I liked this because I greatly respect @sdbaral's commitment on these issues, but in the current circumstances I think it is a lot more complicated than this thanks to all the non-linear aspects of infectious disease 1/n
If folks making deliveries had to negotiate poisonous gas, or a horde of vicious venomous kittens from which others were insulating themselves, then sure. But that’s not so here. The force of infection in the community depends on opportunities the virus has for transmission 2/n
If staff in a grocery store are packing deliveries rather than working the till they are still exposed to their coworkers – but they are not being exposed to people who would otherwise be shopping and providing a highway for the virus into a new host, be it staff or customer 3/n
Or staff in a restaurant working to prepare food for take out. Again, they’re not being exposed to the customers, and the risk of an outbreak that will temporarily shut the whole operation down is reduced, because fewer contacts 4/n
These industries by the way need support, the next month or so will be horrible (if only through staff being sick, or customers choosing to stay away), and we should work to keep the businesses in our communities afloat. Those with the $ to support should do so 5/n
(indeed if we can bail out banks after a crisis with its origins in greed, why can't we bail out the likes of hospitality in the face of an extraordinarily transmissible virus?) 6/n
One of the grosser elements of the last few years has been seeing trolls posting stuff like this, when they could be talking about persistent inequities in access to PPE, to vaccines, to sick pay among many other things (it's almost as if they're not in good faith) 7/n
We should provide sick pay. Why in the name of heaven have we been unable to countenance something as simple as that, so that the sick person does not go to work and expose others? relevant too in the context of shifting advice from CDC nytimes.com/2021/12/27/hea… 8/n
In conclusion, given what is likely to be a short but very intense period of transmission, there are things we can do to avoid contributing to it. Some of us are more able to do that than others, and we can advocate for those who are less fortunate 9/end

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More from @BillHanage

30 Dec
Thread worth your time from @JasonSalemi on the remarkable things going on in Florida - a state in which more than a *third* of pandemic deaths happened in the delta wave, which other states with more vaccination were better able to fend off. I will make a couple comments below
Note some of this dramatic vertical line is likely catchup from slower testing over the last weekend. That said, a subset of folks won't be seeking tests. Not clear how that evens out
and this shows hospitalizations starting at the same rate as the delta wave. This is not good *but* the crucial question is how long they continue to increase and whether there is a very sharp peak. There's one other thing...

Read 5 tweets
24 Dec
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
Read 9 tweets
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

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