Yaneer Bar-Yam Profile picture
Jan 30, 2021 51 tweets 8 min read Read on X
The Virus Changed. Now We Must ‘Get to Zero’ or Face Catastrophe

"Are you tired of COVID?

"I fucking am.

1/

via @TheTyee thetyee.ca/Analysis/2021/…
"And contrary to what our politicians say, there is only one way to deal with a rapidly mutating virus that demonstrates the real power of exponential growth: Go hard. Act early. And go to zero.

2/
"Last January, one strain of this novel virus began its assured global conquest, and since then our leaders have hardly learned a goddamn thing.

"So yes, I am angry, and I will not disguise my frustration with comfortable or polite language.

3/
"In the last three months, several super-variants have emerged that are 30 to 70 per cent more infectious than the original Wuhan strain.

4/
"The old COVID-19 doubled its numbers every 40 days under a particular set of restrictions; under the same conditions, the variants double every 10 days. That means they can outrun any vaccination campaign.

5/
"That means if you haven’t eliminated — or almost eliminated — cases in your region, you are going to learn the meaning of grief.

"These highly-contagious variants have emerged in jurisdictions with high infection rates: the U.K., Brazil, South Africa and California.

6/
"They became global tourists months ago, before you read about them.

"Meanwhile, governments still do not understand the threat at hand.

7/
"..With a reproduction rate of about 1.1 and a death rate of 0.8 per cent, current strains deliver 129 deaths per 10,000 infections.

"A virus that is 50% more lethal will kill 193 people in a month. A variant that is more transmissible wins with 978 deaths in just one month.

8/
"A new pandemic

"Now don’t think of these variants as the same old COVID-19. That’s a big mistake.

"They actually represent an entirely new pandemic.

"In this new maelstrom, this complex coronavirus is just getting warmed up.

9/
"We allowed this to happen by not taking the measures needed to go to zero, doing whatever was needed to eliminate COVID-19 in our province or country. We pretended we could live with this virus and that vaccines would save the day.

"We were wrong. Dead wrong.

10/
"COVID-19 should have taught us one glaring lesson by now: If you do not stamp out this virus, the shapeshifter will come back to defeat you.

"New Zealand, Australia, Vietnam, Iceland and Taiwan got it right. They went to zero and eliminated the virus.

11/
"Atlantic Canada and the North got it right, too.

"But the rest of this country has failed and continues to fail..

"As U.S. physicist Yaneer Bar-Yam notes, “The enemy won’t stop fighting because we surrender. The only exit is to learn from our mistakes and choose to win.”

12/
"Instead of comparing our mediocre performance to the horror show in the United States, Canada needs to adopt a much higher set of standards. And by New Zealand’s or Taiwan’s measure, we look very bad.

13/
"Until citizens demand a go to zero protocol in their communities, they will live in the Groundhog Day alternative — a public game with no real end goal other than endurance that depletes both our communities and economies.

14/
The current approach begins with incomplete lockdowns with no defined goals, travel restrictions that let the rich get away with murder and endless public health chatter about bending curves followed by careless and incoherent openings.

15/
"Exponential viral growth then roars back, jams the hospitals with the sick and surprises our daft politicians, igniting the whole abusive cycle all over again.

"Contrast that reality with New Zealand, which went for zero.

16/
"That country has had no COVID-19 infections for eight of the last 10 months. People attend concerts and sport events. They visit their families without fear. They only wear masks on public transit. There are real international travel restrictions and quarantines.

17/
"Bending the curve doesn’t get us into New Zealand’s safe place, because the power of exponential growth will always win. You have to crush the curve and go to zero.

18/
"While we slowly react, it mutates fast

"Now here is the problem: The virus is evolving while our reactive response is devolving out of neglect, incompetence and fatalism.

19/
"By ignoring or half-heartedly adopting the best advice about travel, testing, contract tracing, masks and aerosol transmission (and the best information did not come from the WHO), our politicians allowed controllable viral spot fires to become towering infernos.

20/
Our current reactive public health goals are outrageous and pretend it’s OK to contain these infernos to long-term care facilities, prisons, working-class immigrant neighbourhoods and hospitals. Instead of going for zero transmission and getting the job done in six weeks..

21/
".they just aim to keep the virus simmering or keep our hospitals on life support.

"Letting the pandemic multiply injustice and inequality exponentially isn’t OK.

22/
"And the longer we pretend we can live with a virus that kills one to two per cent of those infected and disables another 10 per cent with “long COVID,” the greater these inequalities will grow.

23/
"And that’s why we must get to zero, because the longer we draw out this siege, the greater the damage to the body politic. What you have heard is true: pandemics have never been democratic.

