Some thoughts on early to mid pandemic dynamics in the US and the UK

Yesterday I criticized the criticism in this (meta!). But it is worth pointing out that this is after the UK gleefully (irresponsibly?) opened pubs on the 4th of July weekend.

theguardian.com/world/2020/aug… 1/n
The UK and the US offer similar models of pandemic response. Both are bad.

In both, leaders have sought to minimize the consequence of the pandemic, suggesting it will go away ‘magically’ or that normality will be resumed ‘by Christmas’. Both have been mugged by the virus 2/n
Let us start with the US which I know best. We have had months of case counts rising which were predictably followed by deaths. And I do mean predictably look at this (quoting me, predicting it )

msnbc.com/rachel-maddow-… 3/n
And here we are. Hospitals overwhelmed, deaths climbing if hopefully plateauing but wait! Here comes the mid west! It is not surprising. But still depressing nymag.com/intelligencer/… 4/nl
In the absence of any coherent federal response to what’s reasonably the most acute global public health emergency in a century, what do you do? We are relying on our local public health depts. I really hope they get better funded after this 5/n (not holding my breath)
There is a characteristic pattern here. The authorities, Tony Fauci and Dr Birx say the reality cnn.com/world/live-new…. 6/n
And then... cnbc.com/2020/07/27/tru… seriously. It's the opposite of how to responsibly handle an emergency. And the opposite of all the good planning @CDCgov did in the past 7/n
Now my dear, possibly smug British followers... in the UK another populist leader asserts it will be over by christmas (ouch! Unfortunate choice of words) theworldwar.org/explore/exhibi… 8/n
Then that it’s other countries’ fault theguardian.com/world/live/202… 9/n
(he says in parentheses theguardian.com/travel/2020/ju… aren't good either) 10/n
Then that is actually the fault of the people that the govt is supposed to represent and supposed to lead and guide through a public health disaster for not 'following the rules' theguardian.com/world/2020/jul… 11/n
I’ve heard smart folks like @Freedland comment that the only reason the UK gov has gotten away with this is that the US is worse. No the US is just bigger, which provides a larger canvas for its unfolding incompetence (some of which reflects deep set govt structures) 12/n
I am not angry with the UK govt for changing course. I am angry for the suggestion that this was not predictable, when it was 13/n
While I am angry with the Trump administration for its failures in pandemic response up to now. I would much rather see some sort of act got together sooner rather than never. Lives do literally depend upon it 14/end

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More from @BillHanage

Feb 21
“It took me a relatively short time in Haiti to discover that I could never serve as a dispassionate reporter or chronicler of misery. I am only on the side of the destitute sick and have never sought to represent myself as some sort of neutral party.” Dr Paul Farmer. 1959-2022
I saw rumours of the loss of Paul Farmer early this morning, and sadly they have been confirmed. I know so many who have been inspired by his example nytimes.com/2022/02/21/obi…
He also wrote beautifully about the ugly subject of inequities in healthcare. Read this on “Stupid deaths” (incidentally every time I am on Huron ave I think of this piece, for reasons that will be obvious) lrb.co.uk/the-paper/v37/…
Read 4 tweets
Feb 16
Vaccines that protect against severe illness and death have been available for more than a year. In this we estimate conservatively that in the US ~135,000 lost their lives to covid over the Delta wave for lack of vaccination medrxiv.org/content/10.110… 1/n
Because vaccines were not immediately available to all we only look at 5/30/21 to 12/4/21, after which omicron rapidly took over and the situation changed (again). By the start of that time even I (youngish, not in a priority group) was vaccinated 2/n
All this makes use of data from covid.cdc.gov/covid-data-tra… vaccine-status. Please read the preprint for full details, but a few major points follow 3/n
Read 13 tweets
Feb 4
I’ve been thinking the last few days how it’s hard for non-specialists, watching a twitter spat between apparent experts, to know who to believe. Here are a few things I bear in mind when following people outside my own field. A far from exhaustive list 1/n
The person who posts the most is not necessarily the one with the most or the best evidence. They may simply be the person with the most time. Once I'm done with this I will be making my kids dinner and spending time with them, so don't expect me to notice twitter😊 2/n
The person with the fancier credentials is not always right. Nor is it the case that every loud voice with narrow experience is bravely telling truth to power 3/n
Read 10 tweets
Jan 26
This is a completely reasonable request about what recent UK (and other) data means for the pandemic, and in particular BA.1 and BA.2 (let alone BA.3 which, yes, is a thing). Here goes 1/n
BA.1 and BA.2 (leaving 3 aside for this) are *both* omicron. They are deep branching cousins within the lineage, separating almost a year ago (phylogenetic types don't at me, this is in general terms) 2/n
Now they can be distinguished using this neat property of one of the diagnostic tests. BA.1 has a mutation which means some tests produce a weird characteristic result called Spike Gene Target Failure or SGTF. Most other circulating viruses (including Delta and BA.2) don't 3/n
Read 12 tweets
Jan 15
Despite the very sharp drop in wastewater numbers in the Boston area, daily covid deaths are ticking up towards last winter's peak. What can we learn from elsewhere? Well let's compare with the UK, which is a little further along the epidemic curve 1/n
I pick the UK not only because it's where I was born, but because the population is about 10x that of MA, meaning it's easy to do the math in your head, look at this 2/n
So per capita, MA is seeing roughly twice as many daily covid deaths as the UK right now. Lots of possible reasons for that, but this one is important. About 36% of the population in MA is boosted (from mass.gov/doc/daily-covi…) 3/n
Read 5 tweets
Jan 11
What did I say last Friday about the Boston area peaking? The wastewater data are in, and the news is good. @MWRA_update and @BiobotAnalytics providing solid evidence, that importantly *can't* be put down to exhausted testing capacity or other factors 1/n
this is obviously good, but it's not out of the woods good. Many of these infections were in younger age groups. We are now starting to see more infections in older folks, who are more likely to require hospital care 2/n
this would be expected to lead to fewer but more consequential infections in terms of healthcare, and a curve there closer to a plateau. They might drop more quickly than that, and they did in S Africa, but there are more older people here (albeit they are more boosted) 3/n
Read 6 tweets

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