🧵 New work from me: I rebut scientific criticism & re-analyse school data from Victoria, Australia.

What did I find? Primary school children were a bit less likely to cause outbreaks than high school children, but this wasn't statistically significant.
onlinelibrary.wiley.com/doi/10.5694/mj…
The proportion of events resulting in an outbreak was as follows:

Child, primary school (6-12 years): 31%
Adolescent, high school (13-15 years): 41%
Adolescent, high school (16-18 years): 40%
Adult (primary and high school): 39%

But note large, overlapping confidence intervals.
These data also have some important limitations.

First, not all contacts were tested, and so transmission may be underestimated.

This may particularly affect the data for primary school children, who might have been tested least.
Second, primary and high schools are very different settings. While it’s possible younger children might transmit less, differences in behaviour and environment are also important factors that could explain differences in the likelihood of an outbreak occurring.
That is, any differences in outbreaks may reflect the type of school and the opportunities for transmission in it, rather than an age-related difference in transmissibility.
Third, data for primary and high school staff are aggregated. It’s therefore not possible to see if adults were also slightly less likely to initiate outbreaks in primary schools compared to high schools.
The key finding is that children and adolescents appear to transmit the virus to their classmates at fairly similar rates.

This means precautions in primary schools and high schools must be similar.

All children who can safely wear a mask should do so.
A statistically significant difference was observed with regard to the childcare setting.

Children appeared less likely to initiate outbreaks in childcare compared to adults.

However, it is unclear if all of the children were tested, and so transmission may be underestimated.
But transmission clearly does occur in childcare.

Precautions must also be taken in the childcare setting. Ventilation should be improved, and all children who can *safely* wear a mask should do so.

⚠️ Children aged under 2 years should not wear a mask.
cdc.gov/coronavirus/20…
My article also rebuts some of the common misconceptions around children and COVID-19.

Here's the link again:
onlinelibrary.wiley.com/doi/10.5694/mj…

And here are translations:

🇩🇪Deutsch:
translate.google.com/translate?hl=d…

🇫🇷Français:
translate.google.com/translate?hl=f…

🇳🇱Nederlands:
translate.google.com/translate?hl=n…
More translations:

🇪🇸Español:
translate.google.com/translate?hl=e…

🇵🇹🇧🇷Português:
translate.google.com/translate?hl=p…

🇯🇵日本語:
translate.google.com/translate?hl=j…
Finally, you can find my original article and the letters that prompted this response below.

Original article:
onlinelibrary.wiley.com/doi/full/10.56…

Letters in response:
mja.com.au/journal/2021/2…

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More from @DrZoeHyde

3 Mar
(1/5) Serious allegations have been made concerning a paper which suggested keeping schools open in Sweden was low risk.

It is alleged the authors deliberately left out data showing excess mortality rose by 68% in school-aged children.

Read on...
sciencemag.org/news/2021/03/c…
(2/5) The main author of the original paper, Jonas Ludvigsson, is a signatory to the Great Barrington Declaration.

The Declaration suggests that the virus should be allowed to spread in people at low risk of dying from COVID-19, in order to build herd immunity.
(3/5) The emails between Jonas Ludvigsson and Anders Tegnell (the architect of Sweden’s pandemic strategy) that the article refers to, appear to be these ones:
Read 5 tweets
26 Feb
(1/22) Here's a new paper from me about some of the biases affecting research on children and COVID-19, and more importantly, some solutions.

It hasn't been typeset yet (the PDF might be hard for non-English speakers to read?), so I'll do a quick summary.
academic.oup.com/cid/advance-ar…
(2/22) First, "bias" has a different meaning in epidemiology compared to everyday life.

It doesn't mean someone's done something wrong. It just means there's a methodological issue that affects the results.

This article explains some of the common types.
jech.bmj.com/content/58/8/6…
(3/22) Now, on to the paper. It's been argued that children are less susceptible to infection with SARS-CoV-2 than adults and play only a minor role in transmission.

This conclusion is likely premature, because it's often difficult to detect infections in children.
Read 22 tweets
23 Feb
I don't like to dwell on negatives, but something important happened recently that I'd like to make public.

Shortly before Christmas, @mugecevik made a complaint to my university about me. When asked for details, she didn't provide any. My employer took a dim view of the matter.
I thought that was pretty strange, but laughed the matter off. After all, the complaint didn't go anywhere and I was supported by my university.

But last week, she made a complaint to a publisher about an article I recently wrote. It was this article:
theconversation.com/herd-immunity-…
She listed an astonishing 12 complaints (yes, 12!), said the article was grossly inaccurate, and asked for the article to be retracted.

However, no errors of fact were identified, so the article has not been retracted.
Read 8 tweets
22 Feb
Historically, I’ve not been a big user of social media. It never really appealed to me.

But in early 2020, I was pretty sure we were facing a pandemic and so started this account to share my thoughts with friends and family.

It got a bit bigger than I expected.
But as this account has grown, it’s taken up more of my time than it did in the beginning.

I don’t plan to stop tweeting any time soon, but I’m going to have to spend a bit less time on here. For one thing, it’s grant-writing season now, and that’s going to occupy me for a bit.
I’ve also begun to see how social media can be quite an addictive medium and I don’t want to get sucked into that. So I’m going to pull back a little in terms of the amount of time I spend on here.
Read 4 tweets
15 Feb
Here’s some good news. In this study of 514 people who received their first Pfizer vaccine dose, those who’d previously been infected showed a superior immune response compared to uninfected people, even if initial antibodies were no longer detectable.
eurosurveillance.org/content/10.280…
Research has already shown that the vaccine acts like a super-booster in people who’ve been infected with SARS-CoV-2, suggesting that one dose may be enough for them.

However, it wasn’t clear if this would still apply if the antibodies from infection were no longer detectable.
This study shows that everyone got a boost, even if they no longer tested positive for antibodies.

A limitation is that the study only had 17 people with a previous infection (6 with detectable antibodies, 11 without), but the results are still reassuring.
Read 5 tweets
8 Feb
Thread summarising an important presentation on the AstraZeneca trial results for South Africa.

Key points:

➡️ Efficacy initially seemed to be ~75%, but dropped to 22% against SA 🇿🇦 variant.
➡️ Past COVID-19 (original) doesn't protect against reinfection by the SA 🇿🇦 variant.
This was a relatively small trial with only 1,749 mostly young, healthy participants.

People were given two doses of the vaccine about 28 days apart.
The relatively small number of people in the trial makes it suitable for exploring the efficacy of the Oxford/AstraZeneca vaccine against mild-to-moderate disease only.

The trial lacks statistical power to tell us the efficacy of the vaccine against severe disease.
Read 19 tweets

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