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Peter English #FBPE Profile picture
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5 Feb, 4 tweets, 2 min read
This is a great thread with some useful-for-explaining metaphors on how immunity works and how it can be dysfunctional. It left me wanting to know more about…
… It left me wanting to know more about how an immune system, primed to recognise an antigen, is less susceptible to the "cytokine storm" overreaction which is responsible for severe Covid-19 disease.

I would also like to know more about immunity and #LongCovid.
Incidentally, @Felicea's thread gets (adequately, not perfectly) translated by Google Chrome if you use the threadreaderapp.com version threadreaderapp.com/thread/1357490… - blame Chrome where the meaning isn't entirely clear!
I guess, in @Felicea's metaphor, the immune system police officer knows it's being attacked, but isn't sure who the attacker is; so it panics and starts shooting wildly, killing bystanders in the process.

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More from @petermbenglish

Peter English #FBPE Profile picture
5 Feb
Covid-19.

What we (UK) most urgently need to do is to:
a) Cut transmission globally (to reduce mutation and the arrival of variants that evade the immune system and vaccines)
b) Cut the number of people in the UK who get ill enough to be admitted to hospital…
1/9
c) Cut transmission in the UK, see a) above, and to reduce eg #LongCovid

Vaccines - especially when given first to those most likely to get seriously ill and require hospital admissions - will definitely help with b). They are good at preventing serious illness.
2/9
But we still don't really know how effective vaccines are at preventing transmission. And, with variant viruses which are more transmissible than the variant that we had a year ago, it's not clear that vaccines will ever bring Re below 1 without additional restrictions.
3/9
Read 10 tweets
Peter English #FBPE Profile picture
4 Feb
I was on @euronews at 11am UK time (noon their time), talking about the Com-Cov study.
Currently at euronews.com/live
@euronews I have also commented on this at SMC
sciencemediacentre.org/expert-reactio…
@euronews I will update the page on heterologous boosting on my blog - a few more thoughts have occurred to me. Current (not yet updated) page is at
peterenglish.blogspot.com/2021/01/select…
Read 4 tweets
Peter English #FBPE Profile picture
24 Jan
1/6
 Thread by @Dr_D_Robertson: The Home Secretary has suggested that police should get higher priority in vaccinations. There is an article in the @guardian where this is clarified JCVI has set out their recommendation...… threadreaderapp.com/thread/1351848…
2/6
 Of course, there's a traditional way of rationalising these decisions. Risk is product of bad event, and likelihood of event happening. Some occupations - people providing necessary services where contact with large numbers is unavoidable, will be at higher risk.
3/6
 They include HCWs, teachers, transport workers, teachers…

Their risk will be raised, compared to other people of the same age, sex, and health, because their exposure, their risk of being infected, is higher.
Read 7 tweets
Peter English #FBPE Profile picture
5 Jan
How big a hurdle is it to get a license for a slightly modified version of a licensed vaccine?
1/6
One of the advantages of the genomic-driven development of mRNA and vector vaccines is that it is relatively straightforward to modify the base sequences to keep up with pathogen mutations.
2/6
In this 10 tweet thread, @DrEricDing discusses concerns that evolution of SARS-CoV-2 might lead to variants which are not recognised (as effectively) by the immune system following previous infection or vaccination. threadreaderapp.com/thread/1346241…
3/6
Read 6 tweets
Peter English #FBPE Profile picture
4 Dec 20
@sweetanimo @patricia_stoop @abcdiagnosis I have seen some of your conversation on Twitter about the use of Covid-19 vaccines in people who are immune-suppressed, and thought I might be able to help.
1/11
First, the UK guidance, including on contraindications etc., is conveniently all in one place - in the public domain - in the "Green Book", via gov.uk/government/pub…
2/11
But first, let's consider how and why immunosuppression might be an issues with a vaccine.
3/11
Read 13 tweets
Peter English #FBPE Profile picture
3 Dec 20
Thisk, on lateral flow testing "false positives" is from DH guidance, and strikes me as extremely stupid. assets.publishing.service.gov.uk/government/upl…
@deeksj @jackiecassell

1/4
It says the test is "99.6% specificity (meaning four false positives per thousand tests)". (It doesn't mean that actually: it's four false positives per thousand tests that should have been positive - not the same thing at all. Confusing sensitivity and predictive values.)
2/4
But that isn't the stupidest thing.

It then says you can use a test with sensitivity of <70% (in the real world >30% of true positive cases give a false negative result) as a confirmatory test, and cease isolation if the second test is negative.
3/4
Read 4 tweets

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