Thread by @ewanbirney

Dear journalists / editors covering COVID / this delta wave. Some of you are ... great (genuinely) - its not easy out there crafting a path thru information, speculation+ crankiness. But others... time to up your game. Here are some rookie mistakes in describing what is going on:

1. Please please stop with the % vaccinated in hospital. This is genuinely a meaningless statistic. It is just bonkers wrong to quote it. Trivially if a population is 100% vaccinated then 100% of the people in that population's hospital will be vaccinated.

What you want is something surprisingly tricky to calculate; the counterfactual of how many people should be in hospital if no vaccine. Thankfully there is an easy way of doing this which is referring back to the Alpha wave (wave 2/3 depending on counting system in each country)

So for example, you want the *number* of people in hospital when cases levels were at a similar level in the Alpha wave (note, not percentages). Many countries have calculated the counterfactual above (which is trickier than it looks due to age issues) - use that as well.

[for modellers/pros ; I know one should say with the appropriate infection->hospitalisation offset and worry about case detection levels, age stratification, but for an easy to understand number, I think the above 1-to-1 mapping of alpha to delta is ... not awful]

2. You don't need to make COVID any more scary. I know it is tempting, and indeed, there are more variants - the virus evolves all the time (as do... all viruses). It is an open question of whether there is going to be something "beyond Delta" but >>

<< you really don't need anything scarier than Delta. Delta transmits very fast if we do our normal human things (hang out, meet family, have wedding parties, have dinner parties, go to bars and clubs etc) and for unvaccinated/uninfected people, if >50, is very dangerous.

3. Vaccination changes the game, but it is not full time/slam dunk/walk away with the win. It is more like two red cards against the coronavirus (football analogy - english style), but we still need to field our team, play well, ie we've still got to navigate this period.

One v. frustrating (but unsurprising) thing is that some people who are double vaccinated can still catch and pass on Coronavirus. We don't really understand why this happens, but it does, and the vaccines are performing at the high end of expectations.

This is why most virologists / infectious epidemiologists I know, and myself (for what it is worth) think the stable end point of the pandemic is some level of endemic (circulating virus) in which SARS-CoV-2 will be nastiest of the coronaviruses that we live with.

(this is how coronaviruses roll; in humans we have 4 endemic - circulating - coronaviruses, one of which looks like it caused the "Russian 'flu" in Europe of 1888/9. They are one of the types of viruses which gives "the common cold" and responsible for viral pneumonia in the old)

4. What we need to do is now simple to state but still a long road - vaccinate everyone *in the world* at risk (crudely, >50, but a bit more nuanced) + vaccinate or tolerate infection for the rest of the world. Vaccination is far better than infection until you get to the young

as we get there, every bit of transmission we reduce is broadly a good thing. The easiest way to reduce transmission is to be in fresh air - good ventilation - this can be low tech (outdoor lunch, open windows) to high tech (fancy ventilation system) - air exchange is the key.

Other things that help include wearing masks, and not hanging out closely with other people (in particular inside).

5. I have genuine sympathy that this is still all front page news but it seems to move so slowly - one wants to find new things to talk about. My advice here I think is to at least balance scary stories with good stories - the good stories are often healthcare >>

<< healthcare has to cope with whatever the pandemic throws at them - they are the last line of defence, the final backstop and they continue to work through in many places just the flow of people who have this nasty disease. In that there are great stories of - frankly - heroism

A plea to stay away from the extremes. We're clearly in a better place (at least in the developed world) due to vaccines. We've clearly got a worse enemy, but one we understand pretty well. We've got to play this game out well with vaccines, and get vaccines across the planet.