This is an excellent 🧵about this new paper led by @emcat1.
@dgurdasani explains the details much better that I ever could but one important takeaway from this is that Omicron is a rather different virus from Delta in key aspects.
What are the implications of this?
1/8
1. We should be careful when we extrapolate from what we know about delta and previous variants, and from what we know so far about differences between Omicron and Delta.
2/8
2. A virus capable of such plasticity is fascinating but it means that there is a lot we still have to learn about Omicron and we should be cautious.
3. Boosters are important, please get yours if you can.
3/8
4. We need to be particularly careful about neat and falsely reassuring linear narratives like 'SARS-CoV-2 will evolve into a mild virus', which give the impression that variants follow a linear progression down a single path, becoming progressively milder.
4/8
The evidence for this is questionable (unless you include the possibility of a pathogen becoming 'milder' because the only humans left are the ones who were able to survive it, those who couldn't, didn't).
5/8
Omicron really scuppers this linear narrative.
It is not the next step from Delta, it is from a different lineage and seems to have evolved down a different path.
So far it's not replacing Delta, instead we have a dual pandemic.
6/8
If Omicron does turn out to be truly milder- less illness, deaths & LongCOVID- that'd be amazing. But it wouldn't be a nice, neat story about viruses evolving to become milder, it would be a lucky twist in the tale. And not necessarily the last chapter.
7/8
By which I mean, it is unlikely to be the last major variant given the potential of this virus to mutate.

We need to control the pandemic, we can't let it rip, at least for the sake of the Greek alphabet.

Please continue to take care in every way you can.
8/8

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More from @HZiauddeen

2 Jan
🧵COVID-19 : Thinking about the longer-term

Thanks for sending me this 🧵 @timcolbourn. I'm replying here with some thoughts, sorry for the delay in getting back to you.
Anyone else reading this, I've let Tim know I'll be replying via QT to make it easier to 🧵
1/26
I think there are some additional factors to be considered and I'd put them under 3 categories:
1. The real world complexity of ongoing high transmission.
2. The health economic (& broader economic) costs of ongoing high transmission.
3. Messaging & intervening.
2/26
Real world complexity:
-I think we need to consider this as a complex dynamic problem, with potential for rapid, large magnitude changes at different local-global levels e.g large superspreader events, national oxygen shortages, new variants with significant immune escape.
3/26
Read 26 tweets
31 Dec 21
🧵 A New Year's Eve tale:

June 1990
"Hello, could you tell me when the next train to Birmingham is?"
"One moment, ah yes, it's at 1:40."
"Brilliant!"
"People aren't usually this excited about Birmingham."
"I've got a date with Sam, I can't believe it!"
"Have fun young man."
1/12
July 1990
"Hello, are there any trains to Birmingham tonight?"
"Last one's at 8:00 but you'll have 2 changes."
"That's no problem, thanks so much!"
"It's Sam's young man isn't it?"
"Oh, was it you I spoke to last time? Sorry, I was a bit excited."
"Sounds like it went well."
2/12
July 1990
"Hello, when's the next train to Birmingham?"
"Another trip so soon? Sounds like the second date went well.
"What? Oh, yes, very well, thanks. I mean, sorry, seems a bit weird..."
"There's one at 5:20."
"Thanks. I'm Tom."
"Martin. Have fun Tom."
3/12
Read 13 tweets
28 Dec 21
🧵 'What's the alternative?!'/'What's your alternative?!'

This question came up several times in the replies to this 🧵 so I'll take it in good faith and answer it. I'll be very clear and explicit so that you won't have to presume what I really mean or want, I'll tell you.
1/24
Here goes:
First up, there is NO zero-inconvenience option for controlling the pandemic.
We have an airborne virus that is highly transmissible and can cause severe illness and death.
There is no option that will mitigate the impact of the pandemic without inconvenience.
2/24
I say zero-inconvenience very deliberately because all through this pandemic, measures like masks have been deemed an unacceptable inconvenience.

So what is the alternative that many of us (I am not even a bit player) have been fighting for?
3/24
Read 24 tweets
28 Dec 21
This thread by @BallouxFrancois troubles me for several reasons, first and foremost because he is now advising our health secretary Sajid Javid.
The central message of his 🧵is that COVID is inevitable, we're all going to get it, let's just get on with life.
1/23
To be fair, he's not saying anything here that he hasn't said before. It is more troubling because he seems to have the ear of a govt (& media) that doesn't want to do v much to control the pandemic.
I'd like to draw your attention to the seeming reasonableness of the 🧵.
2/23
He says:
'This is not an easy message to convey',
'it gives me no joy to announce (this terrible news)',
'in an ideal world I wish we could have'
'Pretending we remain in control, of sorts, is just becoming too costly'
3/23
Read 24 tweets
24 Dec 21
🧵 COVID-19: The unbearable 'mildness' of Omicron

The 'Omicron is mild' narrative was seeded very early and is being heavily pushed at the moment by the usual scientists, journalists & politicians.

Students of context should be cautious on these grounds alone.
(1/15)
I'll link to 🧵s by much smarter people for detailed information but here's a summary.
-Omicron seems, at best, slightly less bad than delta, which remains very bad.
-Omicron can escape immunity acquired from vaccination/previous infection to a significant extent.
(2/15)
-This means that if you are vaccinated or you were previously infected with delta or other variants (vax/inf), it will not protect you from catching Omicron like it would have protected you from catching delta or catching delta again.
(3/15)
Read 15 tweets
22 Dec 21
Brief update
🧵COVID-19 in the UK: We're SO SO fucked

This last thread👇was written in the golden days when daily case numbers were only in excess of 70,000. Since then a lot has happened and in response, the govt has taken masterful, decisive and definitive inaction.
1/16
Here are our case numbers over the last week:
14/12: 59610
15/12: 78,610
16/12: 88,376
17/12: 93,045
18/12: 90,418
19/12: 82,886
20/12: 91,743
21/12: 90,629

These numbers may plateau soon because we are close to maxing out our testing capacity.
2/16
Things are very grim indeed.
The best case scenario SAGE models are horrifying.
The worst case scenario models are to awful to even contemplate.

The govt has taken the shortest route to find a solution and done away with the issue of contemplation.
3/16
Read 16 tweets

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