Het had niet zo ver hoeven komen – en het kan zo niet verder.
A point which a lot of us have been hammering (pun intended) in for months now.

nrc.nl/nieuws/2020/10…
We have technical resources, we have scientific expertise, we have diversity in our experiences- @rivm and #OMT should consider using all the help they can.
@C19RedTeam has offered their cross-functional expertise. A pandemic isn't just a medical issue, it is a societal issue.
Rather than rejecting any/all collaboration, @rivm and #OMT (for all their excellence) need to be inclusive, swallow their pride and open up.
All the evidence that they have made their recommendations on, needs to be in public domain.
As scientists, we are taught here in #NL, to look at the evidence, compare it with the current literature, critique the evidence, learn from experiences of fellow scientists and come up with methods to improve on it.
None of that can happen under current red-tape.
The gap between the current evidence (the reality) on various #covid19nl #covid19 aspects and #OMT's recommendations for the past weeks has become embarrassingly big.
Unless we are unaware of evidence that exists out there, then it needs to be shared.
Time to swallow false pride.
Time to ditch self-perceived exceptionalism.
Time to be inclusive.
Time to accept expertise from other domains.
Time to be agile.
"Het kan zo niet verder."
Rant. Over.

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More from @phenomstruck

15 Oct
Scientific consensus on the #COVID19 pandemic: we need to act now.
One look at the authors list, and you'll see thought leaders in their fields; working diligently and with scientific evidence to make a difference.
"Just facts" in here, nothing else.
thelancet.com/lancet/article…
The #herdimmunity approach is a dangerous fallacy unsupported by the scientific evidence
The Barrington Declaration for focussed protection towards herd immunity has no basis in science and evidence. Full stop. It is a misguided self-aggrandising document, similar to the one circulating with patient zero at the White House.
Read 8 tweets
23 Sep
Have we misjudged the role of children in spreading #COVID19?
COVID19 research in to kid, especially younger ones, is not perfect. It has gaps, it is evolving and we are learning more by the day.
A short summary of evolving role of children 👇
cmaj.ca/content/192/38…
Statement from Ontario’s science advisory table:

- Kids may play a bigger role in the spread of #SARSCoV2 than initially suspected.

- Early suggestions that children are considerably less important drivers of transmission are not confirmed by more recent research.
Children less susceptible?
1. Contact tracing studies reported that children<10 years old are less likely to test positive.

Limitations: Studies underestimate infection rate in children if infected children are more likely to be asymptomatic than infected adults.
Read 16 tweets
16 Sep
@IHME_UW (Institute for Health Metrics and Evaluation) and @UWMedicine (University of Washington’s School of Medicine), no lightweights, have come out with
global projections of #COVID19 by nation.
Short summary 👇

healthdata.org/news-release/f…
They modelled 3 scenarios:
1. Worse case:
- mask usage stays at current rates, and,
- governments continue relaxing social distancing requirements.
This leads to 4.0 million total deaths by the end of the year.
Best case:
- mask usage is near-universal, and,
- governments impose social distancing requirements when their daily death rate exceeds 8 per million.
This leads to 2.0 million total deaths if by the end of the year.
Read 11 tweets
27 Aug
Huge respect for Aura but some of her responses are contentious. I thank her for the work that she and her team are doing in this ever developing #covid19 pandemic. But one didn't need to understand #coronavirus to implement certain rules.
volkskrant.nl/ts-b73f5cef
Question: Maar anderzijds had u ook best kunnen adviseren: bescherm jezelf nou maar, voor de zekerheid.

Aura: Zeker. Maar dat is met de kennis van nu. Wat we in maart, april dachten te weten over het virus is achterhaald door de snelheid waarmee het zich bleek te verspreiden.
Has any of the field epidemiologists been involved in the decision making, they would have insisted on PPE/masks in healthcare/nursing homes.

Crisis management experts would have insisted it is better safe than sorry.
Read 4 tweets
26 Aug
A descriptive analysis of existing literature presented a #SARSCoV2 risk-chart from asymptomatic people in different settings and for different occupation times.
Lead authors (@trishgreenhalgh) noted that this is an indicative table; and not quantitative or predictive. Image
Great overview of occupancy (indoors/outdoors), ventilation (well/poorly), type and level of group activity (silent, speaking, shouting), time duration and face coverings --> and risk of #SARSCoV2 transmission.
Variation in susceptibility, viral shedding rates were not looked at.
An indicative, traffic-light like chart for an overview of transmission risk. Other take home messages:
1. Distribution of viral particles affected by air flow too.
2. #SARSCoV2 may travel >2m through coughing,shouting.
3. Rules should reflect ventilation,occupancy,exposure time.
Read 4 tweets
20 Aug
Debate (#NL) over face covering or not. On #RIVM/#OMT's advice, @MinPres and @hugodejonge from @MinVWS have unequivocally told us that there is little conclusive evidence (agree) and masks do not work (do not agree).
Great @bmj_latest article, a summary:
bmj.com/content/370/bm…
Face masks have been framed largely as a medical intervention.
Many countries/agencies now mandate/recommend masks against #covid19.
Narrative of face masks as a medical intervention ignores the social practice of this act, and the behaviours associated with it.
Masks as medical intervention (1/2):
Almost all evidence comes from healthcare facilities and addresses the efficacy in protecting the wearer from infection, not as source control.
Using evidence based from healthcare and using it to address community settings? Apples and Oranges
Read 10 tweets

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