@deeksj @vulpine2020 @TAH_Sci @AllysonPollock "The more common a disease is the greater the net benefit of testing" is quite an oversimplification imo.

There's a lot of complications, but it largely depends on what testing is trying actually to achieve.

1/
@deeksj @vulpine2020 @TAH_Sci @AllysonPollock Yes, at higher prevalence it will find more cases, and this may translate to more total infections prevented or lives saved, but the proportional impact on R(t) at high vs low prevalence likely not so different if uptake constant.

2/
@deeksj @vulpine2020 @TAH_Sci @AllysonPollock Also, it is unclear (& to me unlikely) whether UK's PCR testing when at the highest prevalence with slow turnaround had any kind of significant impact on transmission, or whether there was any net-benefit at all when the disease was more common.

3/
@deeksj @vulpine2020 @TAH_Sci @AllysonPollock Arguably, high testing coverage at low prevalence would actually have a > proportional impact, or even > absolute net-benefit (societal) if it means schools & businesses can re-/stay open, young people can meet & have fun, &/or we dont need blunt restrictions on evrday life.

4/
@deeksj @vulpine2020 @TAH_Sci @AllysonPollock And again the epidemic context is important, where testing might have a relatively small impact on R(t), but when Rt is hovering around 1, that 0.2 is vital, otherwise the epidemic likely spirals out of control again and harsher restrictions may be needed again.

5/
@deeksj @vulpine2020 @TAH_Sci @AllysonPollock Idk all the answers, I don't think anyone does really, but I do have concern that dogmas such as testing is only useful at high prevalence, or no test is better than a 'bad' test (without really defining what 'bad' means) are not so helpful to this really quite complex topic.
6/
@deeksj @vulpine2020 @TAH_Sci @AllysonPollock Given the dynamics of SARS-CoV-2 transmission, it would be good to see the meaningful outcome of testing programmes.,
eg. 1/Time to % appropriate action, & net PH- benefit be discussed more, but perhaps twitter really just isn't the best place for any of this sort of stuff.
7/
@deeksj @vulpine2020 @TAH_Sci @AllysonPollock I also don't know if the phrase 'these tests are more accurate in those with symptoms' is quite true either, when they are being used as tests of people shedding infectious virus.
The tests accuracy isn't dependent on symptoms, it is dependent on quantity of virus being shed.
@deeksj @vulpine2020 @TAH_Sci @AllysonPollock But I guess that's for another day.

End, I guess.
@deeksj @vulpine2020 @TAH_Sci @AllysonPollock Actually attempting to study/quantify all these benefits and harms is key though, although ofc incredibly complex.

And ofc acknowledgement (from gov and others) first step to that..

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3 May
Science framework for opening up group events

This paper is a response to a DCMS Commission to inform a research programme to be overseen by the DCMS Science Board focusing on opening events and venues with minimal transmission risk.

Thread ⬇️

assets.publishing.service.gov.uk/government/upl…
It was prepared by a Working Group organised by SAGE-EMG and DCMS that included participants in several SAGE subgroups (EMG, SPI-B, SPI-M) and others (Appendix B).
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Public Health is most probably the discipline of science that materially improves the lives of the most people around the world, striving to use evidence, expertise, and insight from all disciplines to improve the health and wellbeing of the population as a whole.

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