With COVID-19 we are not dealing solely with an acute infection with short-term clinical risks. Much is still unknown about long term implications so the precautionary principle would advocate for taking approaches that minimize this potential risk. mdpi.com/2076-0817/10/1…
“To this end public health policy should focus on significantly reducing community transmission alongside vaccine roll-out. Focusing on hospitalizations and deaths as the only outcomes is short-sighted.”
Relying on post-vaccine infection as an immune ‘booster’ may carry serious risk as such infections can result in increased disease severity [32].
The paper goes on to itemise known risks and why they should be taken seriously in order to reduce transmission

Viral evolution

Thus far the virus has continued to evolve to become fitter, more infectious

High levels of community transmission provide ++opportunities for this
VIRAL OR ANTIGENIC PERSISTENCE.

Possibly persisting in the human gut for up to 4 months, but there’s uncertainty if these particles are viable.

Autopsies suggest persistence of viral RNA.

We need to understand the implications and minimise risks meanwhile.
REINFECTION.

We know it happens but estimates vary from over 20% in one Indian study, far FAR more in an Iranian study, but PHE data puts the number far lower at c23k reinfections.

However community testing in wave one in the U.K. was minimal and the timescale relevant.
Whilst Governments hope that infection post vaccination will be milder and boost immunity there is also evidence in some that, despite previous infection and vaccination, subsequent infections can be severe.

There’s a lot we don’t know.
Prevalence should be reduced whilst we find out.

Another field of risk and uncertainty is IMMUNE DYSREGULATION

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More from @fascinatorfun

31 Oct
Utterly (and deservedly) withering about the JVCI minutes from ⁦@JHowardBrainMD⁩ (with a special kicker at Dingwall)

It should not need to be said, but it appears to be needed
Children should not be asked to act as human shields to protect adults. sciencebasedmedicine.org/jcvi/
“From the viewpoint of some JCVI members, children aren’t independent agents with a right to be protected from a potentially dangerous virus. Rather, because they can serve as human shields for more vulnerable adults, it’s downright good when children get sick.
They explicitly stated that “natural infection in children could have substantial long-term benefits for COVID-19 in the UK.”
Read 12 tweets
30 Oct
🇬🇧 Study
Covid landed in the U.K. in Jan 2020. This study suggests that antibody levels associated with protection against reinfection likely last 1.5-2 years on average

BUT nature.com/articles/s4146…
This waning associated with the severity of disease.

Those who got Covid asymptomatically less likely to mount a long living robust defence than those with severe infection which was likely to present levels of protection present for several years.
So those who are thinking they probably got it, but barely felt it so need not bother with vaccine. Think again.

And what is worrying me, as we approach winter is that we are approaching that 1.5 - 2 year window where reinfection becomes increasingly likely.
Read 4 tweets
30 Oct
And Severn Trent were responsible for 558,629 hours of sewage discharge in 2020 alone.

And they were not even the worst.
United Utilities that covers the NE region discharge 726,450 hours of sewage in 2020. Image
Didn’t stop the CEO of United Utilities being laid a whopping £2.94 million in 2020, making a total of £12.3 mill since £12.3 mill since 2017.

UU were fined £660,000 four years ago for pumping 21 MILLION littes of untreated sewage into the River Medlock in Greater Manchester Image
Read 4 tweets
30 Oct
Following in from @karamballes review of the JVCI meeting in May prior to the MHRA authorisation of the Pfizer vaccine for over 11 yr olds on June 4th.

Let’s have a look at child cases just to the beginning of October (when they have continued to soar (h/t @Dr_D_Robertson )
Or, based on ONS surveillance from September by which time all adults had been offered vaccination and most if not all had time to be double jabbed .

The horizontal axis. Young on left. Old in the right.

Percentage infected on vertical axis. H/t @PaulMainwood
Yet it seems the JVCI made its decision in May in part on the basis that “all adults will be vaccinated and there is a low risk of child to child transmission. Staff and parents will be protected”

Look back again at those charts and think again.
Read 26 tweets
30 Oct
BELGIUM 🇧🇪: This is not looking healthy to me.

9.2k cases is roughly equivalent to 55k cases in the U.K. and, following the relaxation of measures, cases and hospitalisations have been rising rapidly, despite 86% of it adult population (75% of whole pop) being fully vaxxed.
Still rising since the Tuesday figures.

Population of over 11k.
Cases had increased by 76% and positivity by 2% to 8.6%.

How long before we accept that some measures are the price we pay for safety AND freedoms?

brusselstimes.com/news/belgium-a…
Read 4 tweets
29 Oct
UK statistics tsar rebukes UKHSA over flawed jabs data

“Those numbers were misleading & wrong & we’ve made it v clear to UKHSA. I’m lost for words at the willingness to publish a table that led people to believe that, with a footnote that was too weak”
ft.com/content/a51f85…
The NIMS v ONS denominator debate continues to hot up with criticism still robust regarding the latest attempt to “correct” by the UKHSA, sticking with NIMS but adding two pages of caveats.

Still the main (wrong) impression is vaccinated more likely to get infected than unvaxxed
David Spiegelhalter, chair of the Winton Centre for Risk and Evidence Communication at Cambridge university, a statistical research institute, said the “minor changes” failed to address the problem.
Read 4 tweets

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