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Nicola Low #EveryDayCounts #StillFBPE Profile picture
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14 May, 4 tweets, 5 min read
This 👇🏼 #Singapore seeing new large #COVID19 clusters, including #B1617 Changi Airport, Tan Tock Seng hospital. Shows a) #VOC import risk, b) better cluster tracking with low case numbers, c) now is not the time to relax measures 🇨🇭 (1/n) straitstimes.com/singapore/heal…
Excellent thread from @trvrb on growth of nee #VOCs with added analyses from @TWenseleers
Response to #B1617 #SARSCoV2 In #Singapore govt 3-phase model has just reduced group sizes from 5 to 2 and stopped indoor dining. #Switzerland, with >1000 cases daily planning large relaxation 🙈 #PrecautionaryPrinciple please channelnewsasia.com/news/singapore…
Thanks to @trvrb analysis, which includes #Switzerland, we see growth #B1617 similar to other countries. Small numbers now. But that’s the point of prevention. Act now. Follow the data, not the calendar date #DatenNichtDatum (end)

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Nicola Low #EveryDayCounts #StillFBPE Profile picture
18 Oct 20
People are talking about *forward* and *backward* #ContactTracing #COVID19

What do they mean?

I made a case study for the @GOARN @WHO contact tracing group

A fictional contact tracer’s tale

My slides are here:
ispmbern.github.io/covid-19/Forwa…

Short thread (1/7) Forward and backward contact tracing for COVID-19, slideshow
Most #ContactTracing seeks contacts from 2 days before the infected person developed symptoms

#SARSCoV2 can be transmitted before symptoms emerge.
That is looking *forwards*

Who might the index case have infected?

Contacts in quarantine soon enough won’t infect others

2/7
Forward contact tracing can break onward transmission chains.

But it doesn’t find the source who infected the index case

To find the source, we need to go *backwards*

Index cases are more likely to have been infected by a source, who also infected others in a cluster

3/7
Read 7 tweets
Nicola Low #EveryDayCounts #StillFBPE Profile picture
6 Oct 20
@nataliexdean @EpiEllie Ooh, yes. You should judge risk of bias in #LivingSystematicReviews as you would a standard one. @jhjelliott says, „We propose living systematic review as a contribution to evidence synthesis that combines currency with rigour“ journals.plos.org/plosmedicine/a… 1/n
@nataliexdean @EpiEllie @jhjelliott Julian Elliott really started the movement with a project in @cochranecollab community.cochrane.org/review-product… and followed up with a series in J Clin Epidemiol (pt1 here sciencedirect.com/science/articl…) 2/n
@nataliexdean @EpiEllie @jhjelliott @cochranecollab Most #LivingSystematicReviews are geared towards evaluating treatments. If you want to look at observational study examples, we have #Asymptomatic #SARSCoV2, which is quite popular @dianacarbg @MichelDVM @DianneEgliGany @Geointheworld and 3/n
Read 6 tweets
Nicola Low #EveryDayCounts #StillFBPE Profile picture
20 Aug 20
This paper is (mostly) being interpreted as showing that #SARSCoV2 viral load is higher in children than adults. But is it? jpeds.com/article/S0022-… @EricTopol @DoctorYasmin @angie_rasmussen @skepteis @apsmunro @mugecevik My pedantic post-publication peer review thread (1/n)
The headline result on Tweets is that VL is higher in children than adults. But the same p-value seems to appear with different comparisons in different parts of the manuscript. Have a look. NB: I am not a fan of p-values or sub-group comparisons (2/n)
Abstract: “Nasopharyngeal viral load was highest in children in the first 2 days of symptoms, significantly higher than hospitalized adults with severe disease (P = .002).

So, in the first 2 days, when there were 2 adults and 9 children?

(3/n)
Read 12 tweets
Nicola Low #EveryDayCounts #StillFBPE Profile picture
4 Aug 20
The #COVID19 data problem in Switzerland. As ⁦@sbonhoeffer⁩ says, we need to analyse #ContactTracing data to look at where coronavirus is, but they still aren’t available... 1/n

derbund.ch/clubs-oder-fam…
The point is to have info to break transmission chains. Showing that families account for a large proportion of #COVID19 is one thing. But it doesn’t show the source of infection. Where did the family member get infected? #ContactTracing should joint the dots... 2/n
No identifiable #COVID19 source outside the family is a warning ⚠️ That means #CommunityTransmission not controlled. And that means we need to #TestTestTest to find infections, then #TestTraceIsolateQuarantine to stop transmission ...3/n
Read 5 tweets
Nicola Low #EveryDayCounts #StillFBPE Profile picture
2 May 20
This piece on #SARSCoV2 viral load in children and adults has been highly influential.
Can you extrapolate from “Data on viral load” that “we have to caution against an unlimited re-opening of schools and kindergartens in the present situation”
I have serious concerns. 1/7 Response to Christian Drosten group report of viral load by age group https://twitter.com/c_drosten/status/1255555995671150597?s=20
There are two issues: science and politics
On the science
1. There is no methods section about how study population was selected and who they represent
– yes, I know it is a bunch of samples tested in a virology lab - with no denominators about how many samples tested by age 2/7
2. The very low number of samples from children already says a lot about selection into the study. There is no information about their clinical characteristics, stage of infection, etc.
And unequal numbers across the groups makes them very difficult to compare, even visually 3/7
Read 7 tweets

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