This is an interesting article. While it’s talking about the poor (frankly bizarro) management in the U.K. and schools in particular it has wider relevance 1/n theguardian.com/commentisfree/…
The issue is that it has been clear since the spring that the long term management of the pandemic would require serious sustained action, and no rapid return to ‘normal’. However as we are all aware that has *not* been the messaging 2/n
The article lists reasonable suggestions for schools. These aren’t exhaustive. I’m not commenting here on how well they’d work or how feasible they’d be, but rather that *this* is the type of thinking that is required. And notably, people have been advocating for it for ages 3/n
In general there has been reluctance at all levels to accept the degree of disruption that is inevitable with a disease of this kind, made worse by false official statements about the expected trajectory of the pandemic 4/n
So bold suggestions to limit transmission while allowing other things (like education) can get met with a knee jerk “oh we can’t possibly do *that*!”

And then, when things get bad enough, it turns out we actually *can* 5/n
There’s an understandable longing to get back to ‘normal’. Unfortunately ‘normal’ is not on the table, but we can aim for ‘better’. 6/end

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More from @BillHanage

1 Jan
Closing thoughts on this hellish year. I am feeling really low right now, but here are some of the people I’ve valued over the last 12 months. This is in NO way an exhaustive list and is biased towards the contacts I made in 2020. It's a place to start thanking, not to finish 1/n
Writers - talking to @edyong209 , @zeynep and @apoorva_nyc has always been great. When it comes to the great @kakape has almost been therapy (honorable mention too for @yayitsrob who has done and written wonderful stuff) 2/n
I've been delighted to get to know folks like @Dr2NisreenAlwan @drjenndowd @HZiauddeen and @DrDomPimenta and the remarkable @dgurdasani1. Was honored to be a part of thelancet.com/journals/lance… 3/n
Read 12 tweets
30 Dec 20
A few thoughts on the pandemic and 'protecting healthcare', prompted by this heartfelt and urgent article about what it is like to actually work in healthcare during a pandemic
theguardian.com/commentisfree/… 1/n
firstly we should note that healthcare is either stretched or close to it in many places at the moment, and we have yet to see the effects of the Christmas holiday or (in most places) any impact of more transmissible variants 2/n
When we talk about ‘protecting healthcare’ what does that mean? Does it mean preserving ICU beds? If so how many ICU beds are enough to handle the regular requirements of the non-pandemic part of healthcare? 3/n
Read 8 tweets
23 Dec 20
Very interesting preprint on epidemiology of B.1.1.7 (or the 'Variant of concern' - VOC) in SE England. Have not fully digested but there are some important take homes 1/n cmmid.github.io/topics/covid19…
Some have argued B.1.1.7's sudden rise is a 'founder effect' reflecting the VOC getting into a more densely connected network of hosts, and a number of superspreading events. This seems unlikely to me because there were lots of more common lineages available to be amplified 2/n
the preprint agrees. First, here is the increase in the proportion of cases due to the VOC in the SE (pink) compared with the rest of England (these are detected btw through characteristics of the test result). The gray box is the 2nd national 'lockdown' (👈🏼hate that word) 3/n
Read 17 tweets
19 Dec 20
As might have been expected the UK is reintroducing more intense restrictions over the Christmas period. This may be tied to the 'new variant' common in the SE of the country, but should not obscure the fact that the relaxation in early December will have had an impact 1/n
There are several reasons to think this is an important variant, but notably it has increased extremely rapidly since emerging in mid sept (maybe a little earlier) 2/n
Unlike the earliest stages of the pandemic, this variant has been competing with existing and established lineages, and it is against that backdrop that the increase has occurred, strongly suggesting IMO it is more transmissible 3/n
Read 17 tweets
9 Dec 20
I've been getting questions from friends about what to do if their child gets sent from home to quarantine, after a case is identified in their class or 'bubble' (or whatever is the local term) 1/n
First point, be pleased that the exposure was detected. Imagine if it had not been. The information is power which helps you and others avoid infection, that is what the quarantine is for 2/n
the alternative (not testing) means undetected transmission in schools could introduce the virus to many households. Younger children *are* less likely to become infected and suffer severe illness, but they can transmit 3/n
Read 14 tweets
25 Nov 20
Will not be time for many of these and please understand may well be distracted so will miss put too many but given the thanksgiving holiday would like to should out to those like @ImpactMovie who have been admirable friends for months. Happy thanksgiving to you and yours!
I would add @SFDukie happy thanksgiving to you and yours - hopefully in a non generation mixing setting
Or the extraordinary @EIDGeek - this had been a bad year. Getting to know you better has been one of the better parts. Look forward to meeting in person, one day
Read 5 tweets

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