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10 Sep, 6 tweets, 1 min read
This is the tweet I pinned back in March. I want to say a few things about panic and preparedness 1/n
In an emergency, it is reasonable and responsible to minimize panic. However this is not done by denying the existence of the emergency - at best that delays the panic and at worst it magnifies the panic once the truth becomes clear 2/n
Instead earn trust. Honestly present the reality of the situation and reassure people that you are working to control it and minimize the fallout. Work with expert risk communicators 3/n
When it comes to preparing, listen to experts who know more than you. Use whatever time you have to collect the resources people will need - remember their safety is your responsibility 4/n
Be responsive. Recognize that mistakes will be made and learn from them. Don't be distracted. Support those who are suffering and those who are working to minimize suffering. Know that it is a marathon, not a sprint 5/n
Failing to prepare for a real threat is not responsible. Playing down a real risk that you *know* is real is not preventing panic.

It's negligence

6/end

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More from @BillHanage

Bill Hanage Profile picture
12 Sep
The last few weeks it has been clear the U.K. is sliding into a pandemic resurgence, and is very poorly placed to deal with it 1/n theguardian.com/politics/2020/…
Why? Because testing has collapsed. The plans, focusing on symptomatic contacts, were flawed IMO, but even these cannot now get a test 2/n
Meanwhile schools are back, with minimal fig leaves of infection prevention. Without testing asymptomatics we will never know how many outbreaks there are there, but schools *will* add to transmission cdc.gov/mmwr/volumes/6… 3/n
Read 11 tweets
Bill Hanage Profile picture
24 Aug
Some things worth noting about this. 1) it really does look like a reinfection if the sequence is that different and typical of what is circulating in Spain 1/n nytimes.com/2020/08/24/hea…
2) so this shows that reinfection is possible, it doesn't tell us how common it is. That will be a function of how much immune protection exists, and exposure to the virus (depends on current prevalence) 2/n
3) Hong Kong keeps a close eye out for things like this, so it's maybe not surprising it was reported from there. Should remember that when thinking about how common reinfection is 3/n
Read 6 tweets
Bill Hanage Profile picture
14 Aug
This is a phenomenal article on the potential of different sorts of testing, and the ways that we are limited by demands for sensitivity and specificity. There's one important thing it misses out, which I will come to later in this thread 1/n theatlantic.com/health/archive…
Different sorts of questions need different sorts of tests. The US has got hung up on tests and testing, to the extent that it can seem some people think that testing is on its own a sufficient pandemic response. It’s not. It’s just keeping score 2/n
The crucial thing is not the test itself it is what you do in response. For instance to ensure appropriate treatment of cases in a healthcare setting, you want a very sensitive and specific test – meaning you can trust the result because getting it wrong matters 3/n
Read 17 tweets
Bill Hanage Profile picture
9 Aug
This is part of a long and excellent thread that is worth reading in its own right. I am almost entirely in agreement. With the exception that I want to write more about the risk of airborne transmission in superspreading 1/n
Superspreading likely follows a "Series of Unfortunate Events" (great show) however we also think that the transmission of this virus is driven by superspreading events, so they must be common enough to make up for the many that do not transmit 2/n wellcomeopenresearch.org/articles/5-67
And those superspreading events are hard to explain without some recourse to airborne/aerosols. Look at this from @kakape quoting @ChristoPhraser sciencemag.org/news/2020/05/w… 3/n
Read 15 tweets
Bill Hanage Profile picture
3 Aug
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
Read 14 tweets
Bill Hanage Profile picture
30 Jul
OK some thoughts on the fraught situation with schools and the pandemic. There’s been quite a few good opeds on this recently. I hope to add something useful below 1/goodnessknows
Point 1: all kids are not alike. Older ones transmit like adults. It’s hard to say that high schools *drove* the surge in Israel following wide reopening but it is easy to say they didn’t help haaretz.com/israel-news/.p… 2/n
Point 2: household studies of transmission in kids are biased. Because if you detect your index cases by looking for symptoms, you’re not going to catch the kids who are less likely to have symptoms as index cases. Duh. Did I mention non-symptomatic transmission is a thing? 3/n
Read 18 tweets

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