A lot of Twitter currently seems to be a split of either fatalism about Omicron variant, or advocacy for retweetable-but-flimsy measures that are unlikely to suppress transmission of a genuine threat. Discourse needs to be much better - for this situation and future pandemics. 1/
This piece is one of the few I’ve seen IMO asking the right sorts of questions. If we need to update vaccines (still a big if), how much time do we need to buy? What will the scientific, logistic and regulatory challenges be? thetimes.co.uk/article/how-lo…
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And, of course, if we need to update vaccines, how do we get them to places most affected in equitable way? 3/
As well as the many moral reasons for vaccine equity, there is also a selfish incentive here for rich countries: if you want to understand vaccine effectiveness, need to have them deployed where there is most ongoing risk. 4/4
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Reminder that reactive travel bans typically slow but don’t stop importations. If new B.1.1.529 variant genuinely more transmissible/can evade immunity to some extent, reasonable to assume already undetected cases in other regions... 1/
For example, Israel had multi-pronged efforts to keep Delta out (which bought time for more vaccination), but even so the rise was only a couple of months behind UK: 2/
Countries should therefore have plan to deal with local outbreak. Recent reintroduction of control measures across Europe may be helpful coincidence (in short term at least), reducing contacts & making it harder for imported cases to establish... 3/
A few thoughts on current COVID situation in Europe… 1/
Any proposal to reduce COVID transmission that doesn’t now have vaccines and rapid tests front-and-centre is not a proposal that’s had much thought go into it. Booster data looks very good - roll-out of these is likely to play a large part in how well countries do over winter. 2/
I think any country reintroducing lockdown-type measures needs to outline very clear criteria for lifting them. What’s the exit strategy? When will these disruptive last-ditch measures finally be off the table? 3/
A question I often see: if COVID transmission continues, when will it reach a stable ‘endemic’ state? One way to look at it: the dynamics of endemic infections are typically driven by emergence of new susceptibility. A few thoughts… 1/
Many endemic infections continue to circulate because new susceptibility is gradually accumulated as unexposed children are born: 2/
For other pathogens (like seasonal coronaviruses) new susceptibility can also come from waning of existing immunity, or antigenic evolution of the virus - which has the effect of making previously immune people susceptible to infection again: 3/
The terms ‘safe’ or 'unsafe' appear often in discussions of COVID threat, but they're vague, subjective words. What level of risk vs disruption is acceptable in long run (whether COVID or another disease)? 1/
As an example, I spent a chunk of my childhood paralysed and unable to walk thanks to a post-infection condition (GBS). Lingering effects for years. Not nice at all. But what should we as a society sacrifice to prevent a given level of risk? 2/
Vaccination is massively reducing COVID risk (at least in the countries that bought up most of the doses). So at what point are specific disruptive measures (whether at local or cross-border scale) no longer justified? 3/