Already people are misunderstanding the new paper showing extremely low risk of children from #COVID19

The paper reports both the population risk to children, AND the infection risk

It also massively *overestimates* the infection risk to children

1/
researchsquare.com/article/rs-689…
The study uses PHE modelling data on infection rates, as case data over the year is unreliable (we tested only people who were admitted to hospital during the first wave)

Through this, they estimate just short of 500,000 infections

This is a massive underestimate

2/
We can get a better estimate of total infections by measuring seroprevalence - who has positive antibodies

By July last year, 4% of children were positive - that is already nearly 500,000 BEFORE the second wave

3/
assets.publishing.service.gov.uk/government/upl…
We don't yet have good current estimates for kids, but for 16 - 25yo it was well over 30% by Feb 2021

Likely to be a bit less for children under 16, but 20% of the population is a very conservative estimate

20% of 12mil is 2.4mil children infected

4/
25 deaths from 2.4 million infections is an Infection Fatality Ratio of 0.001%

This is 5 times less than the IFR quoted in the study

So far from making it look lower risk, the study actually makes it look higher risk for children than it is

Good news! Let's embrace it!

5/

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More from @apsmunro

1 Jul
A quick 🧵on testing kids for #SARSCoV2

Many people believe children are more likely to have false negative results to:
- antibodies tests, due to them having mild illness
- PCR tests, due to difficulty sampling

Turns out, that's almost never the case

1/
First, antibody tests

Most serology tests used in studies test for antibodies against the Spike protein (we call these S IgG)

This nice Australian study, found no difference in rates of children seroconverting to S IgG compared to adults

2/
wwwnc.cdc.gov/eid/article/27…
In fact, not only that - but this study shows younger children actually have HIGHER S IgG levels than adults!

Their super immune systems make a bangin' response

Good work kiddos

3/
sciencedirect.com/science/articl…
Read 9 tweets
25 Jun
A very calm thread🧵

Waiting for data before frightening kids, parents and the general public about variants, children and schools is important. They deserve this.

It has not been well practiced across the board - and given todays @ONS data, it is particularly disappointing

1/ Image
Many will remember (feels like a lifetime ago) a lot of concern about the Alpha variant (prev known as B1.1.7) being very transmissible or more severe in children, disproportionate to its effects in adults

As it turns out, that was not the case

2/
When schools were about to open in March, some people were very clear this would be a catastrophe

This led to a lot of anxiety among children, parents and teachers

Fortunately, it was not a catastrophe

In fact, it was completely fine

3/
ons.gov.uk/peoplepopulati… Image
Read 9 tweets
11 Jun
As people much smarter than me have said, the issue of vaccinating children against #COVID19 is a tricky one

I urge caution if you think it is straightforward

A quick look at recent developments and decisions from around the world to put this into context

1/7
A quick recap of main considerations:

-Children's risk from #COVID19 is extremely low
-Vaccines are very safe but do have some rare adverse effects
-Vulnerable people in other countries need vaccinating, and supplies are limited
-Younger children are different from teens

2/7
First to Germany 🇩🇪

Following EMA approval of Pfizer for 12 - 15yo, their vaccine advisory committee is recommending the jab only for those with existing comorbidities putting them at higher risk

3/7
reuters.com/article/instan…
Read 9 tweets
9 Jun
There are some claims that the ongoing randomised trial of Daily Contact Testing (DCT) vs blanket quarantine/isolation in schools for cases of #COVID19 is "unethical"

Here is a short thread on why that is completely wrong

1/8
Randomised trials are indicated (ethical) when we have "equipoise", meaning we can't be sure which of some options is better

We want to get the best of all outcomes, e.g. a pill which is really good at treating mild coughs but frequently causes cancer is not good overall

2/8
For COVID-19 cases in schools, we know that we want to avoid transmission, but we also know that children missing school is harmful

There is equipoise as to whether the best of *all outcomes* is blanket quarantining of bubbles, or doing DCT

But wait, there's more

3/8
Read 8 tweets
3 Jun
I've spent the last year running #COVID19 vaccine trials, and am leading one now as part of my PhD

I've spoken to A LOT of people about these vaccines!

If you ever feel confused about the vaccines against #COVID19 , hopefully this is the thread for you

We'll keep it simple!💉
Vaccines work by using your adaptive immune system (the part which remembers bugs) which is made up of 2 major parts:

- Humoral: Cells make antibodies to tag/attack bugs
- Cellular: Cells which directly recognise and attack/kill bugs (mainly T cells)
Usually, your immune system would see a bug (often a virus or bacteria) and learns how to recognise it by remembering specific bits we call "antigens"

It makes lots of antibodies and cells against these antigens the first time it sees them, ready to fight next time they appear!
Read 24 tweets
24 May
Some decent data is now emerging regarding prolonged symptoms after acute #COVID19 infection in children

Fortunately the data looks reassuring 👍

Low prevalence of prolonged symptoms in children, especially when compared to a control group

Let's take a look!

1/5
First, a large serology screening study from Switzerland 🇨🇭

No difference between seropositive and negative children with symptoms beyond 4 weeks (~10%), and similarly very low rates of symptoms at 6 months (2 & 4%)

medrxiv.org/content/10.110…

2/5
Next, a study from the UK using ZOE data 🇬🇧

Very low rates of prolonged symptoms at 4 w (4.4%) and <2% beyond 2 months

Of note, severity of symptoms was worse in the comparator group who tested negative...!

medrxiv.org/content/10.110…

3/5
Read 5 tweets

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