I've just seen an editorial calling for people to be more polite on social media. Sounds good, doesn't it? I agree.

But there's some background to this piece that I think people ought to be aware of, because it looks to me like an attempt to re-write history.
In June last year, one of the authors of the editorial falsely accused me of misrepresenting the findings of a study.

Here's how the interaction played out:
This strikes me as hypocritical, given his own conduct.

In this study, Dr Munro said there was "no increase in death". That was so for younger adults, but not those aged >65, who had an increased risk of death from COVID-19.

That's quite an omission.
The article calls for "collegiate, thoughtful, and mutually respectful dialogue", but that's been in short supply.
I’m not the only person who's been on the receiving end of the "unkind, aggressive, or mocking commentary" the authors decry.
Mocking Dr Leonardi for suggesting that SARS-CoV-2 infection might have long-term health consequences is not okay.

It's also quite ignorant.
In remote Australia, we have a huge problem with rheumatic heart disease, which is caused by group A streptococcus infection.

A sore throat is actually often the first sign of infection. If untreated, it can lead to lasting heart damage.
rhdaustralia.org.au
Rheumatic heart disease is one of the major reasons why Aboriginal Australians have a lower life expectancy than non-Indigenous Australians (about 8 years less).

Dr Munro may never have encountered a case, because it's generally rare in the Western world, but not here.
Dr Munro was also dismissive of a mysterious inflammatory syndrome that began to affect children in early 2020.

We now know that condition as PIMS/MIS-C, and it's established that infection with SARS-CoV-2 is the cause.
Disagreements are to be expected, of course. And even if the science is settled there may be many possible policy responses. Spirited debate about the direction we should take is inevitable. But I hope the authors of the piece will reflect on their own conduct as we move forward.

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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…
(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
19 Mar
(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. 👇
Read 8 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

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