Given how serious Omicron could easily be, some people might be breathing a sigh of relief if the worst possibilities are ruled out (I think they will be). But that still leaves a lot of possibilities most of which are Really Not Good. However this is not a thread about that 1/n
Pandemic twitter often tries to divide people into ‘pessimist’ or ‘optimist’ camps. This is not helpful. Especially when it comes to the folks who know most about infectious disease. I am neither an optimist nor a pessimist. I am a scientist and I try to call it like I see it 2/n
I’m not always right, but I am sincere and I try to correct when I am wrong. And I admire people who do the same. I don't always agree with them all, all the time. But that comes with the territory 3/n
Remember folks like me are always thinking about how much worse things would be without vaccination, or indeed how bad they *are* in unvaccinated places. That can make us sound like we are chilled about vaccinated settings 4/n
It should always be remembered that chilled is a relative state 5/n
Likewise, we know that there are other diseases that are not pandemics, but which sicken and kill in numbers that have somehow been considered acceptable in the past. Many of us have spent our careers trying to stem that preventable toll 6/n
That means we develop a perspective. It is not minimizing the pandemic or its risk, and it should not be confused with those who have tried to do so. However I am very happy about any steps that make things better even if they don’t attain the perfection of no transmission 7/n
Now I am thinking about uncontrolled spread of Omicron (or anything). As someone said (sorry I can’t remember who you were but please take credit in replies) if everyone in the world got the common cold at the same time it would be a big deal 8/n
That's why I am into slowing transmission. We might not be able to guarantee we are never infected, but we can work to change the pace with which the virus hits us and our communities. And that is really worthwhile 9/end

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More from @BillHanage

7 Dec
There is a lot of anger in the UK about this. More to the point it is an unambiguous and appalling failure to take the pandemic seriously at one of its most damaging inflexion points. It has come to light at another such moment as Omicron surges 1/n itv.com/news/2021-12-0…
Look at the date of the video: 12/22. In other words the week *after* Matt Hancock announced the existence of B.1.1.7/Alpha in the House of Commons and warned how serious it was. The partygoers cannot pretend to have been unaware 2/n newscientist.com/article/226307…
And look at the consequences of such behavior, the spike in Alpha transmission that was the result 3/n Image
Read 6 tweets
7 Dec
This is a little astonishing to see. Rapid tests are a part of the pandemic toolkit and should be readily available to everyone (*not* after any baroque claim on insurance). Things are, as ever, a little more complicated 1/n
For a start, Rapid Tests alone do not keep case counts low (even if they might be lower than they would be in their absence). Look at the UK where rapid tests have been handed out free for months. Those are not smoothly controlled epidemic curves 2/n Image
There are situations like this, where rapid tests shine 3/n
Read 9 tweets
5 Dec
A little over a week since it was announced it is already clear that Omicron is really serious. Some important pieces of evidence have begun to coalesce. While the worst outcomes still seem unlikely, what we have is quite bad enough to be going on with, a thread, with nuance 1/n
First the spatial spread. Recall previous variants and the pace with which they were reported in different locations. Omicron is already on all continents other than Antarctica in slightly over a week since it got named. I mean... wow 2/n
Meanwhile we get some relatively positive news in that hospitalized cases seem milder than in previous waves. The concern is that those infected and hospitalized so far are mostly young. And we would expect younger folks to have milder infections statnews.com/2021/12/04/omi… 3/n
Read 15 tweets
1 Dec
With #Omicron very real, I thought it worth going back to this, which I wrote with @mlipsitch at the start of the pandemic. It helps to think clearly about 3 types of information we have at the start of an outbreak amid uncertainty 1/n blogs.scientificamerican.com/observations/h…
First there are the facts, then there is the interpretation of those and what they might mean about things that we’ve not been able to yet nail down into facts. This means expert opinion, based on previous experience, unpublished data, and conversations with colleagues 2/n
Then there's speculation. Sure it can be useful. But without a way to test whether we should take it seriously, we shouldn’t. Note that this can include really important things like why a particular policy choice was favored, but that’s not science 3/n
Read 12 tweets
28 Nov
There are a few things to note here. First I want to remind people how many flights from ZA do *not* have cases on board - we won’t hear about those. It seems too that these 13/61 on this flight with omicron are those to have been identified *so far*… 1/n
It will be important to know if there are any common exposures (eg did they share a hotel?) and what on earth happened to any preflight screening protocols? This will be especially true if it turns out there are also any delta cases on the flight 2/n
Anyone who has traveled in the pandemic will know that some procedures are honored in the breach as well as the observance (going to the U.K. earlier this year, my forms were barely glanced at, by an official without a mask at a time they were supposedly required) 3/n
Read 4 tweets
21 Nov
I’ve no objection to working with economists and indeed I have done so during the pandemic! That’s just one of the reasons this article seems to be addressing a straw man. It also misses something really important that shouldn’t be forgotten 1/n nytimes.com/2021/11/19/opi…
Few serious people argue that there are not trade offs between costs and benefits of different elements of pandemic response, but there is only so much a combined model of the sort proposed in the article can do. And at the start of a pandemic it could be actually damaging 2/n
The more complicated a model, the more information you need to make it work. At the start of a pandemic this is typically in very short supply. Remember the arguments about the infection fatality rate that lasted nearly a year? 3/n
Read 10 tweets

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