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Deepti Gurdasani Profile picture
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13 Dec, 5 tweets, 2 min read
I do think this is a possibility, although hard to know at this point. The lower proportion of omicron in children in the recent Denmark report may point to this, but it's early days so very hard to say. 🧵
Essentially, as explained very well here, delta and omicron could have relative advantages in different settings- delta may be more transmissible, but less escape, so spreads in unvax/unexposed while omicron spreads in vax/exposed groups.
The bit we don't know is relative transmissibility (R0) in a susceptible population. We know omicron has a considerable advantage from escape, but whether it's more transmissible than delta in a fully susceptible population is still unclear.
If omicron isn't more transmissible than delta in a fully susceptible population, then it will have a growth advantage in vaccinated/exposed groups but may not in unexposed/unvaccinated groups. It'll be important to monitor the relative growth of omicron in different groups.
This means rather than one replacing the other, they could co-exist for longer periods of time. Then what we may see is rapid spread from one variant on top of existing transmission of another variant, because they occupy different immunological spaces.

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More from @dgurdasani1

Deepti Gurdasani Profile picture
14 Dec
I really thought that perhaps omicron would wake people up to the fact that 'living with' this virus isn't really going to be possible - unless we accept mass death & suffering, and develop an understanding that we need globally coordinated progressive suppression. 🧵
But for many people including scientists omicron has actually strengthened the idea of 'living with it' and dropping all mitigations. This is an extremely privileged take, & completely ignores that the impacts of such policy would be devastating on the most disadvantaged.
So unless you're willing to spell out the consequences of your plans clearly and honestly (mass death, especially among the poor, disabled, vulnerable, elderly, ethnic minorities), and own that this is what you're advocating for society to accept, please don't recommend it.
Read 4 tweets
Deepti Gurdasani Profile picture
14 Dec
I've seen people use 'uncertainty' around aspects of evidence to justify inaction. Uncertainty in evidence *does not* mean uncertainty in policy. As I've said, while there's a lot of uncertainty around the exact impact of omicron, there's little doubt that it'll be severe🧵
Same with long COVID. The greater the uncertainty, the more the need for caution, and the more the need for early action. Even the best-case scenarios look very concerning with omicron. So please don't use uncertainty as an excuse for inaction. Inaction will kill in a pandemic.
Best to act early, quickly & scale back if the response was an overreaction. I can safely say that I've not seen any overreaction in UK pandemic policy though, so this is extremely unlikely. Under reaction which is far more damaging has been the mainstay, and continues to be.
Read 4 tweets
Deepti Gurdasani Profile picture
14 Dec
There's absolutely no doubt that deaths have risen in Tshwane with lags despite all the 'mild' rhetoric & are likely to increase further as impact is felt from the rapid growth several wks ago. Data from Denmark suggests equivalent or higher hospitalisation rates to delta.🧵 Image
And remember that for SA the 3rd & 4th wave were very different in many respects- a large section of the population was exposed in the 3rd wave, and it's estimated that 70-80% of people may have had previous exposure by the end - so v. different levels of pop immunity.
Given the relatively high levels of vaccination the UK had going into the delta wave, the level of background immunity will be different between the 3rd & current wave, but perhaps not as different as in SA - so we may not see the same difference in severity.
Read 5 tweets
Deepti Gurdasani Profile picture
13 Dec
This is ridiculous- these purifiers cost 6x higher than regular ones that are far more extensively used across the globe. It's completely scandalous. For the amount being paid to Dyson (!), they could be making 6x the number of classrooms safer than they are. Why aren't they?
Here's as device with literally the same CADR as the Dyson one, at a tenth of the cost!!
amazon.co.uk/dp/B09HYV7W6B/…
What really angers me is that enriching their friends and cronies is so important to them, that they're very happy to throw the health and lives of children and families out the window, when they could easily be protecting them with standard products everyone is using.
Read 4 tweets
Deepti Gurdasani Profile picture
13 Dec
There is no evidence (despite all the rhetoric in the media) that omicron is intrinsically 'milder' than previous variants. Hospitalisation rate in Denmark comparable with delta at equivalent levels of vaccination. And the rapid spread makes it *much* worse.
Any differences in severity of admissions between 3rd and 4th wave in SA may be attributable to some level of protection from vaccination or previous infection - that *does not* in any way mean that the impact of the variant in places it is spreading will not be severe.
The impact will largely be governed by rate of spread rather than severity - and even if it was half or even quarter as severe as delta (no evidence of this), the impact because of rapidity of spread will be massive in most places.
Read 5 tweets
Deepti Gurdasani Profile picture
10 Dec
It's incremental, inadequate & late action that leads into lockdowns. Pl. don't blame the scientists who've advocated for early mitigations to keep cases low when this inevitably happens. Direct your ire at those who opposed basic public health measures, making this inevitable.🧵
I see a lot of people in the media conflate basic mitigations with lockdowns. I guess in the UK you can be forgiven for thinking that lockdown is a first-line public health measure. It isn't though- it means you've failed to act early. We keep making the same mistake over & over.
I do think with the crisis unfolding now, a lockdown will be needed to prevent healthcare services being overwhelmed with the omicron wave on top of the delta wave. But never forget that none of this was inevitable.
Read 6 tweets

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