Edward Kelley Profile picture
Mar 24 114 tweets 105 min read
2022 has brought new #Covid narrative -
1 #Virus getting weaker
2 #Vaccine situation fine as is
3 We don't need #publichealth measures any more

Some of my colleagues from academia, @WHO & @ApiJectCorp worked to put together this 🧵
We go through a set of 50 "Beliefs" on #COVID19 ,
Asking "Isn't it true that..."
and then providing the reality & evidence on each belief

It felt like a lot when we did it
But there's a lot of misguided thinking now on #COVID19

If we don't fix it, millions will die
So sorry for taking some time w 50+

1) #COVID19 now under control and no longer emergency in #US, #Europe

A: #pandemic not “under control”
Cases up globally
#Omicron killed 900,000 more people than #Delta worldwide.
6,300 deaths a day
That’s 40+ jumbo jets full of people crashing each day

2) #Hospitalizations, #CovidDeaths dropping rapidly in highly vaccinated countries, so we can finally relax

A: Hosps dropping but deaths still high in many countries.
COVID (97% Omicron) killed nearly 68,000 people from Jan. 31 thru Feb. 6
With cases going up, so will hosps
3) Each #COVIDVariant less dangerous
Omicron proves trend of virus getting weaker

A: Not #COVID19's history
#Delta led to a 250% upsurge in fatalities
#Gamma had higher fatalities than the native virus from Wuhan

No scientific reason for the next variant to be weaker simply because #Omicron is less lethal.
Like hurricanes, the strength and severity of each storm is independent.
Mild hurricane this month does not prevent a devastating Category 4 storm next month

4) #Omicron is “mild” even if you are unvaccinated

A: You are 70% less likely to die from Omicron
However, same chance of getting #LongCovid
you are much more likely to infect others such as children.
Omicron is far more infectious than all other variants

5) #Omicron is “mild” - you are much less likely to be severely ill or hospitalized

A: Yes, getting Omicron may have “best” short term impact, but once you get Omicron, you’re in #LongCovid risk pool.

Like #polio , most kids have mild symptoms or none at all, but it can result in lifetime paralysis & death for a small subset of infected children.
Millions of “mild” #COVID19 cases will bring serious illness and deaths in the future

6) We will eventually eradicate #COVID19 like #smallpox, but it will take science some time

A: We will not eradicate COVID
It is carried in too many different animal populations, spreads too easily & mutates too fast.

#Malaria has persisted for centuries, & it is carried by only one insect mosquito species.
Smallpox is one conquered disease & took 25+ years of global coordination
#TB has been with us since ancient Egypt

7) Since we will never eradicate #COVID19, we have to “learn to live” with it

A: “Learning to live” with #COVID is often code for surrendering to COVID
We cannot live w something that threatens millions each year (incl kids) w death & long-term health issues

8) #FaceMasks not worth trouble & even @CDCgov says they are currently unneeded w a few exceptions

A: Not what @CDC is saying
Proper #KN95 & #N95 masks worth trouble- they protect children, many seniors & those on many meds who cannot be vaxed or have weak immune sys
And they protect everyone from #LongCovid .
#N95 mask worn properly allows you to be near an infectious person for full day or more without getting #COVID19 .
Why most hosp workers can spend all day with infected patients and not get infected themselves
9) Yes, some people still in trouble if they get COVID, but not a lot of people, & they are going to have to learn to deal w #COVID like all other diseases.
We cannot live in bubble to protect vulnerable from disease that will be like #FLUID

A: 25% of global pop (1.7B) at increased risk of dying from #COVID19 because of their age or underlying health conditions incl 500 million elderly.
Everyone at risk for #LongCovid
This is not a few people and is more like the 1918 pandemic flu than annual #Flu
Sensible measures - #KN95 masks, HEPA air filters in classrooms, offices & indoor spaces & avoiding unmasked crowds anywhere will
save many lives,
reduce hospitalizations
slow down #COVIDvariants
to let science finally get ahead of virus in terms of #vaccines & #therapies
10) #Hospitals & #HealthCareWorkers have been through some tough times but that’s behind us now
Health system can handle #COVID19 going forward

A: Hospitals have been battered by 2 years of pandemic conditions.
Many nurses & doctors are burned out.
Even if #Hospitals have bed space for patients during #nextwave/#nextvariant
many more doctors & nurses will quit
Worldwide, about 25% of all doctors & nurses show symptoms of stress, many from coping with 20M COVID deaths, as well as treating tens millions serious illnesses.
11) Yes, #LongCOVID is real problem
But not that common, & we still don’t know much about it
We cannot let fear of Long COVID affect our everyday lives

