I follow twitter less than you might think, but I have noticed a trend for people calling themselves "covid centrists". I find this difficult because it suggests a spectrum between extremes. I'm not a covid anythingist, I am just a scientist
This means I think about claims based on the evidence for them as I understand it. If you ask me what I think will happen if we take a particular action, I can tell you that.
That means I also need to admit when things don't go as I expected. For eg, while I expected (and publicly predicted) a dent in the rate of increase in the UK as the schools closed, before transmission resumed. But I was surprised by the scale of the drop. Now about that...
There's now a plateau, and likewise a plateau of ~100 deaths per day. That's not likely to change a huge amount, given continued transmission. And transmission will likely tick up again as schools open once more and the nights draw in
That's what I think, given my knowledge from prior experience and the time studying this and other infections. I'm not going to pull on a shirt and join a team of any kind (I'm probably not great as a team player anyway)
This is not a dig at various colleagues who have self identified as connected with various camps. It's just me saying I'd rather focus on the data. In some cases it is really hard, there's more than one interpretation and reasonable people can disagree
So I'm going to keep trying to learn more and contribute to science. Speaking of which, read this! medrxiv.org/content/10.110…
When I see statements like this, especially now, I wonder what people mean by "the overwhelming of [healthcare]"
We shouldn't talk about healthcare being overwhelmed, we should talk about it being compromised or otherwise damaged, in a way that could have been avoided 1/?
Healthcare is compromised when elective surgeries are canceled, when screening is canceled. It is compromised when we run low on ICU nurses because they are needed in too many places or because they are sick with a virus 2/?
It is compromised when campaigns against scourges like malaria, TB or polio are damaged because of an uncontrolled pandemic 3/?
Some more thoughts prompted by this article - the notion of an 'end' to the pandemic is itself faulty in my opinion. But that emphatically does *not* mean interventions forever. It means that the transition to endemic disease can and should be managed 1/?
The reason 'end' is dangerous is that it suggests a date when everything changes overnight and we return to 'normal'. That takes no account of variants, waning immunity or the fact that most of the world is struggling to access vaccines, among many other things 2/?
However in vaccinated places it is true things are *much* better than they easily could be, but that doesn't mean the pandemic is 'over'. This is Oregon and Idaho *now*. 3/? nytimes.com/2021/09/06/us/…
Trying to write a couple talks for next week based on this new preprint from us on how we expect vaccines to perform against variants with enhanced transmissibility, some immune evasion, or both. A🧵may follow as I sort my thoughts out medrxiv.org/content/10.110… 1/?
One important thing - it is always important to compare impacts of vaccination against the alternative, so we've estimated infections averted for a simple model, and varied stuff like time and pace of vaccine introduction and the point at which variants emerge 2/?
I called it a simple model, but it has quite a lot of compartments. The arrows are the possible ways people move from S (susceptible) through being I (infected) or V (vaxxed). Resistant (thanks to immunity from infection R) and various breakthroughs 3/?
Nate seems to be doubling down on claiming my thread said something that it didn’t. I can accept a lot of misunderstanding but this is something more. This looks like deliberately mischaracterizing what I said for clicks. I am really disappointed 1/x
The point is that places with more immunity should have to work less hard to avoid/control delta surges. Australia has little immunity, due to a very successful early pandemic management approach and a much less successful vaccination program 2/x
In contrast FL and TX have a lot of immunity, due to both a lot of infections and a lot more vaccination. Yet hospitalizations are rocketing there because there is no will to enact *mild* interventions to prevent transmission of delta 3/x
Delta is really transmissible, which is much worse than immune escape. On the other hand, there’s reasons for optimism from the likes of Australia and Vietnam that we can take action other than vaccination to stand on its way. Let me explain… 2/x
Here’s FL and TX, both with substantial prior infection and non trivial vaccination. Cases as high as they’ve ever been (or higher) and they’ve been darned high already and a lot of people have died already. This is down to Delta, and minimal local interventions to combat it 3/x
In contrast Australia. That steep climb reflects the threat of delta, but look at the absolute numbers and recall Australia has *never* had a significant outbreak, so this is small relative to FL and TX and with very little population immunity. It could easily be worse 4/x
There has been a lot of noise about the proportion of COVID cases, hospitalizations and even deaths that occur among vaccinated people. This is misleading. In this working paper we show how getting vaxxed improves your chances using relative risk cdn1.sph.harvard.edu/wp-content/upl…… 1/x
This is the formula relating relative risk of an outcome for unvaxxed vs vaxxed people to efficacy. It tells you how many more time likely an unvaxxed person is to die, be hospitalized etc, relative to a vaxxed person 2/x
Sorry for big table, but the headline finding is that unvaxxed persons were between 5 and 133 times *more likely to be hospitalized* and between 9 and 141 *more likely to die* in comparison with fully vaxxed 3/x