School openings and children (0-18yo) have been the most complex and contested subject of the pandemic.
In this letter, we are calling for balanced and nuanced scientific and media coverage of this subject, which has been hyper-polarised and damages our public health response.
While we all agree in the fundamental argument that children, families, educators, and society deserve to have safer schools, the current info ecology switched from underplaying the threat to exaggerating the risks by reacting to the political climate. This is causing harm.
One would hope statistics should deliver a more objective view. But while solid data offers us insights, the numbers never speak for themselves. They, too, are shaped by our emotions, our politics and, perhaps above all, our preconceptions - @TimHarford
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For instance, although emerging evidence suggests age differences in transmission, prior experience from influenza pandemics left many with strong beliefs re children’s role in propagating community spread that disturbs the interpretation of this data. medrxiv.org/content/10.110…
Some countries kept schools open throughout the pandemic, and many opened schools in April/May - so the argument that we do not have enough knowledge or experience in this regard is incorrect - we can learn a lot from their experience.
We are not suggesting kids are 'immune' or aren't transmitting at all, appropriate measures need to be taken. But sensationalised coverage of this topic esp by self-claimed experts & media causes distress for families, carers and children themselves.
For example, almost on a daily basis, we are hearing that there is a positive kid in a school setting. But identifying a case does not mean a school outbreak. We need to be careful when reporting and interpreting this information.
The complexity of the subject, therefore, demands a weighed expert review of the literature (by those who have background knowledge in the subject) that considers not only the epidemiological but also social, educational and public health concerns to accurately inform policy
For instance, school closures have brought social, economic, and racial injustice into sharp relief, with historically marginalized children and families — and the educators who serve them — suffering the most and being offered the least.
Many school-age children rely on their schools for free or reduced-price daily meals. Despite efforts by school districts to maintain these services, a majority of children have been unable to access the full nutritional benefits to which they’re entitled
While balancing values/principles are important, sadly nuance died some time ago.
"The potential costs of shunning such a nuanced approach are high. It can mean people fear small risks too much and big ones too little." @Mikepeeljourno
Nevertheless, safely reopening schools full-time for children should be a top national priority during the pandemic - which may mean closing nonessential indoor services if necessary. We need to have nuanced and balanced discussions for this to happen. nejm.org/doi/full/10.10…
"Our sense of responsibility toward children — at the very least, to protect them from the vicissitudes of life, including the poor decision making of adults who allow deadly infections to spiral out of control — is core to our humanity." - @meiralevinsonnejm.org/doi/full/10.10…
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Very interesting analyses about the virology of #Omicron, which may explain the faster spread of this variant.
According to a new lab study, Omicron infects & multiplies ~70x faster than the Delta variant and the wild type SARS-CoV-2 in the human bronchus, but not in the lung.
In this ex vivo study (press release), Michael Chan, Malik Peiris & John Nicholls et al. @hkumed show that at 24h after infection Omicron replicated ~70x faster than Delta in bronchus. Interestingly, it replicated ~10x less efficiently in the lung tissue. hkumed.hk/96b127/
Another analysis by @BalazsLab also supports these findings. In this lab study w/ pseudoviruses, Omicron showed greater ability to infect cells than other variants, which was ~ 4 times more infectious than the original strain, also more than Delta. medrxiv.org/content/10.110…
This is a live virus neutralisation assay. Neutralisation studies can tell us whether levels of Ab in the blood (convalescent and vaccinated plasma) are high enough to prevent the virus from infecting cells in the lab.
.@sigallab & colleagues tested plasma from those who received vax only (orange) & those who had vax + previous infection (green) and showed a significant (~40x) decline in neutralisation activity, but this was not a complete escape & reduction was less in hybrid anti-sera.
🦠 There’s a lot we don’t yet understand about Omicron, including its impact on immunity and what it means for vaccines. New data will be emerging over the next few wks, which could be misinterpreted w/o context. What we might expect & how to interpret the emerging data? 🧵(1/n)
1- Genomic data:
The biggest concern with omicron is that it contains >30 mutations in just the spike protein, the part which helps it enter human cells and the target for vaccines. This mutation profile is very different than other VOCs. (2/n)
There are plausible biological consequences of some of these mutations, but we don't really know the combined effect of all these mutations, so full significance of omicron is uncertain.
There is a lot of concern/confusion about vaccine effectiveness against the delta variant. How effective are the vaccines against Delta & how to interpret real-world observational data? So much misinformation is being circulated, so this thread brings key data together. 🧵(1/n)
Vaccine efficacy measures the relative reduction in infection/disease for the vaccinated vs unvaccinated arm. For instance, a vaccine that eliminates all risk would have an efficacy of 100%. Efficacy of 50% means you have a 50% reduced risk compared to an unvaxxed person. (2/n)
All studies assessing the performance of vaccines against Delta are based on real-world data (vaccine effectiveness), which are influenced by variant transmissibility, human behaviour, and immunity status of the population, therefore they require careful interpretation. (3/n)
There is a lot of confusion about the efficacy of AstraZeneca/ChAdOx1 vaccine against COVID19 due to B.1.351 / 501Y.V2 - summarising the results of phase 1b/2a double-blind randomized trial conducted in South Africa (based on @GovernmentZA press conference).🧵(1/6)
Adults aged 18-65 years without severe comorbidities and HIV were recruited. It was designed to show >60% efficacy against symptomatic disease, but because only 2000 participants were recruited with 42 total events, this analysis was not statistically powered. (2/6)
In total, 1749 participants were recruited, the population enrolled was young and generally healthy; the prevalence of hypertension, respiratory disease, and diabetes was low. Therefore, it was not designed to assess efficacy against severe disease. (3/6)
Concerns about outdoor transmission risk seem to be trending again. What is the risk of transmission outdoors and should we be more worried about outdoors with the new more-transmissible variant? 🧵(1/n)
The risk of transmission is complex and multi-dimensional. It depends on many factors: contact pattern (duration, proximity, activity), individual factors, environment (e.g. outdoor, indoor), socioeconomic factors, and mitigation measures in place. (2/n)(gov.uk/government/pub…\)
Transmission is facilitated by close proximity, prolonged contact, and frequency of contacts. So, the longer the time you spend with an infected person and the larger the gathering, the higher the risk is. (3/n) (academic.oup.com/cid/advance-ar…\)