A: Concern about #LongCOVID should be front & center - especially in children & young adults. Long COVID is like tsunami with very small wave visible on top but giant mass of water under surface.
Likely to hit 10-30% of everyone who got #COVID19 including those w “mild” #Omicron
In 3 years, some leading health authorities believe Long COVID could become world’s top chronic health problem
In addition to symptoms we’ve seen, we don’t know how Long COVID will affect development of young children ( largely unvaccinated/unboosted)

12) If you have had #COVID19 before, you are safe from getting it again.
Very unusual to get COVID twice

A:Not that rare to get COVID twice!
Prince Charles (who then infected Queen of England)
financial reporter Neil Cavuto
Sen. Roger Wicker
rock star Bryan Adams
Eventually, people who get seasonal cold or flu, usually get it again.
Everyone who gets #COVID19 can get it again too. It is a #coronavirus, & can reinfect

13) #Omicron’s effects are quite mild & if you get it - no big deal, especially if you are vaccinated

A: “Mild” variant would not have killed 500,000 people by mid-February
High % of people w #Omicron likely to experience long-term effects
People 40x more likely to die from getting Omicron in 2021 than from the 2021 #flu.

14) If you had a mild case of #COVID19 & fully recovered, you are safe from more serious health problems later

Mild case of #COVID19 does not guarantee no long-term problems

Best estimates are that 10-30% of people will have symptoms of #LongCOVID or impact future health from elevated rates of #heartdisease, #Alzheimer’s & #cancer
Millions still suffering from just initial symptoms year after #infection.
15) #Omicron replaced previous #COVIDvariants like
#Beta &
#OldVariants are no longer threats.

A) Old #COVIDvariants still with us, just in much smaller numbers of people. #Delta, #Gamma, #Beta, etc., can reappear as fast as #measles or old strain of #flu
Older variants can also combine w #Omicron
Currently most Omicron deaths are among #unvaccinated
New #BA2variant even more transmissible in this #pandemic .

16) Getting mild case of #COVID & recovering confers valuable #immunity to previous and #futurevariants

A: Benefit from prior infection hard to measure but usually quite small
So-called “#naturalimmunity” varies widely by person...
...by #severity of illness, & by strain you had or are now being exposed to.
Studies indicate many #mildCOVID cases confer limited/no sustainable future benefit unless combined with #vaccines

17) I am #fullyvaccinated, boosted & had #COVID19 ,
so I am “#bulletproof” & can't get it

A: No bulletproof “immunity” to #COVID
COVID protection steadily drops each week & can drop to zero in 6 months
V different from #measles or #mumps where childhood shots protect for life
18) If you are healthy adult under 60 or so, #Omicron was never really big threat to you

A: #Omicron killing more people now than at almost any time in #pandemic.
Currently, almost 25% of #COVID19 deaths are people <50 w no hlth conditions
COVID kills many healthy people too
19) If you are young child or teen, and in good health, #COVID & #Omicron were never really big threat to you.

A: There is difference between immediate and long-term threats, as suggested by U.S. statistics which may apply globally
58% of #USA children have been infected & #LongCOVID may affect 1M or more of them with chronic impairments

In total > 1,000 US children confirmed dead of #COVID19 so far — terrible tragedy

20) Since kids rarely get serious #COVID, schools don’t need to go overboard on protections such as #aircleaners & #mask requirements

Schools are mandatory long-term exposure so we have a much greater responsibility to protect kids who must be in schoolrooms
We recall blankets that burn only “few” children or crib that killed a single baby
We don't expose children & teachers to avoidable death & long-term disease when precautions (proper KN95 masks & air filters) possible w/o great cost or disruption.

21) #COVID19 deaths are exaggerated because some people died from something else, & also happened to be positive for COVID when they died

A) Unfortunately, opposite is true.
Research revealed many governments are dramatically under-reporting cases and fatalities...
...India – 500K #COVID deaths,
Likely 4-5M dead.
Russia – 348K deaths,
Likely 1M+ l

Global #COVID19 death toll currently estimated 20M, based on “#excessdeaths” vs official govt sources

22) When someone in your family gets #COVID19 , inevitable that you will get COVID too

A) Not the case!
In families using protective measures, > 1/3 of time does family member get infected—even with #Omicron This “secondary attack” rate can be as low as 10%

23) We are all going to get #COVID19 eventually, so might as well get it over by getting mild #OmicronVariant

