemporally dynamic) nowcasts for public awareness.
Models are imperfect, but FWIW, we use similar strategies to monitor & nowcast flu during flu season. Because most folks who get the flu don’t seek care for it (& thus aren’t recorded as having flu in the healthcare system), we use models to estimate infections over time & space.
Read 5 tweets
Jan 2, 2022
Even if you’re not at high risk of hospitalization from omicron, the people you come in contact with might not be so lucky—& overburdened hospitals translate to poorer outcomes, no matter what you’re in for… Including accidents, heart attacks, & other common non-COVID ailments.
If you’re feeling under the weather (& can afford to do so), please get tested if possible & stay home if you test positive. Wear a well-fitting mask (KF94/KN95/etc.) while in (public) indoor spaces. Try to socialize outdoors when feasible, & if you must be indoors, ventilate!
I know that people have had to make a lot of sacrifices since 2020; my colleagues & I are people, so we’ve had to make sacrifices, too. Because of this, I’m not asking anyone to stop living their lives. I’m just asking us all to try & live them a little safer. Every bit helps.
Read 5 tweets
Dec 31, 2021
I’m an outbreak epidemiologist.

Much like 2020, I spent 2021 responding to COVID.

But I also met a creative milestone:

In 2021, I wrote my first novel—about a lady plague doctor in 17th century Mughal India.

(High-stakes science meets court intrigue & romance!)

THREAD 1/
This is a big achievement for me—something I never dreamed I could do. But last year, I committed to making more space for my creative pursuits, & I’m proud of myself for seeing it through.

11 readers have given me feedback so far, & I've been truly moved by their reviews.

2/
Needless to say, working on this story has helped me immensely in coping with my professional responsibilities, & I’m so fortunate to have had the support in my personal life to be able to tell it—both for my own sake & for readers who might be seeking this kind of narrative.

3/
Read 6 tweets
Jul 16, 2021
As more folks get #vaccinated, the % of folks who get sick with #COVID19 & happen to be vaccinated will increase. This is expected (at rates that my team & others are monitoring), & it doesn't mean that #vaccines aren't working; rather, it reflects the realities of probability.
A few of y’all have asked for clarification about the math here. I may get around to doing a more comprehensive thread, but for now, the easiest way to understand this is in the extreme situation where 100% of Population A is vaccinated & a sick person visits from Population B.
Because the vaccines we have aren’t 100% effective, a fraction of Population A is still susceptible when the visitor from Population B comes on by. In such a situation, ~100% of folks who subsequently get sick in Population A (via the sick visitor) will have been vaccinated.
Read 4 tweets
Dec 31, 2020
2020 has been a tough year for pandemic responders & scientists, but I am extraordinarily proud of my team.

Here’s a thread of quote-tweets that compiles some of our #COVID19-related work since January 2020.

Please join me in celebrating my amazing trainees & colleagues!

1/X
Read 29 tweets
Dec 4, 2020
As an introverted (& socially anxious) pandemic responder, it’s been hard for me to maintain social ties with folks beyond my family & colleagues — not because I don’t want to, but because I need time alone to recharge between seemingly endless Slack messages & Zoom meetings. 1/X
Due to the nature of the job, the amount of person-to-person interaction I’ve had professionally since January has been increasingly overwhelming for someone like me... So, by the time virtual trivia night comes around each week, I’m usually too Zoom’d out to join my buddies. 2/X
But here’s the thing: please keep inviting me. Please don’t cancel me & others like me. We love you & care about you, even if every spare minute we have right now is dedicated to trying to recuperate (& to grieve) in between the demands of our professional responsibilities. 3/X
Read 4 tweets

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