The unexpected dynamics of COVID-19 in Manaus, Brazil: Herd immunity versus interventions | medRxiv

The recent & brutal resurgence of Covid in Brazil, in particular Manaus, belies earlier (contested) studies suggesting the region had reached her immunity medrxiv.org/content/10.110…
Buss et al suggested (largely from blood bank data) that 76% prevalence had been reached by last summer leading to the reduction in cases.

In fact by December hospitals were overwhelmed again.

Whilst there were no national lockdowns local NPIs were introduced
Despite Bolsanaro’s continuing unhelpful interventions the likeliest reason for the reduction over the summer were those NPIs in Manaus and many other states and cities, with the local provision of financial support for isolation.

Climate factors, too, may have played a part.
Others had previously challenged the Buss study eg @WesPegden
Given the even worse second wave it seems self evident that those challenges are well founded

NPIs work as long as they are followed

Herd Immunity is likely to be very hard to achieve absent extensive vaccination

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More from @fascinatorfun

2 Mar
Critics slam letter in prestigious journal that downplayed COVID-19 risks to Swedish schoolchildren

Bloody hell.

Having published a letter suggesting that deaths in children had not significantly increased emails revealed a very different picture
sciencemag.org/news/2021/03/c…
This is a paediatrician!

The original letter he wrote combined the ages 1-16years when counting deaths from any causes. 69 children March to June 2020 v 65 on the 5 year Average.

He also incorrectly reported NO major school outbreaks, ignoring one where 18/76 staff infected
One of the teachers died. Children were not tested.

It gets worse. Contrary to his published letter Ludvigsson wrote to Tegnell that “unfortunately we see a clear indication of excess mortality among children ages 7-16 old, the ages where ‘kids went to school.’” Image
Read 4 tweets
1 Mar
Agree with @SimonUbsdell

“Nearly four in five (79 per cent) of those who were currently in favour of Leave voted for the Conservatives in the 2019 election. In contrast, only around a half (49 per cent) of those who backed Remain gave their vote to Labour.”
“If Labour had succeeded in emulating among Remain voters the Conservatives’ success among Leave voters, the party would have outpolled Boris Johnson and been in a position to oust him from power”

But it didn’t. It lost critical remain votes and is on its way to doing it again.
Labour's difficulty, of course, was that it was in competition for the Remain vote in England and Wales with the Liberal Democrats, a party that was clear if not always effective in its advocacy of the argument that Brexit should be cancelled,
Read 4 tweets
1 Mar
#Channel4 #ConditionCritical

Half the people in this unit are younger than me. Think about that. Working age NHS staff saying this.

Most nurses feel the pandemic has had a negative effect on their mental health.

How are we caring for them?
#dispatches

If anyone knows the @ handle of the doctor leading this programme please let me know.

I would just like to find a more personal way of recognising the hardship, grief and greenshoots. Especially for Nathan and all new medics and nurses and with her own family
Thank you THANK YOU @SaleyhaAhsan and Nathan and all your colleagues.

I know there are gainsayers out there but they are a tiny spit in the great sea of our gratitude.
Read 4 tweets
1 Mar
I’ve been wondering about a 2-stroke approach depending on population based vaccine efficacy

I think AZ vaccine works more slowly but well.
What if we vaccinated most at risk pops once but delayed the second dose a bit longer to get high contact front line workers vaccinated too
I welcome vaccination for myself (an acknowledged at risk group if not in the oldest “most at risk” group).

But I feel quite uncomfortable about being given protection when others who are public facing don’t.

And maybe there is a difference between vaccines in that regard?
So what if those who, by virtue of their work/volunteering have more contacts.

Maybe it would benefit all of us to vaccinate them sooner?

Maybe a more “chugging” than “sprinting” vaccine could help when prevalence is high?

Even mixed vaccines.
Read 4 tweets
1 Mar
“The British government casts its fight in superlatives: the fastest authorization of vaccines, the speediest rollout of inoculations. But there is another, more macabre marker: a higher per capita death toll than any other large country in the world.”

nytimes.com/interactive/20…
The disease’s impact is visible in shuttered shops.

I see it in my own home town, Cheltenham.

The shops were shutting before Covid “thanks” to Brexit.

But, as with humans, Covid has been the nail in the coffin for many more.
“The worst thing was seeing other ps around me die” said Hayward Sal.

“I heard a lot of people beg every kind of God they could think of to survive”.

It isn’t just the dead who suffered. So did those who survived and their friends and families.
Read 19 tweets
1 Mar
Quick summary with usual Monday data lag ⚠️

🦠🦠5455 new cases -lowest we have seen since 22nd Sept when we should have locked down. But LFT were not being used then.

⚰️⚰️ 104 (28 day cut off) deaths

Even allowing for Monday data lag the fall seems to be accelerating👏👏👏
🏥 ADMISSIONS 1112 (23/2/21) but England admitted 976 patients then. By 26/2/21 it admitted 718. I am hopeful we may see under 1k in a day this week.

🛌 IN PATIENTS 14,808 (25/2/21) Still very high. But by 28th England had dropped from 12.4K to 10.6k.

VENTILATION 🛌 1971
💉205,584 doses administered Sunday bringing the total to

💉💉 21,091,267 doses given to 20,275,451 people

💉💉💉 Of those 815,816 have received two doses.

Expecting a big push in the next couple of weeks and to see second doses increasing.

WELL DONE VACCINATION TEAMS! 👏👏
Read 5 tweets

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