Following some hoopla that my tweet ππ» causedβ¦
1. I want to applaud all the medical workers in #Montenegro - epidemiologists, support staff, technicians, nurses, doctors - who are at the front line, caring for the many sick people in the hospitals around the country (π§΅1/10)
I want to make sure that what Iβll say is #not meant to indicate that the #services you provide in π²πͺ are not good - I know that you are doing your very best, and I thank you from the bottom of my heart (2/10)
*reminder: health services is not a synonym for health system
My comment that it doesnβt make sense to use #CFR (or as was referred to βlethalityβ) for comparisons between countries, and as a mirror of the quality of health system quality is based on the following facts (3/10)
The #CFR (case fatality ratio) is, as you should know by now:
[(number of deaths)/ (number of βconfirmedβ cases)]
The number of confirmed cases depends on many factors.
Now, the quality of health systems is one of the many factors, and Iβd want to believe that this is the only factor that has kept the CFR low in π²πͺ. In the best case scenario, this might be true, but the number of infected people is a reflection of how we are doing too (5/10)
Second - one can #not use the CFR to compare the performance of countries in the time of pandemic, as explained in the bulk of #epidemiology literature and for reasons explained for example here bit.ly/3cJso6e (6/10)
What is important to know is the #IFR (infection fatality rate), which is
[the (number of deaths)/ (number of βconfirmedβ + undiagnosed cases)].
You canβt calculate IFR unless you have serological data on disease prevalence in the country, you can only estimate it (7/10)
The time will show what the #IFR in π²πͺ and I feel somewhat silly writing about this when we have some fantastic epidemiologists in @ijzcg who can explain this better.
Why not give them the podium and let them educate the public, as they did so well last year? (8/10)
For the end I will just repeat that yes, we have lost more than 1,300 lives in a country of 660,000 citizens, the #CFR per capita is high and this all breaks my heart.
One last clarification: making conclusions from complex data based on just one variable is called #cherrypicking. Nothing wrong with #cherrypicking per se, but might be misleading in understanding of a larger picture (10/10).
Thanks to the @CEPIvaccines@WHO@EuWHOEurope#Covax and others, 24,000 doses of #AstraZeneca vaccines arrived in π²πͺ last week, and this is just fantastic! But as in other European countries, there is a lot of hesitancy and fear related to this vaccine. ππ» (π§΅)
The ministry of health @MinZdravlja made the #AstraZeneca vaccine available to all 65+ old citizens, and this is great news as they are the most vulnerable group that was not eligible for @sputnikvaccine and #Sinopharm vaccines given in previous weeks to people 70+ ππ»
The main fear from what I understand is related to the inconsistent recommendations about the appropriate target groups and recent reports of #thrombotic events recorded in several EU countries now. Letβs address the issues one by one ππ»
The main findings are discussed in the 𧡠that follows (1/n)
KSHV and its cousin EBV use an envelope glycoprotein complex called gH/gL to bind to #EphA2 receptor tyrosine kinase to gain access to host cells. We set to determine the structure of the KSHV gH/gL-EphA2 complex and perform functional studies to understand the mechanism (2/n)
While we were gathering the functional data Su et al. published the 3.2 A structure and provided some interesting insights few months ago.
But under our 'no scoop good enough' mantra we kept working and obtained some cool data that we can now share (3/n)
Seemingly good news are coming from π²πͺ and this makes me happy, but I implore @VladaCG not to give false idea of security to its citizens. The number of detected cases dropped by 50% as their graph shows, but that is largely due to the β¬οΈ numbers of tested performed daily. (1/4)
If you look at the incidence rate, it shows a very small decrease that cannot be reliably attributed to 'a better situation' in #Montenegro (2/4)
Don't be fooled that the situation will get better until most people are vaccinated. The B.1.1.7 (UK) strain that is wracking havoc around Europe now is growing in Montenegro too, it's just that we don't know which % it is at now because of the lack of sequencing (3/4)