As John Maynard Keynes said: "Anything we can actually do we can afford". We can give three COVID jabs to everyone: the developed and developing world alike. We cannot afford not to vaccinate everyone to eliminate reservoirs
There is a false dichotomy being spread that we have a choice either to give third doses to the developed world, or to vaccinate the developing world with two doses. Developed nations must donate their "booster" doses to developing countries
What is needed is effective funding and infrastructure to manufacture vaccines for the developing world. The world needs to come together to produce this. What is lacking is a global drive to attain that goal
Nor do simplistic insinuations to the effect that the developed world is stealing vaccines from Africa to run a vanity booster programme stack up when one accepts that COVID shots are 3-dose vaccines. This fact remains true of everyone in the world. The supply follows demand
"Anything we can actually do we can afford". That means if there is a financial structure to fund vaccination for the developing world, supply will follow. Both funding and manufacturing should follow war-time crisis modes. The world needs to get going on this now

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More from @ToshiAkima

24 Oct
People get curiously upset about the idea that viral infections might drive neurodegenerative disease. But this is an old concept that has been well explored in the literature. For example the link between Herpes simplex and Alzheimer's nature.com/articles/s4146…
There are people who get upset over the fact that I am tweeting on an area I'm not published in. It doesn't change the fact that there are peer-reviewed publications on the subject statnews.com/2020/05/06/res…
I believe in anthropogenic climate change, yet I am not a climatologist. Likewise, it is reasonable for me to post material viruses causing neurodegenerative disease where I am able to support my statements with quality citations pubmed.ncbi.nlm.nih.gov/34205498/
Read 8 tweets
22 Oct
Rephrasing this argument, I'd say that RCTs should be demanded for the more high-risk strategy eg to prescribe a drug, to deprescribe a precautionary public health mandate. Demasking is the higher-risk strategy so RCTs need to be demanded from those wanting to proscribe it
There is mechanistic aerosol physics & observational data pointing to lives saved from masking. The burden of proof in running RCTs should fall on those asserting it is safe to demask the populace during COVID-19. Ditto for accepting their claims of mask harm
The reason we demand RCTs before approving new drugs is that the higher-risk strategy is to prescribe novel drugs. The burden of proof must fall on those proposing the riskier strategy. So this isn't a capricious reversal of the burden of proof at all. Safety first
Read 5 tweets
20 Oct
There is only one possible explanation for why Japan had a lower case-fatality rate than Australia, despite Japan having an older population #COVIDisAirborne
Aerosol mitigation (including mask-wearing) means that even if you contract COVID, you get exposed to a lower dose of viral copies resulting in a milder illness. Because #COVIDisAirborne aerosol mitigation saves lives
Australian states must mandate the universal wearing of high filtration efficiency masks and other aerosol mitigations. Cleaning the air in COVID is like cleaning the drinking water in cholera. You can't just rely on vaccines #COVIDisAirborne
Read 5 tweets
18 Oct
Afterthought Nr 2 on this thread: I found myself using the term "primary source control". Why was I saying that?💡I teach my medical residents/registrars to always pursue "primary source control" of infections all the time instead of relying on antimicrobials
Primary source control of infection is a much more ancient, pre-antimicrobial era method of infection control. You drain the pus, debride or amputate the gangrenous limb, remove the foreign object/device/hardware/prosthesis
Even today if you don't achieve primary source control antibiotics won't be enough and you may lose your patient. Teaching point: Don't be overreliant on treating infections with pharmacological interventions
Read 5 tweets
17 Oct
Lockdowns are the crudest possible form of public health intervention. Far better is to identify the correct mechanism of spread for a pathogen and use that insight to control the infection at its source: just as we did with cholera in the 19th century
In London, cholera outbreaks in 1832 and 1849 killed a total of 14,137 people, because the Thames had become severely contaminated by overflow from sewerage. They'd got the mechanism of spread wrong, thinking it was spread in the air by "miasmas" en.wikipedia.org/wiki/1854_Broa…
The "miasma" theory is very archaic. "Malaria" for example means "bad air" in Italian. Medieval plague doctors wore respirators with aromatic scents in them to ward off the foul-smelling "miasmas" to avoid getting infected en.wikipedia.org/wiki/Plague_do…
Read 11 tweets
1 Sep
The unspoken assumption of "living with COVID" is that it is in the economic best interests of the nation to allow the self-regulating forces of competition to liquidate the uncompetitive for the sake of net economic gain. Sacrificing lives to the gods reaps monetary rewards
This is a form of Social Darwinism in that it assumes that the self-regulating force shaping society for the better is that of the principle of capitalism as the "survival of the fittest". One devalues the "wealth of nations" by interfering to stop it
The assumption comes along that allowing the weak to perish under natural forces of competition increase the "wealth of nations". Economic intervention to support the economy during lockdowns keeps non-viable entities alive in violation of the law of the survival of the fittest
Read 13 tweets

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