Thread by @SGriffin_Lab

Strikes me that some may think taking a stand against the mass infection policy and freedom day means that I lack faith in our excellent vaccines and, apparently, am a "lockdown zealot".
I'd like to reassure everyone who knows/follows me or sees this at random that this is untrue

This sort of polarisation of debate is all too common on twitter, and is sadly churned up and propagated by certain cynical characters combined with consecutive failures in pandemic policy. It's in no way black and white, but the main thing is that we ALL want an end to this...

So, in an attempt to collect my thoughts, I've followed advice from @lucy_prodgers and FINALLY written a list...🤪

1. First, we have some AMAZING vaccines, developed by scientists and companies, importantly WITH govt backing, with efficacy and safety proven by trials and real

world data. Some of these are far better than any flu vaccine we've ever made.
2. My view is that this makes these wonderful medicines a precious commodity that should be protected (see below), but also made available to all #COVAX
3. In this regard, it's notable that the UK was

amongst countries refusing to share patent rights etc at the G7.
4. We have massively over-ordered vaccines, as have other rich countries. To me, this obliges us to do the job properly. We have exported alpha, we are now exporting delta...
5. Some consider vaccinating "vulnerable

" groups to attempt to break the link between infection and disease sufficient as a strategy to move out of the pandemic, followed by a cyclical booster/surveillance programme, modelled on flu...
6. This certainly should be part of our strategy going forward, but I have a strong

view that we should be pushing as much population immunity as possible at the same time which, based on estimated Rt of delta, probably requires at least 85% of the population as a whole to be protected, not just adults.
7. My reasoning here is that only through establishing a

a comprehensive and long-lasting vaccine programme can we ensure that any outbreaks in the future immediately face an Rt<1, manageable by TTI. This will help protect everyone, including those unable to receive or respond to vaccines.
8. Coverage absolutely should, in my view,

include children, at least 12+, as they are certainly not invulnerable and also suffer from long COVID. This is discussed brilliantly by @jneill and @ProfColinDavis , so I won't duplicate here.
9. So, what do we need to protect our precious vaccines from, exactly? Well, variants!

Now, it's vital to understand that the vaccines hold their own, certainly in terms of preventing severe disease and death, against all VOCs identified to date. However, they're not perfect, mainly because we're a genetically diverse race and we respond with subtle differences to

them. We do, of course, know that some VOC are less well neutralised by a significant proportion of patient sera, by no means all, but enough to have some real world consequences such as needing two doses rather than one, or the reinfection of those with so-called "natural"

immunity following infection, as seen in Brazil. There's also evidence that major T Cell epitopes may change. Nevertheless, a well vaccinated population ought to be very well protected from VOC as things stand.
10. So, why worry? Well, the evolution of vaccine resistance is

complicated, and I would defer to @ArisKatzourakis on this as I'm more comfortable with antivirals. However, it seems that even though CoVs have proof reading mechanisms and long, densely utilised genomes, they are eminently capable of lineages that collect enough changes to

become an eventual VOC...the scope for change is debated, but certainly appears to be v large at present, certainly in terms of spike. However, other regions of the genome and aspects of host responses additional to antibodies are almost certainly factors influencing evolution.

@stuartjdneil no-doubt has keener insight than I on this...the other issue is the sheer scale of infection across the globe, not least as will arise here in the UK. This is because, as predicted by @PaulBieniasz and others, high prevalence combined with either partial or poor

(In terms of efficacy) vaccine coverage is the perfect crucible in which this may occur in the future...and this really would put us back at square one!
11. But surely, if all the vulnerable are vaccinated, others will become immune safely via natural infection? This total 💩 is

the perspective of the GBD, and I've wasted plenty of oxygen debunking this previously, along with the vast majority of colleagues. The fact that this AIER funded fringe outfit continues to dabble in public life is not based on science, but due to the influence of certain groups

with, shall we say, political and media influence...
12. Simply put, naturally acquired immunity appears to wane more quickly, and to be less potent/broad compared to vaccines. There's also the potentially lethal inconvenience that you are infected with SARS2 in the process, this

is NOT, as some folks appear to say, trivial.
13. The only reasonable point, imo, made by GBD is to point out how socially disadvantaged groups suffer most during pandemics, and with restrictions. However, they have naturally borrowed this from elsewhere, a place called logic!

The inequalities though, are preexisting, and of course those disadvantaged by health and/or wealth, have suffered most of late.
14. However, the unmitigated failure to avoid CONSECUTIVE lockdowns is a result of policy, not Science. I shan't dwell, but suffice to say, too little,

too late, sums most things up...unless you're SERCO or setting up a cottage PPE industry, of course! 😉.
15. As @LindsayBbent
once said, most folks saying live with COVID actually mean to live near, or not so near to it...a bit NIMBY imo.
16. Some folks ask why we make exception

for COVID, but not flu. Well, actually we don't just "accept" flu. We have surveillance, annual vaccines etc. Whilst vax may lessen the CFR for COVID, the incidence of long term issues is just not comparable.
15. So, why is freedom day bad? It's bad for young people, those least

well off or clinically vulnerable, and those with public facing jobs. High prevalence will increase long COVID to epidemic proportions, and favour viral evolution to the world's long term detriment.
16. So please read this 👇 thelancet.com/journals/lance…

And I should add it's been wonderful to work on this with @dgurdasani1 @theAliceRoberts @chrischirp @Zubhaque @ReicherStephen @martinmckee @ArisKatzourakis @SusanMichie @adamhamdy @trishgreenhalgh @Kit_Yates_Maths @DrZoeHyde @carolecadwalla @McCoolingtons @HZiauddeen and others