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Dr Zoë Hyde Profile picture
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20 Oct, 6 tweets, 2 min read
(1/6) A new pre-print study (interpret carefully) describes *in vitro* evidence of antibody dependent enhancement (ADE) after natural infection with #SARSCoV2 in some people. ADE is when antibodies make a second infection worse.
scmp.com/news/china/sci…
(2/6) If ADE occurs, it is most likely to happen late after recovery when levels of neutralising antibodies have waned.

Here’s the actual study:
medrxiv.org/content/10.110…
(3/6) This review describes what ADE is, how it can occur, and what we know about ADE and other coronaviruses so far.

There is no evidence of ADE occurring with any #COVID19 vaccine under development yet.
stm.sciencemag.org/content/early/…
(4/6) However, it will be necessary to watch the vaccine trials carefully to ensure ADE does not occur.

This is one reason why it’s a terrible idea to approve a vaccine before the completion of phase 3 trials.
(5/6) If ADE does occur, it would be the final nail in the coffin for infection-acquired herd immunity.

Such a strategy is now unjustifiable if reinfection could commonly lead to a more severe illness. (It was already a grossly unethical idea).
(6/6) A final reminder not to panic:

It doesn’t rule out a vaccine, because vaccines can be targeted to produce a specific immune response.

There are also many different types under development, which gives us plenty of options should one (or more) be affected by this issue.

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More from @DrZoeHyde

Dr Zoë Hyde Profile picture
14 Oct
This article is damning. I strongly recommend reading it to the end.

“The Swedish way has yielded little but death and misery. And, this situation has not been honestly portrayed to the Swedish people or to the rest of the world.”
time.com/5899432/sweden…
Sweden:

“Only 13% of the elderly residents who died with COVID-19 during the spring received hospital care”
Sweden:

“Policymakers essentially decided to use children and schools as participants in an experiment to see if herd immunity to a deadly disease could be reached”
Read 6 tweets
Dr Zoë Hyde Profile picture
14 Oct
(1/8) Contact tracing study from Brunei. Household contacts of symptomatic cases were more likely to be infected than those of asymptomatic cases (14.4% vs. 4.4%). Children and adults were similarly likely to be infected (3.4% children vs. 2.8% adults).
wwwnc.cdc.gov/eid/article/26…
(2/8) This study describes the contract tracing which occurred after 19 people who attended a religious gathering in Malaysia (in which a superspreading event occurred) returned to Brunei.

51 cases were identified via contact tracing (plus 1 further case identified separately).
(3/8) A total of 1,755 contacts were traced, of which 381 were persons aged <18 years, and 1,366 were adults. Age was not recorded for 8 contacts.
Read 8 tweets
Dr Zoë Hyde Profile picture
13 Oct
(1/4) Study of a #COVID19 cluster at a family gathering, in which a 13-year old girl was the index case. Despite being only mildly symptomatic, she likely transmitted the virus to 11 of 19 family members (58%). One person was hospitalised, but recovered.
cdc.gov/mmwr/volumes/6…
(2/4) The index case had been exposed to a large #COVID19 outbreak away from home. After returning home, she was tested with a rapid antigen test (four days after exposure) which was negative. She was asymptomatic at the time of the test, and developed symptoms two days later.
(3/4) Rapid antigen tests are generally less sensitive than a PCR test, meaning that not all infections may be detected.

Anyone who is exposed to a person with #COVID19 should self-isolate for 14 days, even if their test result is negative. It may be a false negative.
Read 4 tweets
Dr Zoë Hyde Profile picture
3 Oct
1. Updated thread on children & #COVID19 summarising the most recent research.

Summary: further evidence children & adults are equally susceptible & equally likely to transmit; school clusters are increasing; precautions needed in #schools.
#edutwitter #kinderen #Schulen #auspol
2. First, a recap, showing the risk associated with schools is largely dependent on community transmission.

If it is low (for example, at a level contact tracing can handle) then schools are low-risk (although precautionary measures are still needed).
3. Another large antibody study has shown that children and adults are similarly likely to be infected.

Importantly, young children and teenagers were just as likely to be infected.
Read 33 tweets
Dr Zoë Hyde Profile picture
30 Sep
(1/4) Study of #SARSCoV2 transmission on a 5-hour flight from Sydney to Perth. There were 11 people considered infectious on board. Eight probable & 3 possible secondary cases resulted from the flight. 27% sat more than 2 rows away, & 64% had window seats.
wwwnc.cdc.gov/eid/article/26…
(2/4) Two of the secondary cases who sat in window seats never left their seat during the flight. This, and the fact that 27% of secondary cases sat more than 2 rows away from index cases suggests aerosol transmission may have occurred.
(3/4) Index cases didn’t seem equally infectious, and transmission was only detected in the mid cabin. No secondary cases were detected in passengers sitting in the aft cabin, despite infectious passengers being in this area. This raises the possibility of a superspreading event.
Read 4 tweets
Dr Zoë Hyde Profile picture
29 Sep
(1/7) Study of #COVID19 in US children. 277,285 cases were reported between 1 March and 19 September. Incidence higher in adolescents compared to young children (although more adolescents were tested). 1.2% were hospitalised (0.1% ICU), and 0.02% died.
cdc.gov/mmwr/volumes/6… Image
(2/7) The overall average weekly incidence was as follows:

Ages 5-11 years:
19 cases per 100,000 persons

Ages 12-17 years:
37 cases per 100,000 persons

However, more older children were tested than younger children. Image
(3/7) Overall, adolescents were more likely to test positive than younger children, but this was not the case in all regions.

In some regions, there was no difference in the proportion of younger and older children testing positive. ImageImageImageImage
Read 7 tweets

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