A) W #COVID, you cannot be just done with it, any more than you can get a cold & be done with all colds in future
Never safe to get this #virus
#LongCOVID can devastate your life and lives of others you unintentionally infect
You could accidentally kill child by getting in an elevator
Risk & moral hazard far greater than many people seem to realize
Nobody wants to hurt others thoughtlessly

24) #COVID19 will eventually degrade into something like #flu & we will treat it as background fact of life

A) No scientific basis for this belief!
Some scientists refer to this belief as “hopium” - it is wishful thinking
#COVID19 may become like #flu in 50 or 500 yrs...
But no way to know that
It could just as easily turn into something much worse like

25) Entire world needs to be #vaccinated as quickly as possible, but it is going to take some time to do it

A) Complacency is major risk.
#NewVariant emerged avg every 4 mths for 2 yrs
#Omicron proved half people in world can get infected in just 60 days
We can #VaccinateTheWorld faster & in our interest to do so safely

We cannot continue to have millions of #vaccinedoses expire unused around world because national leaders fail to approach #VaccinationPrograms comprehensively

26) When it comes to effort to #VaccinateTheWorld, we are doing best we can

A: Working together, countries can move #vaccines #TheLastMile into patient’s arms.

We need to help inject billions of doses in places w not enough doctors & nurses, but millions of #CommunityHealthWorkers ready to assist

@UNICEF @LastMileHealth @VillageReach
27) We have delivered #vaccines & medicines all over world & promised to do much more in the coming years
Western nations have done more than their share

A: Yes, countries with strongest economies have donated millions of vaccine doses worldwide
...world still needs 20B doses & we need to work together to deliver them

Only 14% LIC pops have 1 dose & almost none have boosters.
Arguing over what each nation’s “fair share” should be like arguing who should help most to put out fire in burning submarine.
Really true that no one is safe until we all are
#Viruses ignore national borders.
28) Now there are plenty of #vaccinedoses available around world
Doesn't that solve global #vaccination problem?

A: We do have hundreds of millions of vaccine doses available, but they are not making it into patients’ arms in low-income countries
Much lacking: #trucks, #refrigeration, trained clinicians, #syringes, local vaccine #manufacturing & #FillFinish
Result: dose #deliveries falling; #vaccinationrates lowest ever in pandemic
Wealthy countries poised to destroy hundreds of millions of expiring doses by summer 2022
29) We basically “won the war” against #COVID19 by discovering &mass-producing effective #vaccines.
Now just mopping-up operation.

A: This #COVIDWar already killed estimated 20M people worldwide, including over1M Americans, based on #excessdeaths reported in each country
We are still preparing for inevitable future waves & are not ready
We need more people #vaccinated, #boosted, #trained, & ready to treat citizens
Worldwide, we must “get vaccines in arms” or war will come back to all shores again

30) If you are vaccinated with 2 shots, you are mostly protected
Having 1 shot is useful, though not ideal

A: Protection varies widely by #variant & time since your 2nd shot
For example, 2 shots & no booster provides just 0-10% protection against getting #Omicron
Studies show #VaccineEffectiveness typically wanes by 30%+ after as little as 4 months
Like deep suntan, your protection steadily fades faster than you want

31) New, variant-specific vaccines can quickly be developed for major #nextvariant
Shouldn’t we wait for those #vaccines?

A: So far, variant-specific vaccines have neither been approved by regulators or been manufactured at scale
What’s more-no guarantee of success
Current #Omicron-specific vaccines, being tested now, performing WORSE against #COVID19 than original vaccines

Even if we create better vaccine, #NextVariant will arrive before we can scale up production for #vaccination

32) Pretty soon we will have shot that prevents ALL #coronavirus infections so we won't need more shots in future

A: Pan #coronavirus vaccine is probably at least 5 years away
R&D makes sense but viruses are tricky & billions of years old
We shouldn’t count on a miracle shot — as #HIV has proved
33) Yes, #VaccineHesitancy is problem, but doesn’t threaten vaccinated pop & people should have right to choose what to believe

A: Up to 50% of people are vaccine hesitant or averse in some countries
If they keep getting infected they will spread new #COVIDVariants locally...
... & perhaps worldwide #VaccineHesitancy risks everyone’s future, not just those making their #PersonalChoice

Why #schoolchildren must be immunized for many diseases before they expose other children & those children’s parents

34) Almost all #COVID19 deaths are among #unvaccinated
W 2 doses, or 2 doses+booster, you are not going to be hospitalized or die unless you are old or have health problems

