This potentially incredibly good news

Twitter is about to be full of articles about "herd immunity" again, but now with words laced in honey rather than shouting and hissing

Some things we now need to consider...

1/6

statnews.com/2020/11/09/cov…
We need to see the data

I note it is a difference between arms of *symptomatic* infection - this might mean reduction in disease severity, but we need to know about transmission

Why is that important?

2/6
With only ~90 events there's no way we'll be able to see efficacy in the highest risk groups who we are trying to protect (and who we're most worried won't mount an effective immune response)

Nice to turn COVID into a cold for younger people, but not what we're aiming for

3/6
On which note - we need to determine priorities for vaccination

We can't roll out 7bil vaccines all at once

The UK JCVI have a guide on their priorities, which is generally the elderly and those who look after them

Kids likely way down the list

gov.uk/government/pub…

4/6
Some other vaccines are not far behind - what happens when we have several licensed?

What happens to people we enrol in clinical trials?

Combination trials are being planned for this circumstance

Which are more/less effective alone/in combo and for who?

5/6
In any case, it's great to finally see some fledgling data on clinical efficacy on the back of the published reports on immunogenicity

Hopefully a good sign for the other candidates in the pipeline too!

6/6

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More from @apsmunro

6 Nov
A criticism of the data regarding children and #COVID19 from the first surge is that it was acquired with schools closed

Its now surge 2 and they're open

Let's look at the up to date info from @PHE_uk and @ONS infection survey and see what is going on

#schoolsreopening

1/10
After an initial surge, in the recent weeks of @PHE_uk data we have seen a decline in cases in the 10 - 19y age group

Otherwise lowest cases remain in the 0 - 10y ages, although still trending up

assets.publishing.service.gov.uk/government/upl…

2/10
What about school outbreaks?

They've been flat for the past several weeks despite rising prevalence in the community

Unfortunately doesn't tell us about how many cases involved or whether it's children or staff/teachers

assets.publishing.service.gov.uk/government/upl…

3/10
Read 10 tweets
13 Oct
Quick thread on latest @ONS infection survey data, which is very informative!

FYI: the survey involves mass random population testing for #COVID19 in England and Wales, so is not biased by symptoms/test seeking - so very useful indeed!

1/7
I can't go any further without pointing out the massive regional disparities between the north and south of England

Whilst not completely straight forward, this is likely in part due to socioeconomic differences which we know influence effects of disease transmission

2/7
But of course, I'm interested in the KIDS!

Schools open for nearly 6 weeks with fairly limited infection mitigation, and cases rising exponentially across the country

What's happening with primary school age kids?

Not much at all

Even I am surprised about that

3/7
Read 7 tweets
1 Oct
"If there's one thing we learn from history, it's that we don't learn from history"

A new study from India looks at #COVID19 contact tracing

And now reported, "[children] transmitted the virus at rates similar to the rest of the population"

🤔

latimes.com/world-nation/s…

1/10
There is SO much to dig in to here because these findings are complex - but we'll stick with the major issues for now

Child index cases were found to have a high proportion of positive contact of the same age

They must infect them easily, right?

science.sciencemag.org/content/early/…

2/10
The first caveat, is that to be defined as a index case, the child was almost certainly symptomatic

Symptomatic people seem to be much more infectious than asymptomatic

A large proportion of children seem asymptomatic (~50%) so findings are not generalisable

But wait...

3/10
Read 10 tweets
25 Sep
🔥Hot off the press🔥

New article in @JAMAPediatrics from me and @SaulFaust

"The education and well-being of the current generation of children and young people should be the highest priority in any national strategy to reopen society."

jamanetwork.com/journals/jamap…

1/8
Children have been spared the worst of disease from the pandemic, even considering the extremely rare post-COVID-19 hyperinflammatory syndrome

But school closures have been harming children, so the question regarding their role in transmission has loomed large

2/8
A new study from brings us a step closer to understanding

In a meta analysis of contact tracing studies, children acquire the infection less than adults. Looking at household transmission specifically, by less than half (OR 0.41, 95%CI 0.22 - 0.76)

jamanetwork.com/journals/jamap…

3/8
Read 8 tweets
21 Sep
Fascinating

2 groups of scientists with opposing viewpoints on handling the pandemic write open letters to the chief medical officers

Strangely I found them both compelling, and agree with the majority of both letters

Links in following tweets

1/4
First a group recommending more acknowledgment of non-COVID harms of interventions, and recognition of the age disparity in risk for future interventions



2/4
Next a group recommending strong virus suppression with sustainable measures, and arguing against age stratified intervention



3/4
Read 4 tweets
15 Sep
There has never been more confusion about the role of children in transmission of #SARSCoV2 , and tensions are running high over implications for #schoolsreopening

Time for some clarity

@Damian_Roland and I review ALL the evidence on @DFTBubbles

dontforgetthebubbles.com/the-missing-li…

1/13
When considering transmission risk we must consider 2 classes of factors;

Non-modifiable: The biology of the host and pathogen

Modifiable: Behavioural or environmental influence

Since we can change the latter via policy/guidance etc, we'll focus on the former

2/13
How easily to children catch the virus?

Household contact tracing studies suggest less easily than adults; by about half given the same exposure, based on 4 reviews of all the evidence (links in next tweet)

3/13 ImageImageImageImage
Read 13 tweets

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