It’s come to my attention that some leaders of Western countries, and @francoislegault, still haven’t understood that herd immunity is achieved through vaccines, not infection, and are dangerously subjecting their citizens to Great Barrington ideology. A thread. 🧵
Some background on The Great Barrington Declaration. GBD proposes a focused approach “to allow those who are at minimal risk of death to live their lives normally to build up immunity to the virus through natural infection, while better protecting those who are at highest risk.”
I can see why this ideology is attractive to politicians, among others. Not only can people at “minimal risk” live their lives normally and run the economy, they’re also framed as silent heroes that are exposing themselves in order to protect “the herd.” How noble.
The obvious false virtue of it should be the first clue that it’s is a fantasy with no basis in science. The second clue is that it was sponsored by a Koch-funded libertarian think tank. It’s been debunked and called out as dangerous, unethical and *unachievable* many times.
Politicians and signatories that once openly supported this idea have since distanced themselves from it but an idea never dies, especially a convenient one. So, paradoxically, with the coming of vaccines the GBD approach has made an unwelcome comeback...
Now I can try to convince you that it’s impossible to shield the elderly from rampant community transmission but many before me have tried and the GBD crowd persist in believing it can be done. So let’s focus on something else.

Let me introduce you to the city of Manaus, Brazil.
Manaus is the city of GBD dreams. A city of 2 million (like Montreal) with a very young population at “minimal risk of death” (94% younger than 60) that stopped “believing” in covid sometime last spring. In a population this young, the infection fatality rate is “only” about 0.2% Image
I’ve tweeted before about being wary of small percentages with covid. Covid lives in a world of large numbers and small percentages are deceiving. The first wave brought utter devastation to this city with over 4000 deaths. This is where they buried the bodies. Image
But even mass graves of young citizens won’t sway the GBDers. Though they’d never say it, they see this as sad but inevitable. Because after the carnage, 76% of people in Manaus were immune and the holy grail of herd immunity through infection was achieved and they could move on.
Many articles were written on the topic in the media and submitted to scientific journals.

medrxiv.org/content/10.110…

theconversation.com/coronavirus-is…
There was a small uptick in new cases come October but nothing alarming. Then came December. And a new strain. And a massive resurgence in cases.
This still wouldn’t be enough to sway the GBDers because right now they’re thinking “they have partial immunity though, so a resurgence of mild cases is nothing to worry about.”
And as usual, the GBD crowd with their belief system that has absolutely no basis in fact or science would be wrong. Manaus has declared a state of emergency amid an onslaught of new hospitalisations and deaths.

telegraph.co.uk/global-health/… ImageImage
So to summarize, “allowing those at minimal risk of death to live their lives normally to build up immunity through natural infection” leads mass graves of young, healthy citizens *and still no herd immunity.* This approach is unethical and misguided.
So can we finally put this fantasy to bed and focus on the science? The only way out of this pandemic is to aggressively control it until all your citizens are vaccinated. Even if you’re “willing to risk it” the risk won’t pay off. There’s no other way out.

CC @francoislegault
One more tweet to point to another string of tweets to show how in the era of the #variantwave, exposing kids, parents & young adults to these highly transmissible variants could make the above scenario could play out very quickly with no way to stop it.

When I wrote this thread this morning, I knew the situation in Manaus was critical but I had no idea that it was evolving into a true humanitarian disaster. They’ve run out of oxygen. Patients are being manually ventilated.

apple.news/AtUJVDJJYTfeUA…
“Anyone who has any oxygen available please bring it to the clinic [near the airport]. There are so many people dying, for the love of God.”

“In the coming hours Manaus is going to be the protagonist of one of the saddest chapters of the Covid-19 epidemic in the world.”
ID specialists have spent months urging authorities to impose some kind of lockdown to avoid exactly this situation. Their penultimate petition warned Manaus was again being “plunged into chaos”“We need to save lives and not repeat 2020’s health and humanitarian tragedy in 2021.”
“Politics kills,” the Getúlio Vargas hospital health worker said.

I would add that denialism kills. The pandemic is not over. Kids and younger adults are not invincible, it’ll be many months before the population is fully vaccinated and we’re in a critical situation *now*
With nearly no beds left, even a small surge of regular covid would lead to tragedy. If a more transmissible variant establishes itself here, we could find ourselves facing a humanitarian disaster of our own. Denialism kills. We need a REAL lockdown. Yesterday.

@JustinTrudeau
I was alerted to this crisis by this post on my thread. My heart breaks for them. His link only allows donations from Brazil but maybe @redcrosscanada can let us know how to help?

They’re also asking for our prayers. 😢

https://t.co/sMbrkygejY

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More from @lisa_iannattone

14 Jan
Oh this makes me sad. A wonderful hospital where patients are no longer safe. Most of their covid patients caught it at the hospital. Because it’s *airborne* !!!! Why isn’t a situation like this being treated like an emergency? Get engineers in there! Give HCWs appropriate PPE!
This hospital is located in the east.
So to recap, there’s:
-⬆️ transmission in schools
- which = ⬆️ community transmission
- which = ⬆️ sick adults & HCWs
- which = a hospital with several outbreaks
- which = more sick patients & HCWs
- which is a risk Legault is willing to take
Read 6 tweets
13 Jan
Finally. A terminology guideline we can all agree on!
Is it in the air? Yes? —> airborne

#COVIDisAirborne Image
Aerosol 😆
Now if we could just rectify the air purifiers issue...

https://t.co/BRgxHjcOZf
Read 6 tweets
13 Jan
I’m sorry but I can’t let this go. I wondered out loud the other night about the ethics of not preventing transmission of a novel virus in children. Then these heat maps brought to light that less privileged kids are the ones that are by far most exposed by this calculated risk. Image
And now this is unethical on a whole new level.

@francoislegault @jfrobergeQc @cdube_sante @JustinTrudeau
Are you okay with this? Because I’m not. Protect these kids. Invest in the safety of their schools and education.
And honestly, any doctor that advocates for opening schools in unsafe circumstances with uncontrolled community transmission needs to take a hard look at these heat maps first and consider checking the bias afforded to them by their privilege.
Read 4 tweets
13 Jan
Excellent thread on @profSBVA’s study. I think the most important thing she did here was look at different areas of Montreal individually. This is so important. She showed us the glaring inequity of the “calculated risk” to open schools in unsafe circumstances.
We’ve known since the first wave that covid doesn’t affect us all equally. Lower socioeconomic and racialized neighborhoods are disproportionately affected. Montreal and Toronto both put out reports about it.

santemontreal.qc.ca/fileadmin/fich…
It turns out that school openings in the second wave have also worsened the pandemic unequally, disproportionately affecting those same neighborhoods that got the worst of it in the first wave.
Read 5 tweets

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