Prediction: 2021 will be the year that COVID-19 becomes a disease of children.
Why do I predict COVID-19 will become a disease of children in 2021?

In developed countries, the majority of adults should be vaccinated by the end of the year.

But children probably won’t be, and so the virus will predominantly circulate in children and adolescents.
Additionally, many countries are still not doing enough to protect schools. There may even be pressure to completely end *all* public health measures once adults are vaccinated.

Under these conditions, the virus will spread unchecked in children and adolescents.
We could then witness the full spectrum of disease in children.

The majority of cases in children will still be mild or asymptomatic, but in absolute terms we can expect a large number of children to get seriously ill, especially with long COVID.

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More from @DrZoeHyde

14 Mar
(1/8) Important pre-print study (interpret carefully), estimating how long vaccination lasts.

A vaccine with an initial efficacy of 95% might drop to 58% after 250 days, but a vaccine with 70% efficacy could drop to 18%.

BUT: protection from severe disease may last much longer.
(2/8) First up, the authors found a strong association between the amount of neutralising antibodies a vaccine induces, and its efficacy.

Pfizer-BioNTech (BNT162b2), Moderna (mRNA-1273), and Novavax (NVX-CoV2373) are in the top right corner.
(3/8) Based on the limited data for mRNA vaccines available to date, the authors estimated that the half-life for vaccine-induced antibodies (65 days) was similar to those produced by infection (58 days).
Read 8 tweets
13 Mar
(1/4) More evidence SARS-CoV-2 is airborne. In this report of 3 cases, proven by sequencing, ordinary surgical masks and face shields were not able to prevent aerosol transmission.

But don’t panic. There are ways to hack your mask!
academic.oup.com/cid/advance-ar…
(2/4) It’s important to remember that this does not mean that surgical masks are completely ineffective.

They do prevent transmission much of the time, but they are not foolproof.

Partial protection is better than no protection, and there are ways to improve mask effectiveness.
(3/4) The authors recommend the following:

➡️ Improving mask fit by using ties, rather than ear loops
➡️ Adding mask filters
➡️ Switching to a P2/FFP2/N95 mask if available (although this may be more appropriate for doctors caring for patients, or in regions with high incidence)
Read 4 tweets
11 Mar
⚠️ Not a joke.

Australians (including me) risk fines for sharing information about vaccines on social media.

Advertising medications direct to consumers was already prohibited in Australia (for good reason), but recent guidance about COVID-19 vaccines approaches censorship.
It seems social media posts comparing the efficacy of different vaccines may be considered advertising by Australia’s regulator (the TGA), because they could lead people to seek out a particular vaccine.

The TGA doesn’t muck about when it comes to fines.
tga.gov.au/infringement-n…
Additionally, pharmacies, doctors, and organisations that are part of the COVID-19 vaccination programme are banned from advertising whether they are using the AstraZeneca or Pfizer vaccine, and must instead use official government materials.
smh.com.au/business/compa…
Read 5 tweets
4 Mar
🧵 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.
Read 12 tweets
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

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