How to start on the problems with this? Herd immunity to SARS-CoV-2 through unmitigated outbreaks comes at an abysmal cost in deaths, and chronic outcomes of infection. Ok we know that now but... 1/?
We knew that *then* theguardian.com/commentisfree/… 2/?
We knew it in the autumn too theguardian.com/commentisfree/… 3/?
What I am trying to make clear is that the consequences of the policy were not up for debate, but pretty evident at that point. I wish people had been more upfront. As it happens I’d rather people didn’t lie about what a pandemic means in terms of death or suffering 4/?
(And I include the negative consequences of NPIs in the suffering that needs mitigating) any attempt to attain herd immunity through infection in the U.K. should be throughly scrutinised. A few headline questions... 5/?
“To what extent were expected deaths considered in policy decisions. What attempts were considered to mitigate them?” 6/?
“Was the impact of a surge on NHS capacity to handle other important elements of healthcare explicitly considered?” 7/?
“Please explain the reasons scientific advice that had been shown to be substantially accurate has been dismissed throughout the pandemic. And describe the consequences” 8/end

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More from @BillHanage

16 May
Thinking about the uncertain situation w B.1.617.2 in the UK as the country opens up, this is very good (no surprise, it's @adamhfinn answering the questions). I have a few additional points and a mild point of disagreement 1/n theguardian.com/world/2021/may…
The additional point - it's really not clear what is going on with 617.2. It has certainly been growing, but that doesn't necessarily mean it is (much) more transmissible. It may have merely had more opportunities 2/n
As more contacts and opportunities for transmission arise in the UK, we can expect them to result in more cases. Having said that of course, we need to ask why one lineage rather than another is lucky enough to take those opportunities - maybe it's more than luck 3/n
Read 11 tweets
16 May
Upon seeing this I had to go look for what prompted it. Although that might not have been the intent of the original post, I’m glad I did 1/n
Here’s the preprint. It’s not clear why MIT should feel ‘shame’ (isn’t academic freedom a good thing?) or what it has to do with the prolific aforementioned scientist. arxiv.org/pdf/2101.07993… 2/n
If nothing else, we need to accept that preprints happen, that sometimes they are less good than regularly published work and sometimes they are better. They have a special role in a rapidly changing situation like this 3/n
Read 4 tweets
10 May
There will be a lot of people answering this the obvious way, but what strikes me is that *even now* there’s not enough immunity from prior infection in Sweden to stop this happening.
Whatever else that means, it suggests that population protection through infection induced immunity is not going to happen without bad consequences. The idea might have been defensible at the start when we were more uncertain about severity, it hasn’t been for some time
If people compare per capita mortality in Sweden with elsewhere note that an appropriate comparison is the other Nordic countries, all of which took a very different route, rather than other European countries with their own stories
Read 4 tweets
8 May
It’s great that public health has been getting some recognition. Many 🙏🏼. If you’d like to donate to help this work, which is mostly done by really underpaid and devoted people, here are some ideas. @MSF_USA @CEPIvaccines @PIH @NFIDvaccines for a start 1/n
If you want to help public health donating to established non profits is better than say, someone from twitter on patreon, for a bunch of reasons. For a start there’s oversight of where your $ go and an existing system of governance, hopefully with accountability! 2/n
I don’t want to deter donations to new initiatives like @crisisreadiness, but just to point out that if you really want to help, think about the best way to help 3/3
Read 5 tweets
7 May
This article, on the arrival of B.1.617 (et al) in the U.K. is important, but is missing some really important context. Notably, we expect clusters, even in vaccinated people. It’s how *many* there are when compared with unvaccinated that matters 1/n theguardian.com/world/2021/may…
Look at this. No deaths. That’s not the usual story when it comes to this virus and care homes. I don’t want to draw strong positive conclusions from small numbers, but nor should we draw strong negative ones 2/n
It’s actually rather like this. Again an outbreak, but nowhere near as bad as we’d have expected in the absence of vaccination cdc.gov/mmwr/volumes/7… 3/n
Read 6 tweets
1 May
The only thing more mind boggling than the fact this is happening, is the idea that it is a “test” that will provide useful data. It isn’t, period.
It is happening at a time of low prevalence, in this age group due to few contacts offer the last few months, which makes any findings of questionable relevance to circumstances with higher prevalence
Negative test before entry is good, but ‘urging’ people to get tests after (or before for that matter) is not follow up. It’s not even an adequate study.
Read 6 tweets

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