Recently asked to comment for an end of year 'what we've learned since January' story.
There is no way to do this justice in a few quotes or a short story.
We've learned so much about so many things.
Like the virus, disease, inequities, inequalities, the chaos sown by
misinformation, the driving desire of some to want things to blame & punish, the role of science in leadership, the need for public health institutions to have a greater role in education & authentic communication,
the importance of speed & flexibility in labs, that scientists can also be biased or mean or idiots (=group of humans), from lab test processes aren't widely understood (most of the time no one cares though),
border closures *are* a tool that can help halt pandemic spread, masks have a role, aerosols have been grossly underestimated & under-studied in real-world situations , transmission specifics are lacking for most "respiratory viruses",
"the economy" also epends on the population feeling safe & being healthy-put profits on hold, Govt supporting mental health & jobs & rent & business during lockdowns is essential, response speed is everything, half-measures lead to failure, listening to expertise matters,
communication must span education, understanding & language, habits are the hardest things to change (start work early), new vaccines need early explanation & expectation management (we're not doing enough) & everything👆 (& probably 👇) is complex & hardly ever binary

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More from @MackayIM

7 Dec
Hey all, if you want a mug like this; a guide.
Check my pinned tweet thread. Near the bottom is a link to my @figshare page where there's an editable .svg (Other images there as well).
I use @inkscape to make & edit .svg files.
Install the font I used (Repirse Script) *first*, Image
or use your own.
Edit the image to remove the text in the bottom right. Or keep it. Also think about squashing the image a little vertically tighter so it stretches further around mug, horizontally.
Export in a relavent image format (I save as .png format for here & my blog)
Next, find your local mug-making site. I used @Vistaprint but closer to home means faster delivery. Pick a mug colour (find another site if you can't get mug colours!). Place your image as a wraparound using the site's tool. Pay.
Read 4 tweets
28 Nov
COVID-19 testing and correlation with infectious virus, cycle thresholds, and analytical sensitivity cebm.net/study/covid-19… via @cebmoxford
Upfront-how one interprets late PCR results DOES MATTER. No argument. I am very much aware that late Cts mean less RNA (and by extrapolation based on history and experience, less virus) is typically present.
How does that relate to "false positives" & PCR cycle numbers?
A false-positive PCR result typically means that the PCR was positive when no virus had ever been present.
This is different from an infected person's sample not having any *infectious* virus, yet still returning a PCR-positive because of "dead virus"/RNA fragments being shed.
Read 14 tweets
28 Nov
The BMJ 'bolide as origin of COVID-19' is a joke piece though. Right?
"we have developed the unorthodox proposal that the Covid-19 virus, like many other pandemic viruses, may have an extraterrestrial origin and was initially dispersed in the high atmosphere from a disintegrating cometary bolide"
bmj.com/content/371/bm…
"In our model of the pandemic we argue that trillions of virions entered the Earth’s upper atmosphere sometime in the latter part of 2019. Virus-laden dust clouds were thereafter able to break through to ground level locations,
Read 4 tweets
25 Nov
In the spirit of filling those with no PCR experience in. This is a lunchtime thread showing the progress of a reverse transcription polymerase chain reaction (RT-rPCR) "run".
The thing being amplified-the target or template-is a tiny amount of RNA I'd previously made
...in the lab ("in vitro transcribed RNA").
At this point there's too small an amount of RNA to view or use to get specific virus info from, so we put it through some chemistry & cycling temperature changes (the RT-PCR process) to copy it to levels we can "see".
RT-PCR isn't the only way to do this but its the topic here
So after the ivtRNA is added to a tiny tube (0.2ml) with enzyme, buffer, water, 2 primers and a probe, it's incubated at 50'C for a few minutes for RT enzyme to copy the RNA into complementary DNA (cDNA).
No signal yet
Read 24 tweets
24 Nov
Just a reminder that we have two-fifths of FA real data on how any single person or group gets infected by SARS-CoV-2.
We're not there to observe the process. We mostly can't exclude surface or droplet or aerosol. We can apply what we expect to have happened.
But remember...
...we do that using our current settings with all their glorious biases. Some of the knowledge that came before has evidence that's a degree removed - we know SARS-CoV-2 survives in aerosols & can infect primates; but we haven't infected a human that way.
We know droplets are emitted when we cough, yell & sing & not when we breathe or talk normally. But aerosols are always emitted so how do you know droplets were in play & not time (dose) of aerosol exposure if you're proposing close-up infection was only by droplets? You can't.
Read 7 tweets
20 Nov
I think these graphs from @NSWHealth are both beautiful and really interesting.
Look at that RSV take off. This will be impact young kids and those with asthma I'd expect. But it's a *very* late season. Highlights that "seasonal respiratory viruses" are about more than "season"
RSV and RV peaks don;t line up - but RSV lags RV. Here's one hypothesis (lest call it the RV as MASTER hypothesis)- RVs wane - for whatever reason, lots of immunity - RSV able to get a foothold and takes off.
Or RSV as MASTER, hypothesis: huge cohort of immune naive kids for RSV to take hold in, pushes out RVs (lag due to this happening in the background, not being captured by testing for some reason)
Read 4 tweets

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