24/
Now consider the trauma of Roberta Place, a long-term care facility in Barrie, Ont.

..the U.K. variant, B117, appeared on Jan. 8. It flew in on a jet, because travel connects everything on this planet with a dangerous totality.

25/
"(Is there anything wrong with travel? No. But with billions travelling a year, the scale has become an unremitting health hazard that, with a different virus, could drive our sorry-assed civilization to extinction in a matter of weeks.)

26/
"But back to B117, which slammed the U.K. with its highest infection rates and death tolls to date.

"In just 10 days, a single case at Roberta Place became a massive outbreak affecting half the residents, and nearly half the workers.

27/
"Today, every resident of Roberta House and almost all workers are infected. All the physicians and essential visitors got infected too.

"The variant moved so fast that the facility couldn’t even separate the infected from the non-infected. There are more than 40 dead.

28/
"Given that B117 overwhelmed a long-term care facility in Ontario just two weeks ago, it is already burning through the community. (This variant only needs about six weeks to become the dominant strain in a community.)

29/
"So we are once again thinking about how to react to evidence that we have not collected. Taiwan and New Zealand didn’t do that. They went to zero.

30/
"An astonished virologist

"Now listen to German virologist Christian Drosten

"He finds it astonishing that COVID-19 has boosted its infectiousness by 30 to 50 per cent over previous strains by doing what viruses do: evolve, mutate and adapt for more effective reproduction.

/31
"He notes that a more infectious virus is more dangerous than a more lethal one, “because every new case will infect more people, and each of them will infect more people, such that the number of cases will grow exponentially.”

/32
"Drosten was the virologist who developed the first diagnostic test for COVID-19 and discovered that children carry high viral loads and are just as infectious as adults.

"No politician wanted to hear that evidence, and many continue to ignore it.

/33
"He compares the variant phase of the pandemic to a truck with bad brakes driving down a steep mountainside.

"“We don’t know what curves are coming up and whether the road is suddenly about to get steeper. We also don’t know how far we still have to go,

/34
"..but we do know that we absolutely have to avoid missing a corner. In a situation like this, closing our eyes doesn’t help. We have to keep going and do one thing in particular: Hit the brakes, even if they might be rusty.”

/35
"He thinks getting to zero — in Germany — is possible but would be tough.

"“But it would absolutely be worthwhile to at least identify zero new infections as a target. Primarily because I am quite apprehensive about what might otherwise happen in the spring and summer.”

/36
"Ripping through the Amazon and Ireland

"Let’s go now to Manaus, a city located in the Amazon jungle where..Nearly 70 per cent of the population was infected in the first wave. The city dug mass graves in the red earth of the Amazon.

/37
"Now a variant is ripping through the community with such intensity that hospitals have run out of oxygen. And more graves are being dug, largely for people below the age of 60.

/38
"Now let’s go to Ireland, where the U.K. variant has filled hospitals to overflowing. The country got off easy in the first wave and then threw things open before Christmas just as the variant arrived.

/39
"“I think that this is a lesson that governments around Europe should learn. What is happening in Ireland shows just how vulnerable countries are that are trying to live with the virus, and that it’s..increasingly more difficult..dealing with the new variant of the virus.

/40
"And what did the U.K.’s chief scientific adviser Sir Patrick Vallance say after COVID-19 killed 50,000 citizens in the last three months?

/41
"“The lesson is go earlier than you think you want to, go harder than you think you want to, and go a bit broader than you think you want to in terms of applying the restrictions.”

/42
"It’s only going to get worse. Go to zero

"For my last point, consider this paper by Israel’s Weizmann Institute of Science.

"In the lab, researchers fooled around with the virus (they modified the genome) to mimic what occurs naturally as it mutates and evolves.

/43
"Not surprisingly, the lab variants sported many of the same mutations that Mother Nature has thrown out recently, plus this shocker. One lab variant bound 600 times more successfully to human cells than the original strain.

/44
"“The laboratory experiments described here suggest that naturally-occurring variants have not yet reached the peak of infectivity,” researchers concluded. (The good news: natural virus selection is not as efficient as in vitro selection.)

/45
"..imagine COVID-19 as a rapidly growing tree. The original strain serves as the trunk. New branches represent the variants. Each branch is “more fit to survive in its environment, the human population, than is its immediate ancestor.”

/46
"There is only one way to prune this tree, and that’s by reducing the number of infected humans by going to zero.

"Getting to zero is a political choice. The best public health experts support it, and most Canadians would rally behind action that brings freedom from COVID.

