1/n “lives vs economy” is unhelpful, it is not primarily the economy and jobs that are diminished by full or partial lockdowns, rather the almost unimaginable richness of life in all its domains suffers. We are social beings, and a major part of that sociality is stripped from us
2/n Thus we must not think of lives vs the economy, we should frame this as lives vs lives, as Ramesh Thakur wrote with respect to covid in India in April johnmenadue.com/ramesh-thakur-…
3/n Think of the grandparents not seeing their grandkids in person for months, the number of new relationships not started, the number of friendships that have naturally become distanced - and for each of these multiply up by the vast number of those so affected
4/n Think of the current and long term futures of kids whose education has been thrown – irreversibly for many – into chaos. Think of what you enjoy that has been reduced or disappeared, the banter over last night’s match, or how unbelievable that plotline has become ...
5/n Think of the cafes, music venues, small businesses of all kinds, pubs, independent record and bookshops, restaurants, sports shops – whatever it is you value – that you see permanently closed as you walk thru your local town.
6/n Think of the people dying alone (and compulsorily so, before that inhumane prohibition was relaxed) and the time now spent in aching regret by those excluded from these passings
7/n Think of your worst experience of loneliness and imagine it spread backwards and forwards in time, until it simply becomes how time passes.
8/n But most of all think about what it is that you value and enjoy most that has been constrained by full or partial lockdown, and share it by quote tweeting here, so we can have a rich compendium of what we need to put on the debit side of the “lives vs lives” calculus
9/n Adverse consequences fall particularly heavily on those with fewest resources. Conversely, those housed with more rooms and space per resident, with gardens or other outdoor space, with financial resources that can cushion against adversity, in conditions in which home ..
10/n schooling their children is possible, who can work – and work comfortably – from home, who are not reliant on public transport and who are not constrained by arduous caring responsibilities will generally find it considerably easier to adapt to full or partial lockdown.
11/n Hedonics is not an exact science - what aspects of life matter most is highly individual - and thus weighing up whether risk reduction is preferable to the constraints on life will differ between individuals and groups. Policy influencers are largely drawn from those ..
12/n with privileged backgrounds, who have weathered lockdown conditions in more favourable circumstances, which will be reflected in what they decide to tell us about how we all should - indeed have to - behave
13/n We hear of "saving lives or saving the economy”, but in the end you don’t “save lives” - we all die – you delay deaths. Given most people don’t make it to 90 it’s striking that for women the age category with the largest number of covid deaths in the UK is 90+
14/n We need to evaluate the full range of adverse consequences of SARS-CoV-2 infection – we should indeed #CountLongCovid and all adverse outcomes, not merely years of lives lost due to covid deaths. But we *must* also count the every increasing burden of collateral ..
15/n non-covid related health damage consequent on the imposed restrictions, and we must also consider the whole range and massive volume of the loses to the lives of the living. For many the goal of life is more than simply years lived and risks averted
16/n As Bernard-Henri Lévy reminds us “a life is not a life if it is merely life”. Let’s hear no more of the endless riffing on “lives vs the economy” – this is much more serious than that: what we face is the weighing up of lives vs lives
17/17 Finally, we should not be in the situation we are in - public health interventions should never be implemented without first considering the full range of their potential consequences
1/n In 2019 @BMJ_latest published a non-linear Mendelian randomization (NLMR) paper with the conclusion that gaining weight would reduce mortality risk in many people. The NLMR method produces spurious findings MR's credibility calamity in this 🧵 bmj.com/content/364/bm…
2/n The sad story of NLMR and the delays in journals and authors in issuing retractions of clearly spurious papers containing damaging public health messages that include *literally impossible* findings is told here /cont
Just seen that @ucl have made Lyndsay Farrall's 1969 PhD "The origins and growth on the English Eugenics movement" easily found with new intro by @profjoecain It remains perhaps the best overview of the topic, and deflates some myths. The survey of /contucl.ac.uk/sts/sites/sts/…
2/n the well-known members of the "Eugenics Education Society" and a random sample show academics and medical doctors the most common professions, that leftists as well as conservatives well represented, that Lamarckian eugenics was a thing (so much for the bizarre notion /cont
3/4 that transgenerational epigenetics in its soft inheritance form is somehow more progressive than genetics), that biometricians were as common as Mendelians amongst the early eugenicists. Essentially the desire to stop the working class reproducing was ahead of racism /cont
A brilliant 1984 chapter in the "Encyclopaedia of Medical Ignorance" by Richard Peto anticipated much of the advances in understanding of cancer since then, and is now accessible in @SpringerNature European Journal of Epidemiology. A personal🧵on it/ cont link.springer.com/article/10.100…
1/n I first read this sitting on a stool in the HK Lewis medical bookshop on Gower Street soon after it came out; the book was outside my budget & the rest not so interesting. It felt like the 19th century in Lewis' anachronistic shop, there were hardly any customers /cont
@Lyonpaul @mrc_ieu @SpringerNature @The_MRC 2/n no one seemed to buy anything and the rumour was it was a front for an MI5 office. I was left alone reading away, and was entranced by the sparkling language but must admit I understood hardly any of it. I recalled it when reprinting another Richard Peto chapter in/cont
A twee story on tea by @TorstenBell in @guardian suggests increased consumption of tea (using boiled water) led to a fall in mortality in Britain. This might be true, but there is no mention of how this was linked to massively increased deaths in India 🧵 theguardian.com/commentisfree/…
1/n The academic paper @guardain story is based on suggests that growing tea consumption by the working class after 1784 in Britain led to a fall in mortality. It uses what it calls "The Tea and Windows Act of 1784" which led to a dramatic fall /cont repec.iza.org/dp15016.pdf
@guardain 2/n in taxation on tea. There was no such act, though the 1784 Commutation act did decrease tax on tea from over 100% to 12.5%, and tea imports went up. Why was this act introduced? It was introduced on the behest of Richard Twinning - of Twinning's tea that some vanity /cont
In 2018 we published a non-linear Mendelian randomisation (NLMR) study in @ObesitySociety and it is now clear the method we applied is deeply flawed, so in October we published a Perspective correcting it. A 🧵on the cautionary tale of NLMR onlinelibrary.wiley.com/doi/epdf/10.10…
2/n Naïve observational studies report J- or U- shaped upturns of mortality at lower levels of BMI. Our paper using UK Biobank (UKB; @uk_biobank) data suggested overall adverse effects of BMI on mortality, and (though very imprecisely estimated) the NLMR suggested a lower /cont
Ultra-processed foods (UPFs) are apparently the new poison, and a recent @bmj_latest report by @rebeccacoombes suggests conflicts of interests in the “expert” views presented @smc_london that weren’t enthusiastic enough in promoting this notion. /contbmj.com/content/383/bm…
2/n Opposing these @DoctorChrisVT says there is “overwhelming evidence” of UPFs being harmful. The prospective studies (contrary to the quote, these were not “trials”, where people were randomised to higher or lower UPF consumption) do not show UPFs cause harm / cont
@DoctorChrisVT 3/n Their use is strongly patterned by socioeconomic position, health behaviours and other factors that would generate non-causal associations in such studies. Nor does the fact the studies were done @imperialcollege or adjust for some covariates. An equally large body / cont