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25 Nov, 5 tweets, 2 min read
A really fascinating paper looking at contact tracing in England that provides some convincing evidence that testing/tracing reduces infections and deaths

warwick.ac.uk/fac/soc/econom…
The authors used the now-famous Excel spreadsheet stuff-up to perform a quasi-experimental analysis of whether places where no contacts were traced had higher levels of infections

They did
The estimates imply that, for every case that was not traced, there were an additional 25 cases down the track
And hats off to the authors for being so beautifully careful about their estimates. Yes, it's possible that a lack of contact-tracing lead to a 120k infections, but it is a very uncertain point estimate!
What we can be fairly certain about from this paper, however, is that testing/contact tracing/isolation probably prevents cases in the future

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More from @GidMK

Health Nerd Profile picture
25 Nov
This is actually an excellent point that is not made often enough. Most vaccine trials are done over years, so they have smaller numbers because more people get infected. The COVID-19 trials are VAST
We won't pick up on any long-term side-effects that only take place after 6-12 months, of course, because of the shorter time frame

Still, the trials are pretty amazing
Worth noting here that when I say "long-term" I really mean "only diagnosed after 6 months". By the time vaccines are rolled out, we'll have at least 6 months of follow-up data so anything that you'd expect to be picked up in that time-frame should show some signal
Read 5 tweets
Health Nerd Profile picture
25 Nov
I added some very useful context

Tests take a short time to be recorded as cases. Cases take a while to go to hospital and then be recorded. Deaths take weeks to appear in the stats

The deaths reported today represent people who got sick ~3-6 weeks ago 😬
The corollary, of course, is that we won't see deaths attributable to the enormous rise in cases for another few weeks, and that hospitalizations from the record-breaking days of new cases are still coming in
This is all very rough, and since @COVID19Tracking aggregates all the different states there's a lot of variance. Different places report differently!
Read 4 tweets
Health Nerd Profile picture
25 Nov
In the dissection of the Year That Was COVID-19, one of the most depressing failures will probably be the vast, almost uncountable sums we've spent proving over and over that HCQ doesn't work
Glad that these results are getting published, but it's still astonishing just how much effort we threw behind a single drug despite many early indications that it was a red herring
We should never really have been in a situation where, simply because it was popular, most of the urgently needed research funds (and patients) went to research a single medication
Read 4 tweets
Health Nerd Profile picture
24 Nov
If the U.S. maintains current infections (~200k/day) of COVID-19, and assuming about 17% of the country has already been infected, it will be about a year before the country reaches herd immunity

Compare that to vaccine rollout schedules
Calculations:

US pop: ~328mil
17% infected: ~60mil (per serology and @youyanggu)
40% (low) HIT: ~131mil
131-60 = ~71mil
~71mil/200k = 356

Add a few weeks for everyone to be ~immune~, and it's a bit more than a year
Yes, this is assuming the 200k number is reliable, which we know it is not. It is likely that there are instead 400k infections per day, which halves this number. It is also likely that the HIT is 60-70%, which doubles it 🤷‍♂️
Read 4 tweets
Health Nerd Profile picture
23 Nov
You have to wonder what the "herd immunity through everyone getting sick" people are saying now that there is likely to be an effective vaccine beginning roll-out within weeks/months
I mean, the entire IDEA of letting everyone get sick was that a vaccine was a distant future that we couldn't rely on

Well, now it appears that we probably can
It would be the height of hypocrisy to not shift your message given that the foundation of the argument has now completely changed
Read 4 tweets
Health Nerd Profile picture
23 Nov
If you want to know who is an expert on vaccination programs, look for the people focusing on the supply chain side of the new vaccine as opposed to the 70% efficacy that they found in a clinical trial
The truth of the matter is that, while efficacy in clinical trials is important, a better supply chain may make the biggest difference in people actually getting the vaccine in real life
This is even more true when you consider that a cheaper supply chain makes the vaccine cheaper too, and most of the world probably will have trouble affording -80 degree cold storage
Read 4 tweets

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