Our commentary on the Smith et al @NatureMedicine paper on child deaths in England up to Feb '21
led by @LawtonTri
Key takeaways:
-their results actually validate ONS data
-ONS data now has >70 deaths in 0-19 yr olds
-population rates are v. misleading!
The premise of the study is unclear to me- it seems to just recapitulate ONS data from death certification (done by the treating clinician), so not sure why all these cases were reviewed. It's bizarre that the paper doesn't seem to mention ONS data or compare with this at all.
By contrast to the reports from the paper, the vast majority of PHE deaths 'with COVID-19' are currently 'from' COVID-19- unlike during the period covered by the paper. And infection rates in children, and deaths are unfortunately the highest they've ever been.
We cannot extrapolate data from earlier in the pandemic when many more mitigations were in place, schools were closed for 16 wks or so and a less transmissible variant was circulating to now- when infection in children is extremely high, and delta is circulating.
Even relatively 'rare' outcomes can results in unacceptable numbers of children dying when almost all children get infected due to negligent government policies.
And of course death is not the only impact in children. Many more children have been hospitalised, and long COVID numbers in children are rising rapidly (69,000 children with long COVID at last count). Many children have been orphaned or are living with parents with long COVID.
We should be protecting them, rather than minimising the impact on them. Population denominators are particularly misleading in this regard, and a fatality rate of 2/million is just wrong. Even if you calculated this per population, with current rates this would be *much* higher.

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More from @dgurdasani1

21 Nov
Exceptionalism the scientific community which is justifying exceptional govt policies is killing us. Yet, some of our scientists seem to continue to justify this in the face of overwhelming evidence for failure. Why?
A thread.
I'm seeing actual scientists/medics saying that our govts policy of mass infection through summer was a good one because we've got more 'population immunity' than Europe now, and this will protect us through winter. Let's examine this claim.
A central argument to this claim is that exposure to mass infection over summer - to prevent future infection over winter was a good thing. First, this argument doesn't pass basic scrutiny because vaccines are a much safer and more effective way to get 'population immunity'
Read 22 tweets
21 Nov
This is outrageous and deeply offensive. The fact that Asian and black people have 2-3 times higher death rates than white people doesn't have to do with pulse oximeters. It has to do with structural racial discrimination, deep social and health inequalities. Please stop. Image
So many of this govts hostile policies already contribute to this structural discrimination, and the anti-immigration rhetoric has stoked so much hate. Please stop denying the painful lived experience of minorities, after having spent decades contributing to that pain.
And I want to say that as a medic I've used pulse oximeters every single day on hundreds of patients, and believe me, medical device bias isn't the reason people die. It's racism and denial of this that kills.
Read 6 tweets
16 Nov
Interesting messaging here by @NickTriggle - the devastation of the NHS is inevitable, and there isn't anything we can do to stop what's happening now- long A&E waits, and people dying in ambulances. Manufactured inevitability is how we normalise death.
And it is manufactured! Yes, the NHS has been struggling for years (deliberate underfunding by the Tories), but if we haven't had such long waiting times for A&E In the past, or all ambulances in England on black alert..
Causes- COVID-19 is an important cause- not just current, but the fact that an uncontrolled pandemic has meant people with other conditions waiting for routine care for longer, and now needing emergency care as well. This is all attributable to poor handling of the pandemic.
Read 10 tweets
12 Nov
A quick look at what's happening in at least some parts of Western Europe where cases are surging.
Seems to be a combination of:
-school related surges due to lack of mitigations
-premature easing of restrictions
-over-reliance on vaccines, lack of multi-layered strategies
1) Austria: There's no doubt that children and young people are driving the pandemic. Austria removed masks from within classrooms when schools re-opened in Sept replacing this with a 3x wkly testing.
They also relaxed rules on quarantine, exempting vaccinated contacts & shortening quarantine with test and release on the 5th day for quarantine of contacts. There was supposed to be focus on better ventilation and air-purification but this doesn't seem to have materialised.
Read 37 tweets
12 Nov
Ok, so worth really looking closely at the @NatureMedicine paper that's been cited widely on the impact of COVID-19 on children's deaths.
This has several key limitations, and should not be cited in the way it is being🧵
The analysis is between March '20-Feb '21. Why is this important:
-delta was not dominant
-there were 3 lockdowns during this period
None of this is relevant now with delta, no mitigations, the highest infection rates we've *ever* had in children (4-5% even post- half-term)
The authors carried a review of 61 deaths in children who were positive for SARS-CoV-2/had PIMS-TS and come to the conclusion that only 25 were due to SARS-CoV-2. They conclude that only 25/61= 41% of all children who died 'with' COVID-19 died 'from' it.
Read 25 tweets
11 Nov
For the "we've reached herd immunity in kids, and infections have peaked" crowd: unfortunately, this isn't true. It's the usual half-term related drop that is reversing. The trends are clear in many places, & early rises being seen in England. This is expected but very worrying🧵
The pattern is clear in places like Leicestershire that had half term a week before other parts. Rises clear in all children age groups and young people. Very likely other parts of England will follow.
Similar trends in Scotland where half term also started and ended earlier than England.
Read 16 tweets

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