We can’t vaccinate our way out of the pandemic.
We need both: Vaccines AND Public Health (PH) measures.

It was barely possible w/ original variant (A). W/ Delta, both PH measures and vaccines became less effective (B). But combined – they may still work.

Theoretical model:

1/ ImageImage
Even if vaccines are only 60% efficient against transmission & only 75% eligible people (64% total) get vaccinated, by combining PH measures & vaxx we may still be able to control the spread (C). Barely.

But…

2/ ImageImage
But if by allowing the reckless spread we culture a variant 2x more transmissible than Delta → our current strategy (i.e. acting only when ICUs get full) won’t work anymore.
Our tools: PH measures & vaccines will not be effective enough to quickly halt the exp. growth (D)

3/ Image
Delta is our wake up call.
Our tools still (although barely) work against it.
We urgently need local and global COVID elimination strategy.
@WHO @DrMikeRyan @mvankerkhove @GovCanHealth @CPHO_Canada

fin/
Appendix:
Real life experiment demonstrating that vaccinations *alone* don't stop Delta growth. UK (54% total population fully vaxxed), Israel (61% pop fully vaxxed, w/ Pfizer), Netherlands (46% pop fully vaxxed) 👇

Plus: When there are cases → there are hospitalizations. ImageImageImage
Addition to tweet #3. We don't need to wait for a variant w/ R0 = 12.
A variant w/ R0 = 8 might be already uncontrollable.

H/t @DGBassani Image

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More from @GosiaGasperoPhD

Nov 23
Important:
Once PH sees a first case of ID, it means that a lot of it is already circulating‼️

On Jan 25, 2021 a 1st community case of UK variant was detected in AB

In March when old samples were analyzed, it turned out that UK variant was here already in *early December*

1/ Image
Image
Image
With H5N1 we are on graph type 1:
single *presumably community* cases of infected kids detected

It'd be extremely ignorant to assume that 1 case in hospital means that there's no community spread

Time to act is now. To ensure that graphs type 2 & 3 won't become the reality Image
H5N1 is airborne. Treat it as airborne. We know and can stop airborne spread.

Influenza has much lower R value than SARS2 or measles --> it is EASILY stoppable

We stopped seasonal flus from 2020 till march 2022

We don't have to have H5N1 pandemic Image
Read 4 tweets
Oct 7
Oh, so that’s why there are almost no books/novels/short stories/poetry about COVID and the pandemic.
Not because people don’t write them. But because publishers decide not to publish such work.

Cool.
There are some. But very few.

It is possible to write a good book without erasing the context of physical/biologjcal/social reality:

“Our Country Friends” by Gary Shteyngart Image
Image
I remember reading two articles early in the pandemic on fading of collective memory (1918 flu, tsunamis) and how the same may happen with coronavirus (yes, back then they called it coronavirus)
Aug 13, 2020:
scientificamerican.com/article/the-19…
Read 5 tweets
May 9
Babies have the highest SARS2 ICU admission rate among all age ranges.

They should be protected from infection by those around them and those around pregnant people & parents.

1/ Image
Things that'd protect newborns in NICU from infections w/ SARS2, RSV, Influenza

1) Mandatory N95s for staff & visitors (stops short range aerosol transmission)
2) Mandatory testing for RSV/C19/Flu
3) Vaxx requirement C19/Flu & other
4) Medical leadership implementing #1-#3

2/
Safety of newborns (and their future health) hinges on point #4:
i.e. Medical leadership deciding to prevent irreversible health harms to newborns.

3/
Read 4 tweets
Apr 3
Hopeful claims w/o evidence: "thanks to gained immunity reinfections pose minimal risk of #longCOVID"

Scientific evidence: studies that reported on reinfections & LC show that #longCOVID incidence follows (almost too well) the theoretical cumulative risk growth pattern.
1/ Image
For hopeful claims that "SARS2 reinfections pose minimal risk of LC" to be true, observed data points should form a horizontal line (parallel to X axis).
They don't.
Even for those infected only with Omicron subvariants.
2/ Image
Risk increases w/ the # of infections.
Long-term COVID-19 symptoms prevalence per number of infections, reported by StatsCanada, fits perfectly the theoretical cumulative risk growth curve.
Also for infections w/ Omicrons only.

3/
www150.statcan.gc.ca/n1/pub/75-006-…

Image
Image
Read 4 tweets
Mar 6
Measles among vaccinated is not a “rarity”, has serious epi implications👇, & health officials ‼️should know it

3-5% is👏not👏rare👏
It means 1 in 33 to 1 in 20 people
Something that has an incidence btw 1:10 to 1:100 is *common*

+spread is exponential



Image
Since 4 years (at least - that’s when I started paying attention to what they say) some 🇨🇦 health officials are feigning ignorance and innumeracy.
It is unserious. It needs to stop.
It misleads ppl & decision makers, leading to misinformed personal decisions & errenous policies
Basic basic basic math:
3% is 1 in 33
5% is 1 in 20

In medical lingo when talking about drugs’ side effects 3% or 5% means ‘common’.

Calling 3%-5% ‘rare’ (especially when dealing with exponential phenomenon) is a serious misinformation.

3/ Image
Read 4 tweets
Mar 3
Misleadingly “reassuring” narrative circulating in 🇨🇦:
“Reassuring: measles outbreaks will fizzle out”

Yes. They will. That’s how measles behaved before it was eliminated.
That’s its intrinsic feature — outbreaks that die out (and come back later)

Grounds for reassurance = 0
1/
https://www.cambridge.org/core/journals/epidemiology-and-infection/article/agespecific-measles-mortality-during-the-late-19thearly-20th-centuries/F4D013C76395921C5338067A0BD0278C
https://www.ecdc.europa.eu/sites/default/files/media/en/publications/Publications/SUR_EMMO_European-monthly-measles-monitoring-February-2012.pdf
Measles was eliminated in Canada.

Now it isn’t.

That’s a fundamental and *categorical* difference.

Anyone understanding epi-math knows it.
It should be honestly communicated.
We crossed the qualitative border btw two “states”: From ‘zero/elimination’ to ‘circulating’

2/
The immediate effort should be to quickly go back to ‘zero/elimination’ state.

‘Elimination’ is a lower energy state. The costs of sustaining it are lower than costs of “controlling” a highly transmissible harmful disease which circulates.

3/
Read 5 tweets

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