Higher prevalence amongst children actually makes the argument to do these pilots stronger.

Swathes of lost education nationwide, and children/whole classrooms having to repeatedly isolate & not receiving normal school-based care/fun generally, carries significant harms.
If there is a way to reduce these harms without increasing transmission through daily testing of contacts, which modelling/logic suggests can work, then it is worth evaluating through (high-quality) pilots.
There are no easy answers here, and everything is trade-offs. But if every pilot and attempt to understand ways to improve the situation & reduce total harms now we are in the vaccination era results in outcries of unethical study, we are unlikely to get very far.
Children have been abandoned throughout the pandemic. The harms will be felt for years to come.

WHO, UNICEF, Child (public) health experts are unanimous in that.

Science can help, but only if we let it.
Would also state that even if it results in a subtle increase in transmission, then, given the harms of isolation, lost education, and repeatedly taking children out of school support systems, then that doesn't mean this intervention isn't of net benefit.
Trade-offs & balancing harms - complex, but necessary.
Much of this outcry/rage continues to point towards an under appreciation of the sig health, social, & economic 'non-direct' COVID harms, & assumptions it is relatively straightforward & harmless for children to repeatedly miss school & parents to magic up childcare/time off work
Perhaps it is relateively easy for most academic professionals to WFH, or sort childcare on a days notice, or keep their own children up with the curriculum and provide adequate support structures and mentors. But that is in no way representative of the society we live in.
Summarises my thoughts more eloquently than I could ever hope to.

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More from @ScienceShared

9 Jun
Really beginning to question the scientific integrity of those who state with certainty that the restrictive interventions they favour 'work' for net-PH benefit, while any attempts to actually study &/or optimise implementation of more focussed PH interventions are unethical.
Perhaps this Wikipedia page will help?

en.wikipedia.org/wiki/Harm_redu….
Would also remind people that we have all been living through one local, national, and global 'experiment' over the past year, with a package of blunt interventions of completely unknown (cost)-effectiveness and many collateral (known and unknown) harms.
Read 5 tweets
9 Jun
Came across the UEFA Guidance on Euro 2020 Testing in Stadiums.

Is it up to scratch e.g., likely to be effective?

Short 🧵on the effectiveness of UEFA Euro 2020 event testing protocols..

uefa.com/uefaeuro-2020/…
For event testing to be most effective, you want to ensure swabbing quality & that people are testing as close as possible to the event (ideally within 12 hours but 24 hours is acceptable).

NB - Ensuring same-day event testing at a test-site is logistically challenging.
The current guidance states a self-administered swab for a rapid antigen test must be taken within 48 hours of stadium gates opening, and 'proof' of result given via text or email.

These tests can be self-administered (at home), or taken at an asymptomatic testing site.
Read 12 tweets
8 Jun
All of the below can be true

1) LFDs can be a very useful PH tool
2) People in the testing industry make a lot of money
3) The tests aren't being used in a particularly (cost) effective/efficient programme
4) DHSC are not evaluating them anywhere near well enough..
5) Misinformation around (LFD) testing, promoted by prominent academics in the media and certain newspapers, has, and continues to, erode trust in testing and public health, impacting on uptake and therefore impeding pandemic responses.
6) Seemingly subtle differences in transmission control can have significant net health/societal benefit at certain key points of the epidemic (e.g., when R close to 1, and/or in a tight race between mass vaccination & reopening with VOCs circulating).
Read 5 tweets
7 Jun
Fellow researchers - Which 3 papers are most relevant/important to your current work?
Mine are

1) Single-molecule imaging of microRNA-mediated gene silencing in cells

biorxiv.org/content/10.110…
2) PANDORA-seq expands the repertoire of regulatory small RNAs by overcoming RNA modifications

nature.com/articles/s4155…

3) Phase Transitions in the Assembly and Function of Human miRISC

pubmed.ncbi.nlm.nih.gov/29576456/
Read 4 tweets
7 Jun
The problem with models forecasting late into 2021/early 2022, with implications for challenging winter waves, etc, is that there is still evolutionary space for the virus to become more transmissible &/or acquire further (partial) vaccine resistance.
Therefore, these forecasts will soon become somewhat redundant imho.

The most optimal strategy is still to keep prevalence low with focussed and effective evidence-based interventions, balancing harms & not losing focus, & take each day, week, month as it comes...
Scenarios, not forecasting, obviously - sorry.

Read 5 tweets
5 Jun
The fine margins on this are just crazy. Note this is illustrative data, but (illustratively), R(t) dropping by 0.1 per day due to vaccination = no exit wave, while R(t) dropping by 0.05 per day = large exit wave.

I have written about the fine margins of R(t) and epidemic outcomes numerous times throughout the pandemic.

Many seem to forget, or haven't acknowledged, when evaluating the effectiveness of an intervention, such as symptomatic or asymptomatic, testing, it is not static...
A dynamic epidemic means sometimes an intervention, such as testing, can have a small effect on transmission, therefore seeming ineffective.

However, at certain phases in the epidemic, a reduction in R of eg. 0.005 can completely change the course of the pandemic...
Read 6 tweets

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