(1/8) Study of 12 million adults in England, showing that living with children during the second wave was associated with an increased risk of testing positive or being hospitalised for #COVID19.

Risk of death was increased for adults aged >=65 years.
bmj.com/content/372/bm…
(2/8) In real terms, the effects were modest and equal to an extra:

40-60 infections (5-7% ⬆️) and 1-5 hospital admissions per 10,000 people for those living with young children; and,

160-190 infections (20-23% ⬆️) and 2-6 admissions (1-4% ⬆️) for those living with adolescents.
(3/8) The risk of dying from COVID-19 was not increased in people living with children who were aged under 65 years.

However, the risk of dying from *any cause* was less in people living with children.

There’s a very important reason for this. 👇
(4/8) People living with children were younger than those not living with children and were also healthier and had higher socio-economic status (less deprived).

These are all protective factors for health and mortality. One would therefore expect lower deaths in this population.
(5/8) For adults aged 65 years and older, the authors found an “increased risk of infection associated with living with children of any age and of ICU admission and death from covid-19 for those living with children aged 0-11 and 12-18 years.”
(6/8) While the risks were greater for those living with adolescents, this likely reflects the virus being more prevalent in older children at that time, and secondary schools being environments more conducive to transmission than primary schools (more mixing).
(7/8) That is, these results do not necessarily imply that younger children are less likely to transmit the virus than adolescents.

It’s also important to note that an increase in risk was not seen during the first wave, but schools were largely closed during this time.
(8/8) In summary, this study shows that living with children is associated with an increased risk of testing positive.

It strongly suggests schools are places in which transmission occurs.

Hence, it’s vital to implement mitigation measures in schools.

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More from @DrZoeHyde

20 Mar
(1/7) Pre-print study (interpret carefully) showing that monkeys infected with SARS-CoV-2 developed abnormal proteins in their brains (Lewy bodies) that are linked to the development of Parkinson's disease and a type of dementia.

H/T: @fitterhappierAJ.
biorxiv.org/content/10.110… Image
(2/7) In this study, 4 rhesus macaques and 4 cynomolgus macaques were infected with SARS-CoV-2, and developed mild-to-moderate symptoms.

Lewy bodies developed in all 4 rhesus macaques, and one old cynomolgus macaque.

i.e., Lewy bodies developed in 5 of 8 monkeys.
(3/7) Animal studies do not always translate well (or even at all) to humans, and so these results need to be interpreted very carefully.

The monkeys also received a higher dose than most humans would likely be exposed to.
Read 7 tweets
15 Mar
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.
Read 4 tweets
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

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