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Anthony Costello

@globalhlthtwit

19 Apr

I respect Susan Hopkins but this troubles me. Watch from 37.04 when she is asked on isolation. She says people when contacted are already isolating and that if people have got a test the vast majority do the right thing. But the evidence is different (1) bbc.co.uk/iplayer/episod…

1. No. of contacts for each COVID-19 case is 17 per case in Taiwan, 2 in the United Kingdom.
2. China had 1 LOCAL contact tracer per 1200 population in Wuhan. UK has less than one per 10,000.
3. Successful countries test contacts and use apps to monitor isolation. We don't. (2)

4. The CORSAIR study showed self-reported adherence to test, trace and isolate behaviours was very low (selfisolation) 18.2%, 95% CI 16.4% to 19.9%. gov.uk/government/pub… (3)

Read 8 tweets

Anthony Costello

@globalhlthtwit

14 Apr

Remember the global financial crash? Packaged mortgage securities? The Big Short? This time the problem may be hedge funds borrowing to gamble on stocks, using the same stocks as securities.(1)

The hedge fund industry has borrowed a reported $814 billion in the past year, to gamble on stocks, a 49 per cent increase since Feb 2020. The true figure is likely much higher, into trillions. (2)

Gambling on stocks using borrowed money pushes up share prices which can then be sold. But some hedge funds may get the timing wrong, leading to big losses if the market smells a rat. This is what happened with Archegos, a relatively small family hedge fund. (3)

Read 9 tweets

Anthony Costello

@globalhlthtwit

8 Apr

Covid UK: Different models make different assumptions. 'Clearly, there is a substantial amount of uncertainty about these long-term forecasts as indicated by the wide credible intervals. Part of this uncertainty is due to the fluctuations in transmission risk and mobility.' (1)

Here is the LSHTM model for a large surge in hospitalisations in September 2021 (2)

Here is the Imperial model for hospital admissions. Looks a bit worse, with an earlier even higher peak under the worst case scenario (3)

Read 9 tweets

Anthony Costello

@globalhlthtwit

5 Apr

Vaccines alone will not control the pandemic. Isolation of cases and their contacts is critical as cases fall. (1) theguardian.com/global-develop…

Sir Patrick says they got it right a yr ago when they predicted a 2nd + 3rd wave. But he + SAGE on Mar 16 2020 wrote that they were 'unanimous' that China and Asian states wd face a massive second wave. They didn’t. Why? Bec they suppress outbreaks rapidly w trace +isolation. (2)

Two weeks ago Sir Patrick agreed test, trace and isolation would be critical as cases fall. Yet no mention again today of our leaky programme - test results delayed, contacts missed, isolation not monitored, Tories on TV saying £500 'encourages people to be infected'. (3)

Read 4 tweets

Anthony Costello

@globalhlthtwit

26 Mar

Control of the global pandemic is a balance between achieving population immunity (vaccines, natural infection) and containing/suppressing/eliminating the virus through public health measures (find, test, trace, isolate, behaviour change). Lockdowns are a sign of failure. (1)

Countries that implemented public health measures at speed (S Korea, Singapore, Taiwan, Vietnam, China, Thailand, Finland, Iceland, Denmark etc) avoided national lockdowns and their terrible economic effects. And have far, far lower death rates. (2)

Attention to local public health detail is essential...isolate all people with suspected symptoms, rapid test results, one community worker per 1500 population in teams of 5-6, links with primary care teams +data, supported + monitored isolation, reimbursement to all. (3)

Read 10 tweets

Anthony Costello

@globalhlthtwit

10 Mar

My lengthy thread on test, trace and isolate in light of Sir Patrick Vallance’s comments and the Public Accounts Committee Report committees.parliament.uk/committee/127/… (1)

Yesterday, when asked about his assessment of TTI by Greg Clark, Sir Patrick Vallance said ” Test and trace is working very well at the moment” (March 9 Science Select Committee, 11.32am) (2) parliamentlive.tv/Event/Index/36…

Sir Patrick agreed that “The isolate bit is very important (at all levels of cases)..TTI is more important as case numbers fall”. He also identified the importance of backward contact tracing i.e finding which contacts caused the case infection in order to identify clusters.(3)

Read 26 tweets

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