/47
"It’s a nuanced strategy with a clear goal of eliminating the virus so we can all breathe again. It combines travel restrictions between sensibly defined geographic “regions” (towns, rural areas and counties),

/48
"..along with brief and decisive localized lockdowns followed by an aggressive program of find/test/trace/isolate/support while hunting down the virus.

/49
"Counties and towns free of the virus connect to other COVID-19 free zones, just like the successful Atlantic Bubble.

"Eliminating the virus is a much better way to live, as one Irish doctor put it, “than the confused and meandering uncertainty of mitigation.”

/50
"If you want to fail and live through a third wave, just wait for a vaccine.

"If not, then flood your politicians with one message: Go to zero.

/51

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More from @yaneerbaryam

Feb 23
Blood–brain barrier disruption...with long COVID-associated cognitive impairment

"Using dynamic contrast-enhanced magnetic resonance imaging, we show BBB disruption in patients with long COVID-associated brain fog.

nature.com/articles/s4159…
Image
"brain regions with reduced volume in patients with previous SARS-CoV-2 infection" Image
"Fig. 4: BBB permeability is associated with structural brain changes. Image
Read 4 tweets
Jan 23
Important News from CDC on HICPAC Infection Control recommendations:

"Based on the significant interest in the draft recommendations, CDC is taking a proactive step of communicating back to HICPAC some initial questions and comments...
1/
blogs.cdc.gov/safehealthcare…
"In addition, CDC is working to expand the scope of technical backgrounds of participants on the HICPAC Isolation Guideline Workgroup .. in accordance with the Federal Advisory Committee Act (FACA) regulations and guidance.
2/
"The expanded workgroup and the HICPAC with the newly appointed members will review and discuss these additional considerations and guideline at the next HICPAC meeting, which is open to the public.
3/
Read 8 tweets
Jan 19
"Long Covid: NHS legal action launched by family of girl

"The mother of an 11-year-old Aberdeenshire girl with long Covid has launched a legal action against their health board, in what lawyers claim is the first case of its kind in Scotland.
1/
bbc.com/news/uk-scotla…
"Helen Goss, from Westhill, is seeking damages from NHS Grampian on behalf of her daughter, Anna Hendy.
"The action claims the health board is responsible for "multiple failings" in Anna's treatment and care.
"NHS Grampian said it would not comment on individual patient cases.
2/
"The claim alleges failings were avoidable, that they caused Anna "injury and damage", and led to her condition worsening.

"Anna became unwell after contracting Covid in 2020.

3/ Image
Read 12 tweets
Jan 18
Handwashing, Gloves, and Masks: Oh My!
In 1847, German obstetrician Ignaz Semmelweis saw that obstetric patients died of childbed fever at a much higher rate than those treated by midwives...he suggested to his colleagues that they wash their hands
1/
whn.global/handwashing-gl…
..before examining their new mother patients. His idea was ridiculed and ignored. Patients continued to suffer unnecessary illness and death until Louis Pasteur’s experimental confirmation of germ theory in 1861 was disseminated and accepted in the medical community. ..
2/
"Today handwashing is a mainstay of medical protection and of basic hygiene far beyond the medical arena.

"When I was a child in the 1960s and 1970s, my dentist and physician conducted exams and dental work with clean hands but no gloves.
3/
Read 8 tweets
Jan 12
"Covid is everywhere, and I’m wearing a mask again – why is that so weird?

"Spain has made mask wearing mandatory in hospitals and health settings as the country faces a wave of Covid and flu infections. A junior doctor says she thinks Britain should do the same

1/ Image
"As of this week, masks are mandatory in Spain’s hospitals&health centres as the country experiences a surge in Covid, flu & other illnesses. As the UK navigates a similar surge this winter, Chidera Ota, 29, explains why she’s started wearing a mask while out and about.

2/
"At the end of December, I started wearing a mask again. I was taking the coach from London to Edinburgh for Christmas, and as I was queuing in the coach station, all I could hear was coughing and spluttering. I knew Covid cases were reaching a record high, flu was everywhere. 3/
Read 15 tweets
Dec 14, 2023
"What Companies Can Do Against Long Covid
By Britta Domke

"Many companies are overlooking the significant risk posed by Long Covid, a decision that could have serious repercussions. With a few targeted measures, it's possible to make workplaces largely safe from coronavirus. 1/
"Deserted workplaces, everyone's out with Corona: For businesses, this wave of illness often translates into considerable revenue losses.
2/
"The news from Jena University Hospital barely made a ripple in most newspapers. The business sector remained silent. However, what an interdisciplinary team from Jena revealed in a study with 40 Long Covid patients should be a cause for concern among employers.
3/
Read 15 tweets

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