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Bill Hanage Profile picture
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1 Feb, 4 tweets, 2 min read
I am all for large amounts of testing, but I doubt this will be sufficient to do more than slow things down (good in its own right of course). There's also not much in here on what will be done in the event of a positive test. theguardian.com/world/2021/feb…
That's what people forget. If a positive test does not lead to action that stops transmission, meaning support to allow isolation and quarantine of contacts, you're really only keeping score for the virus
and then @leilaluheshi said what I was going to say next
(albeit around sequence data, which is a whole other thing! But rapid test results also matter, which is one of the reasons I signed this rapidtests.org/expert-letter)

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More from @BillHanage

Bill Hanage Profile picture
2 Feb
I think it is fair to say now that B.1.1.7 is definitely more transmissible, and possibly more virulent. This also reports cases that have acquired E484K, a mutation found in the other variants. This is concerning, but not reason to go crazy. A thread 1/n assets.publishing.service.gov.uk/government/upl…
First let's put to bed any suggestion that overdispersion in transmission explains B.1.1.7's rise. Consider data from Denmark, Ireland and now LA to mention only a few. It's behaving as we expect 2/n
This is the weekly increase in England documented in the linked report since early October. It's quite interesting that it's not taken over completely but don't want to speculate why 3/n Image
Read 15 tweets
Bill Hanage Profile picture
23 Jan
Some recent credible studies from the UK suggest that the variant B.1.1.7 which was first detected there is not only more transmissible but associated with greater severity, measured by deaths. A thread 1/n
The studies on which this is based are summarized in this document. Notably, it is not founded on one study, but several. They incorporate different data, methods and different biases and they are all imperfect, but they point in the same direction. assets.publishing.service.gov.uk/government/upl… 2/n
The upshot is that people infected with B.1.1.7 are about one third more likely to die than similar people infected with the pre-existing viral lineages. There is a LOT of uncertainty around that number. For a lot of reasons. But some increase (even if small) seems legit 3/n
Read 11 tweets
Bill Hanage Profile picture
16 Jan
My announcement that I was running with a mask got a LOT of comment (from all sides) earlier. It’s in response to changes in the state of the pandemic and the transmissibility of the virus. Worth unpacking 1/goodness knows
First I posted the photo after a couple of interviews this week in which mask use outside was discussed in the context of surging infections due to the variant B.1.1.7. Here's one
And then this with RTE where were talked about mask use in the context of the situation in the Republic of Ireland, where cases are surging. I commented that I run with a mask. Hence the tweet

Read 13 tweets
Bill Hanage Profile picture
15 Jan
I’ve thought long and hard about this. There is a constellation of circumstantial evidence around the most recently identified variant P.1, and what has been happening in Manaus, Brazil which makes me very seriously concerned. A thread 🧵
First Manaus has already been very hard hit by the pandemic. News reports in earlier stages told of rushed burials and bodies piling up reuters.com/article/us-hea…
The crucial thing was the rapid rates of transmission, not really mitigated by ‘flattening the curve’ any. total per capita mortality was not as high as might be expected elsewhere, but only because the age structure of the population in Manaus skews young citypopulation.de/en/brazil/amaz…
Read 13 tweets
Bill Hanage Profile picture
14 Jan
The UK has other problems for the next month or so, but this decision in my opinion hugely misses the point of rapid testing for schools or other places 1/n theguardian.com/world/2021/jan…
Imagine you only detect 75% of true cases of infection. Well, you just cut the risk of transmission in school by 75% and that's not nothing. What about the remaining 25%? Use masks as well. Anything that makes it through the rapid test now has to beat the mask 2/n
Two masks actually, if everyone is using them. This article with @j_g_allen and @jenkinshelen explains why this is important 3/n theguardian.com/commentisfree/…
Read 9 tweets
Bill Hanage Profile picture
13 Jan
There is a new ‘variant’ clearly identified today, P.1. And it is worth saying a little about what we have learned about it, and from the variants we have identified so far virological.org/t/genomic-char… 1/quite_a_few
First these are not simple ‘mutants’. Mutations happen all the time and most mean nothing much and either persist at low levels or are removed by selection. The variants are characterized by *multiple* mutations – one of the reasons we call them variants and not mutants 2/n
Those multiple mutations are in parts of the genomes that are not exactly the same, but they overlap to a really pretty marked degree (esp the receptor binding domain). This looks like convergent evolution in which different lineages find the same solution by different routes 3/n
Read 15 tweets

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