With many other experts in infectious disease and allied fields, I'm proud to sign and have done my bit to help write this in @TheLancet which explains the *actual* expert consensus on the #COVID19 pandemic and the need for action marlin-prod.literatumonline.com/pb-assets/Lanc…
The letter states as clearly as can be that approaches to the pandemic that seek immunity through natural infection are dangerous, and explains why
This is a collaborative effort with many brilliant people, but @dgurdasani1 deserves special mention, for the tireless way she combined viewpoints and expertise from many different fields to build this statement of *consensus*.
We are calling it the #JohnSnowMemorandum. Why? Because John Snow was the pioneering epidemiologist who removed the handle from the pump in London's Soho that was the source of a dreadful cholera outbreakhttps://www.cdc.gov/mmwr/preview/mmwrhtml/mm5334a1.htm
After the pump handle was removed, the outbreak dwindled. At the time 'germ theory' was controversial and John Snow was no stranger to political conflicts with those who did not want to hear what he had to say en.wikipedia.org/wiki/John_Snow
It never pays to pretend science points in a direction it doesn't, not in the long run. Nature cannot be fooled, and we will need science to defeat the virus.

And winter is coming
Full text now available at thelancet.com/journals/lance…

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More from @BillHanage

16 Oct
The changing political geography of the pandemic in the US. In the spring the densely populated deep blue NE was hit hard, but since July things have flipped and cases and deaths are now highest in rural GOP voting areas. Featuring work from us
It also quotes @AliHMokdad who says, rightly "it didn’t show up immediately in rural communities,” he said. “And then people in these communities felt, ‘That’s not us, that’s the big cities.’ They let down their guard.” But there's something else here
the introductions to large urban areas are predictable, simply because of the numbers of opportunities, while for smaller rural communities it is more random. But given time the virus will get there eventually
Read 7 tweets
11 Oct
This is a very interesting deep dive into the controversial route Sweden took through the spring and summer of the pandemic (HT @AliciaJWeston). A few things stand out... sciencemag.org/news/2020/10/i…
First Sweden did not ‘do nothing’, there were sensible steps taken including restrictions on large gatherings (implemented early on), and there was considerable evidence of altered movement patterns. High schools and universities remote learning too. However...
There was still a very large, very rapid surge in healthcare demand and lot of deaths in a short period during the spring. Mortality was concentrated in nursing homes - which *are* part of the continuum of healthcare. Figures are not easy to interpret because of issues with...
Read 9 tweets
10 Oct
The first statement is sort of true although a bit misleading - many pathogens are disproportionately dangerous to those who are vulnerable for one reason or other, but Covid is especially so.

But the 2nd statement leaves me at a loss. I can’t think of an example 1/n
We don’t use naturally acquired immunity in this way. Btw have you imagined the stink there would rightly be if a vaccine had the risks associated with Covid-19? 2/n
There are some diseases where the risks of infection vary given the age you first encounter them. Mumps is an eg. Post pubertal males can be rendered sterile. Chickenpox is another where it is milder in younger age cohorts 3/n
Read 6 tweets
8 Oct
This illustrates a few of the points made by people who, whatever their motivations, should not be really taken seriously when it comes to talking pandemic - not least because these arguments come from the part of epidemiology that deals with *non*infectious disease 1/n
(Firstly anyone who says Covid mania has already revealed that they’ve got what you might call a pre-existing condition when it comes to the science. I don’t think that more than 200,000 and counting deaths is worth joking about. Call me crazy) 2/n
‘May not’ vs ‘may’. Yes it is right to be cautious about these statements. But not to the level of relativism implied here. The ‘may’ formulation is not equivalent to ‘may not’. It implies that we think about its consequences 3/n
Read 7 tweets
6 Oct
Scientists are not "divided". If you want to know what scientists really think, ask them and interpret the results scientifically 1/n spectator.co.uk/article/with-s…
What do I mean by that? I mean that obviously people have some disagreements about interpretation of the data and the best way forward, but mostly there is more that they agree on than that they do not 2/n
First identify the people who you should take seriously on the subject. That is those with relevant expertise, in this case infectious disease. No matter how much someone knows about say cell cycles, they aren't qualified for this 3/n
Read 7 tweets
6 Oct
A short thread on this new Working Paper "Counting the missteps of the U.S. Federal Government's handling of COVID-19" . This is me w Nancy Krieger @_christiantesta
Jarvis Chen, L Davis, E Pechter and @MauSantillana hsph.harvard.edu/population-dev… 1/n
First of all - we can all learn from the first part of the pandemic. But to do that we have to be honest about the mistakes. The first misstep is letting the virus in, and not even looking for it 2/n
This was eloquently discussed in this from @tomaspueyo et al. (which actually adopts a far wider angle lens and is worth your time) but also illustrates the point. Stopping introductions matters 3/n nytimes.com/interactive/20…
Read 17 tweets

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