Some brief thoughts on the concerning relativism I've seen creeping into media, and scientific rhetoric over the past 20 months or so - the idea that things are ok because they're better *relative to* a point where things got really really bad. 🧵
Many pointed to summer in the UK saying it was a success because 'freedom day' didn't translate to anything like Jan 21 or March '20. No it didn't, but >18000 people died since (many deaths may have been avoided with simple measures like mask mandates, mitigations in schools)
And of course we have 1.2 million with long COVID with children seeing a doubling in 4 months. But all this is okay, because it's not as bad as Jan, or March last year. When the pandemic hit in March, we were thoroughly unprepared.
We've had 20 months of learning. So why are we still ready to accept things getting as bad as Jan '21 or March '20 before we act. Surely, with all we've gained in 20 months we should be less accepting of people getting ill & dying, rather than comparing with Jan.
The reason this worries me - is that I think two years ago, the idea of 170,000 deaths happening over 4 months (many avoidable), and 1.2 million people, including 77000 children getting chronic illness would've been far more shocking than it is now.
Now we're happy to accept 30-50,000 deaths/year, despite all the research on COVID-19, all the technological advancements. It hasn't meant we accept less suffering as a society, it's bizarrely just meant we tolerate more infection as long as deaths are *less than* before.
In effect govt, media, and sadly even some scientists have moved the target to it's ok as long as it's not like the catastrophe it was at x point in time - which means we just tolerate more infection, rather than consider that perhaps we should do better.
I think when we're okay with 1000 people dying each week from a preventable illness, and say this is good news, maybe we need to recalibrate where we've gotten to. When we say, a crisis leading to 100K cases is ok, because it may not get us to Jan '21, maybe it's time to reflect.

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More from @dgurdasani1

23 Dec
On BBC London just now challenging the 'mild' narratives. Takeaway: please stop blaming the scientific community for changing narratives in the media! That's down to media (assisted by some scientists with a track record of minimisation).
From 17:12
bbc.co.uk/sounds/play/li…
Omicron is a serious threat- it was before & it is now. As we get more information, we will be able to refine the level of threat more, but the data from yesterday doesn't at all mean that it's not a serious threat!!! If media has portrayed it that way, that's on them.
I'm actually really frustrated by the media rhetoric targeting scientists, and suggesting the public are frustrated with scientists for changing narratives and evidence. Evidence will change, but the way it's been portrayed in media does create whiplash, because it's misleading!
Read 4 tweets
23 Dec
Just a quick note- if you're comparing hospitalisations currently with Jan levels and saying - 'NHS not overwhelmed because they're lower', that's not a reflection of reality. The NHS has way less slack in the system than it had in Jan. It's already overwhelmed. 🧵
We can't keep comparing with Jan peak, and going 'if it doesn't get that far, it's fine' when people can't get timely emergency care now. Not having routine care available fore millions of people for 2 years means there is a lot more burden on emergency services than there was.
Short term thinking and putting the NHS repeatedly under overwhelming pressure over the last few years has massively reduced resilience in the system. And many more people need emergency care due to lack of routine care over the past two years - not just COVID-19.
Read 7 tweets
23 Dec
Wanted to say - although the Imperial paper shows protection from hospitalisation *if infected* remains comparable between omicron and delta, the protection *from infection* is vastly reduced. This will mean overall reduction in efficacy against hosp with omicron.🧵
To explain further - vaccine efficacy against hospitalisation is two components:
- protection against infection
-protection against hospitalisation *if infected*
The Imperial study suggests that while the latter isn't affected much (70-80% protection with 2 doses, boosters) *if infected*, your protection from infection is really reduced with omicron. This means *overall* protection from hosp is lower.
Read 9 tweets
22 Dec
🧵on the Imperial study on omicron severity TL;DR:
-*intrinsic* omicron severity similar/bit lower to delta
-*observed* severity lower due to omicron more likely to re-infect
-vaccine efficacy against hosps maintained
-growth rate likely to override impact of lower severity
Before I get into the rest, I want to re-emphasise that the overall impact of omicron will be determined by growth (exponential) and severity (linear)- even with lower severity, growth in itself will cause serious impact at population level, even if severity is moderately lower.
The Imperial study is a complex piece of analysis, and I have to commend the Imperial team for dealing with important confounders in the analysis.

I want to first explain this a bit more.
Read 33 tweets
22 Dec
A thread slightly borne out of frustration on the widely misrepresented discourse on long COVID, esp in children. This is for the 'long COVID studies in children with controls are rigorous and loads of controls have symptoms so not sure this syndrome is real or important' group🧵
First, controls per se *do not* make a study sound - How do you account for the fact that children are often asymptomatic acutely, serorevert quickly or don't seroconvert at all. Long COVID itself is associated with lower Ab levels, furthering this bias.
Rigorous science is v. important, but let's not pretend that studies are rigorous because they have controls (just like people pretend RCTs are superior to observational evidence by virtue of being RCTs, even if they're conducted badly).
pubmed.ncbi.nlm.nih.gov/34273064/
Read 31 tweets
21 Dec
An important study- it suggests that Omicron has a much greater growth advantage among the vaccinated, and previously infected, and possibly a lower growth advantage compared to delta among those who were susceptible (not vaccinated/infected or waning of immunity)
This doesn't mean vaccines are not effective. It means that among the vaccinated and previously infected, omicron has a higher advantage compared to delta because it has higher escape from immunity (although both have lower infective probability compared to unvaccinated)
It's possible that intrinsic transmissibility of omicron relative to delta (apart from escape) may not be much higher, or possibly even slightly lower. But it would still have a massive advantage among those with prior immunity through vaccines/infection.
Read 10 tweets

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