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Alasdair Munro Profile picture
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12 Jul, 8 tweets, 3 min read
It's important we are all cognisant of the impact of highly emotive and fear based messaging around #COVID19

It can create deep and lasting damage, and is often counter productive

This is especially the case when it comes to children

1/
It is great to use facts to and establish risk and to inform people (although for kids this is almost universally reassuring when used in the right context)

But to deliberately stoke fear and anger is not healthy, and will not end well

None of this is new to public health

2/
There is a long history here with HIV in particular

Potentially creating lasting fear and stigma around sexual relationships

Are we creating the same around social experiences? Around our children attending school?

How are we communicating?

3/
journals.sagepub.com/doi/10.1037/10…
It can also be totally counterproductive - achieving the opposite of what was intended

Check out experts views on the new Australian campaign videos, and compare them to other countries

4/
theguardian.com/australia-news…
This is particularly important when it comes to children and their families

We can communicate in ways that inform and no not terrify

That kind of anxiety in families can have damaging effects

We take great care in communicating risks in child health for this very reason

5/
For example - I love @j_g_allen comms around risk prevention

Clear on the risks, but doesn't focus on them or exaggerate them

He empowers with solutions looks at the positives

THAT is how you motivate and encourage people

6/
So let's be mindful of what we want to achieve

Fear and anger are so poisonous. We can see it all over twitter especially.

Empower people. Encourage them. Don't terrify them.

And please don't terrify families. They don't deserve it.

7/
p.s. If you see a group "attacking" a different group etc over #COVID - this isn't public health

This is politics

It is a method to gain traction and influence, and attention

And it's seriously damaging

Don't engage

8/
pnas.org/content/118/26…

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More from @apsmunro

Alasdair Munro Profile picture
13 Jul
Some seems to be some confusion on why it's better to coincide easing of restrictions with schools closing for summer

If schools are not drivers of community transmission, why does it matter?

Don't worry, it's quite simple! Let me explain...

1/
Firstly, closing schools does not just stop transmission in school

When schools are closed, adults have to stay home, change their plans etc to look after children

This appears to be a pretty major source of reduction in R associated with school closures in general

2/
For example, modelling frequently shows closing Primary schools to reduce R by a greater degree than closing Secondary schools, despite more transmission occurring in Secondary age children

This is likely because closing primary schools forces more parents to remain home

3/
Read 8 tweets
Alasdair Munro Profile picture
10 Jul
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…
Read 5 tweets
Alasdair Munro Profile picture
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
Alasdair Munro Profile picture
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
Alasdair Munro Profile picture
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
Alasdair Munro Profile picture
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

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