Modelling preprint from LSHTM published showing that in almost all scenarios, opening schools at this point in England without additional mitigation results in R rising above 1, and exponential rises in cases resuming. Short thread
First, these results are unsurprising given that in our last lockdown in November, new variant cases were rising with an R of 1.45 even during lockdown, but while schools were open. This is the best comparator given the new variant is now dominant across England.
In almost all scenarios R rises above 1 (we are at ~0.8 or so now) when opening primary or secondary schools or both.
Important caveat: The susceptibility & transmissibility assumptions seem to be from studies which examined this mostly before the new variant. The study states that the actual impact on R will depend on the changes in frequency of the new variant - now dominant across England.
All evidence points to needing safety measures in schools prior to opening. We've been here several times before- it's crucial we don't make the same mistakes again - leading to yet another wave & school closures once again. We need a sustainable strategy for school opening.

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More from @dgurdasani1

18 Feb
Brief thread to debunk the repeated claims we hear about transmission not happening 'within school walls', infection in school children being 'a reflection of infection from the community', and 'primary school children less likely to get infected and contribute to transmission'.
I've heard a lot of scientists claim these three - including most recently the chief advisor to the CDC, where the claim that most transmission doesn't happen within the walls of schools. There is strong evidence to rebut this claim. Let's look at this.

Let's look at the trends of infection in different age groups in England first- as reported by the ONS. Being a random survey of infection in the community, this doesn't suffer from the biases of symptom-based testing, particularly important in children who are often asymptomatic
Read 19 tweets
14 Feb
Just an observation that while we're still debating mask use in schools in the UK, countries in Europe are revising policy on grade of masks in school (e.g. France on surgical or FFP2 grade masks in schools). Exceptionalism means we're constantly behind on evidence-driven policy.
In the UK, we've built ideologies around exceptionalism.

'Our children wouldn't tolerate masks' (despite millions of children around the world & in Europe wearing these - both in primary & secondary school settings - without any evidence of harm).
We live in an environment where we feel children are exceptional in that they aren't very susceptible to infection, or don't transmit much, and school environments are exceptional environments where significant transmission doesn't occur. These ideas are not grounded in evidence.
Read 5 tweets
13 Feb
Am going to talk about my experience with media bias around discussions of zero COVID & how this is shaping our COVID strategy. I've encountered this again & again. Am also going to speak about why it's important we consider elimination from an evidence based perspective. Thread.
Yesterday I was contacted by a prominent BBC programme to speak about strategy for exit from lockdown & the role of scientists & politicians in defining this. I outlined elimination as a preferred strategy and provided factual arguments to support this on being challenged.
I was told this was 'interesting', but later told me the programme had moved in a different direction (not on zero covid). This has happened to me before. I watched the show- it was clear that the same issues were discussed *except* elimination was not considered at all.
Read 37 tweets
12 Feb
This is irresponsible & negligent- we haven't learned anything from past mistakes. Letting a big wave of infection flow through the UK would mean hundreds of thousands of people with long COVID, and further virus adaptation & spread that may threaten vaccine effectiveness.
We can't count on being able to tweak vaccines to keep on top of virus adaptation- adaptation has happened much faster than we imagined- and is continuing in a way we can't predict. This is the same as the 'focused protection' & herd immunity strategy promoted by the GBD.
We've literally seen the impact of this strategy- which has given rise to more transmissible variants, and more recently variants with mutations that can potentially reduce vaccine effectiveness. We have exported these variants to much of Europe, with impact for pandemic response
Read 4 tweets
12 Feb
Worrying data from the most recent PHE surveillance yesterday - despite these data really underestimating infection in children (as they are based on symptom based testing), positivity rates appear highest in early year settings (fully open) & primary schools (20% attendanc).
The real differences are likely to be greater, given that much of infection is asymptomatic in children. Also worth noting the steep drop initially after school closure, which then plateaus to become more gradual after school re-openings.
Infection among children closely tracks school openings and closures (as we saw even during october half term), and level of attendance (trends in secondary schools where attendance is much lower are different). Again in line with substantial transmission occurring in schools.
Read 4 tweets
11 Feb
“If we let variants emerge, amid high transmission rates, that new variant could easily overtake the whole viral population,” @GuptaR_lab

Stark contrast to the rhetoric from JVT at the briefing earlier this week. We need to contain transmission urgently…
Let's remember that E484K has emerged on the background of the UK variant, not once, but many different times- this means that the virus is evolving in this direction. And if it's allowed to continue adapting, through high levels of transmission, it will continue to do so.
And as I've said before, as pressure from vaccine-acquired immunity mounts, we should expect the selection pressures on the virus to be different - it's entirely possible that if high transmission is allowed to continue alongside vaccination, this will create pressure for escape.
Read 5 tweets

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