This is a disgraceful and evidence-free position taken by the NFL. It is nevertheless an opportunity to explain a few things about omicron and what we are learning about it 1/n
espn.com/nfl/story/_/id…
First the very serious point that the transmission properties of omicron mean that existing quarantine/isolation rules need to be reassessed to prevent extreme disruption. But we don’t have the evidence base for those changes that we would like, and we won't for a while 2/n
Quotes from the piece "I think all of our concern about [asymptomatic spread] has been going down based on what we've been seeing throughout the past several months," Newsflash, there’s a new player on the scene and what was true for delta is not necessarily so for omicron 3/n
Also they say “transmission… is not being driven by people who have no idea that they are infected and they are infecting scores of others.” This is unambiguously false. I know personally of many occasions at which this has happened in recent weeks as omicron has surged 4/n
It's not just private data, it's in a LOT of news reports that have been building up. This was from the start of the month khn.org/morning-breako… 5/n
If vaccinated people assume they cannot be infectious, more people will be infected - including some at greater risk. That's why this isn't just stupid post hoc justification of something they are doing because they want to do it, it's dangerous. Others will follow their lead 6/n
The demand for evidence of asymptomatic transmission is a common trope among bad-faith commentators. They delay action by demanding a standard of proof not possible under the circumstances, and then wash their hands of the inevitable consequences. (See also climate change) 7/n
Finally the @NFL has been collecting samples for a long time. Like the @NBA it has provided a remarkable and valuable resource for the study of the virus - we could use those samples to answer the question of whether asymptomatic transmission is happening 8/n
If they are so sure that asymptomatic transmission does not occur sequence those samples and make the data available to an independent expert like me who can tell them if there’s evidence for asymptomatic transmission. If they don’t you can draw your own conclusions 9/end

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More from @BillHanage

22 Dec
So a great friend who I’ve not seen in years is visiting from London - current epicenter of omicron. What should we do to be responsible if we want to hang out? 1/n
Well first thing is that travel bans between places that have little difference in prevalence now or in the near future are just dumb. So don’t hate on people for traveling, especially because they can have good reasons 2/n
LFTs are obviously helpful. Two negative today build confidence 3/n
Read 7 tweets
21 Dec
Right now delta, which lest we forget is an extremely transmissible variant with substantial ability to cause breakthrough infections, is losing out to omicron in the US. The details are debatable, the overall trajectory is clear (from covid.cdc.gov/covid-data-tra…) 1/n
This is remarkable, but is it due to omicron dodging antibodies better than delta, or just being more transmissible, or both? We can gain some insights from this thread (by @maryebushman in my lab) 2/n
This is a crucial plot. It shows the combinations of the two key parameters consistent with what was observed in Gauteng. Not that 'population immunity' is not seropositivity, it is a representation of total immunity arising from both infection and vaccination 3/n
Read 10 tweets
20 Dec
In one week #Omicron went from 13% to 73% of cases in the US. This is transmitting very fast, and transmission matters covid.cdc.gov/covid-data-tra…
This at a point when cases have been rising and this is already the reality in the North East - fueled by Delta nytimes.com/live/2021/12/2…
I am less sure now whether Omicron will completely replace Delta, or just be the more common cause of infection. After all, if cross protection is limited, that should matter
Read 5 tweets
20 Dec
I am not ‘afraid’ of the virus. I am vaccinated and boosted and young (ish). I am concerned about what unmitigated transmission does to our society, and the potential of Omicron to cause outbreaks in places we don't want them 1/n
Imagine an outbreak among the team about to deliver your baby, some of whom suddenly have to isolate 2/n
Imagine an outbreak among the people who deliver your chemotherapy 3/n
Read 7 tweets
16 Dec
To what does Omicron owe its remarkable properties? Immune evasion or inherent transmissibility. My bet is a bit of each. One thing though is beyond question - it is much better than delta at spread. Look at the household attack rate. This has implications 1/n
So Omicron is infecting roughly 2-3 times as many people as Delta, specifically in the setting of household transmission. It is not as clear outside households but remember, it is much harder to identify all potential contacts outside households 2/n
(That data btw was from last week's amazing technical briefing from @UKHSA. assets.publishing.service.gov.uk/government/upl…) 3/n
Read 11 tweets
14 Dec
Lots of chatter about how early data show #Omicron is "less dangerous". But it is important to correct for the lag between infection and hospitalization when comparing the severity of variants with very different properties when it comes to transmission, here’s why 1/n
Imagine two viruses exactly the same in terms of severity, but one of them infects on average 3 people, and the other 1.1 (I know you can’t have 0.1 of a person, it’s an average). These are the effective reproductive numbers or Re and they determine how quickly they spread 2/n
If we start with 1000 infections with the less transmissible variant and just one of the more, we would expect the latter to overtake the former by the 7th generation (assuming nothing changes). Exponentials are wild 3/n
Read 9 tweets

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