We do not have to choose between lives & livelihoods when fighting #SARSCoV2 - through effective #TestTraceIsolate & suppression, we can allow *everyone* to take part in an open society.

Join myself & more than 80 other #COVID19 scientists & experts - sign the #JohnSnowMemo
Why 'John Snow'? It's not just because winter is coming! John Snow is considered one of the founders of epidemiology - he traced a cholera outbreak in London to a water pump & removed the handle to curb transmission. Quick effective action saves lives!

en.wikipedia.org/wiki/John_Snow
The letter says it best, but why do we stand against 'targeted shielding' & 'natural herd immunity'?
1. We do not fully understand immunity to #SARSCoV2 - we don't know how effective it is, or how long it lasts. It's irresponsible to lean on something we don't know will work.
2. 'Natural herd immunity' doesn't mean eradication. We had herd immunity to diseases like smallpox & measles before we had vaccines - but they did not disappear & caused countless lost lives & disability every year, until a vaccine was found.
3. Shielding sounds good in theory but is incredibly hard in practice. At least 20% of UK population would need to shield - we don't know how we'd do this, with a virus raging outside the door, ensuring absolutely none gets in. What about people who don't know they're vulnerable?
4. It's also very unequal - we don't know how long people will need to shield, or how will they feel about being entirely cut off from society. There's a risk of exacerbating many inequalities & disparities, & decreasing quality of life for an extended period of time.
5. There is still so much we don't know about #SARSCoV2 - it's irresponsible to ask the bulk of the population to contract a virus we do not fully understand. Even rare outcomes in 'young & healthy' people will affect thousands if we are infecting the entire population.
We have evidence the virus can cause damage to some organs & in some people leads to 'long COVID'. Even if none of these apply, it's not uncommon to spend a week or more completely out of action. Nobody should be condemned to this. I certainly have no interest in getting #COVID19
So what do we suggest instead? We believe the best way to save both #LivesAndLivelihoods is by effectively suppressing the virus - making participating in society safer for *everyone*.

But this requires commitment to reducing cases, excellent #TestandTrace & effective measures
We must demand an overhaul of ineffective #TestandTrace systems. We need to be able to trace down outbreaks rapidly & stop them quickly.

We must base our restrictions, if cases rise, in science, not wishful thinking. On what's effective not what's easy.
We have seen through other countries that through suppression we can *all* enjoy more normal, open lives, & return to behaviours & activities that support livelihoods. Until a vaccine is available, that is what we should strive for.

#LivesAndLivelihoods #SARSCoV2 #COVID19
Oh dear - and I forgot the link! Please join us - sign here! johnsnowmemo.com

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More from @firefoxx66

7 Oct
Thanks for helping to spread info about phylogenetics @Laurie_Garrett! But it's critical the info is accurate.

Couple of important points:
These great graphics are come from @nextstrain! You can see a tree with full menus here: nextstrain.org/ncov/global
We update every weekday!
Also, those early genomes aren't 1% different. That would be a difference of 300 bases, and they differ by 0-2 bases.

The divergence of the strain you pick out (see it in yesterday's run nextstrain.org/ncov/global/20…) is in number of changes, NOT percent! Much less worrying :)
As @pathogenomenick says, even the longest branches of the tree are incredibly similar - they differ by ~20 bases out of 30,000 - or ~0.07%

Also, the sequence highlighted has 4 amino acid changes, not 6. This isn't unusual, so no need for alarm!
Read 4 tweets
7 Oct
1/ In much of Switzerland, we had a significant drop in temperature about 2 weeks ago. Likely people have come indoors, closed windows, & turned on heaters - all things that increase #SARSCoV2 #COVID19 transmission.

Winter isn't coming - it's here. And it's making things harder.
2/ In #Switzerland we have been teetering over the edge for weeks: a slow but sustained rise in cases. Our actions were slowing transmission, but not stopping it. The thermostat drop may have just given us a gentle push into more effective #SARSCoV2 spread.
3/ Rising #SARSCoV2 cases are bad on all counts:
- More chance of spilling into older age groups (worse outcomes) 👵🏼
- More chance of rare bad outcomes in younger ages 🤒
- And cases beget cases - the more there are, the harder it is to contain them 📈
Read 4 tweets
30 Sep
1/ #SARSCoV2 #COVID19 transmission isn't equal: some cases transmit much more than others. We know that close, crowded, poor ventilated places (esp w loud talking/singing) link to superspreader events.

Minimising these situations will have an outsized effect - without 'lockdown'
2/ We can also reduce *risk* in those situations: make them less crowded (density rules), make them quieter (no singing, turn down music so talking is easier), increase ventilation (open doors/windows, turn up HVAC), reduce aerosols (wear masks if possible).
3/ @AdamJKucharski explains that this uneven transmission also means a person, on average, was infected by someone who infected others too. If we trace *backwards* & find the 'source' - then trace their contacts - we'll identify more cases.
More effective use of tracing efforts!
Read 11 tweets
25 Sep
Is #SARSCoV2 #COVID19 evolving to bypass masks & hand-washing??

Good news - No! These measures physically remove 🧼👏🏼 or trap 😷 the virus so it never reaches you. These basically can't be evolved around. So keep up the mask-waring & hand-washing - it *is* protecting you!
Ah, you'd like more detail? Sure! The 'mutation' referenced is 'D614G' - it arose in Jan (long time ago!) & we've known about it for months. It's actually the variant that most ppl in Europe & many in the US already had!

So why are scientists still looking at it?
There is evidence the D614G mutation *may* slightly increase transmissibility. Studies in cell culture & looking at the virus structure think it might be /better at bonding to cells/.

That means it has to get to a cell before that mutation can have an effect!
Read 4 tweets
23 Sep
The 'Texas Paper' is getting sensationalist headlines. Remember:
- D614G is same mutation we've known about since spring & been in media all summer
- It happened in ~Jan & most of Europe & much of US had it
- Great to confirm previous work, but not 'breaking'

#SARSCoV2 #COVID19
Worth noting that the authors of this study sat on 5,000 sequences *all summer* meaning they couldn't be used by other scientists to explore any findings in these sequences. Or to better understand Texas's epidemic during its biggest spike.
The author laments the low sequencing rates of #SARSCoV2:

“I think we need to be doing this pretty aggressively in multiple locations on a real-time basis,” Musser said. “I think it’s shameful that we’re not doing that.”

/It's shameful to sit on sequences that could be public./
Read 11 tweets
23 Sep
1/ Has the UK ended up with the worst possible #SARSCoV2 #COVID19 combination?
- /Everyone/ is upset & confused
- Personal life greatly restricted
- Trust in strategy at a low
- Still possibly not applying restrictions consistently enough to make a decisive difference
2/ The local-lockdown strategy seems to have contained outbreaks over the summer - I was encouraged by this.

Convinced that was the end of it, however, the govt seems to have turned attention totally to businesses instead of the possibility that a 2nd wave could come in autumn.
3/ I do not believe a strict lockdown, as in spring, is necessary to stop #SARSCoV2. But the idea that people can totally isolate themselves in personal life, yet continue to patronise bars & restaurants & go work in offices like normal - & this stops transmission - is farcical.
Read 12 tweets

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