A: That was true once, but the #pandemic keeps evolving
Globally, 1 M vaccinated people have died from COVID, mostly in past 3 mos & very few w 2 shots + booster
#Omicron deaths now happening among vaccinated in countries w high #vaccination rates > 6 mos earlier
A #virus doesn’t read newspapers, watch TV or post on social media
It is an ongoing battle to protect people from trillions & trillions of mutating particles

35) We don't really face any problem packaging #vaccines
Plenty of multi-dose glass #vials & they seem to work fine

A: Multi-dose #vials were an emergency choice, triggered by short supplies & high costs of single-dose vials that everyone agrees are much safer
Lead times for large orders of glass vials are now 80 weeks
Shortages of medical-grade vials, suitable for administration in clinics, will grow as orders mount in the next two years to cover most of the world
More importantly, only way world can regularly & reliably administer boosters is to emulate #flu #vaccination strategy by moving to single-dose, prefilled #syringes

36) .@UNICEF predicted #shortage of several billion vaccine #syringes, saying it would drive widespread #SyringeReuse
But we don't read about it, so presumably this risk has been averted

A: #SyringeShortages & #reuse are very real problems worldwide
However, #HealthWorkers & national health ministries reluctant to acknowledge syringe shortages (it’s mismanagement) or #SyringeReuse (which is malpractice)
In most of world, govts diverting millions of #syringes from routine child immuniz efforts to use for #COVID19
They are using non-vaccine syringes to keep up, approach which in 80s & ‘90s led to millions of #HIV & #hepatitis infections

& we predicted it
37) World has not seen large outbreaks of vaccine-preventable diseases in kids, so #RoutineImmunization programs are fine

A: Last year @UNICEF reported fewest kids immunized in more than decade of steady improvements.
Due to syringe diversion to #COVID & other factors, over 30M children now #under-vaccinated or #unvaccinated, & consequently at risk for diseases much more deadly to them than COVID, including

38) We have plenty of #HealthWorkers in field, so like #smallpox, they can #VaccinateTheWorld against #COVID
We can keep re-boosting world’s population
A: We have nowhere near enough medically-trained #HealthWorkers to vaccinate world's population w a doctor, nurse or pharmacist prepping & using syringe.

@WHO estimated before #COVID that we would be short 18M HWs by 2030
#COVID19 has made this gap much bigger, much sooner
We need solutions for people to help themselves & their families quickly & w/o medical personnel.

39) #COVID19 help for other countries is a humanitarian act, but it doesn't really help or affect donors

A: When any one country gets a dangerous transmissive #NewVariant, every other country will get it too
The virus doesn’t care about or respect man-made borders.
#COVID came from #China
#Beta came from #SouthAfrica
#Gamma came from #Brazil
#Delta came from #India & killed 4-5M in India alone
#Omicron came from #Botswana & has killed 3M so far
Pattern is clear, global & 100% consistent.

BTW #NewVariant could also begin in #USA!
40) #China has done excellent job keeping #COVID under control
If China loses control & #COVID spreads widely there, it will be their problem, not ours

A: Yes, #China has kept #COVID under control but...
...eventually they are likely to lose control since both humans & animals spread virus
Already happening in Hong Kong w #BA2 #OmicronVariant & large vaccine-hesitant elderly pop
If #China loses control before scalable cure found & widely produced, impact will be felt worldwide & could be severe.

China alone has 1.4 B people. Remember 2020? #PPE supply chain?

41) All #pandemics eventually end
#COVID has lasted >2 years & looks like it’s due to end soon

A: Many #pandemics never end, & we have no way to predict when COVID will

#Smallpox lasted hundreds of yrs.
#Measles at least 200 yrs
#Flu with us for centuries
#HIV jumped from African apes 40 years ago & has killed 35M people
Ancient Egypt had #tuberculosis
#COVID19 virus could be threat for many generations

42)A #pandemic is natural phenomena
We should not get overly concerned about next one
We have new tools & experience, & we are ready

A: Yes, until now all #pandemics have been natural, but next naturally occurring pandemic could be far deadlier & kill 100s of millions of people
It could potentially collapse global economy or cripple critical food supplies on several continents
#NextPandemic could intentionally be much worse in form of a human-made lab-engineered #bioweapon.
We are not ready for either future
43) If I stand 6 ft away from someone, I am mostly safe from getting infected or infecting others
Tiny water droplets we breathe in or out with #virus fall to the ground

A: This was thought to be case initially but has turned out to be proven wrong
#COVID19 is invisible #aerosol that can travel 20+ feet from infected person

#Aerosols linger in room for hours, like smell of #tobacco smoke or perfume
You can get infected by walking in room an hour after infected person is gone
Social distancing & masks critical as part of total defense that includes #N95 #KN95 #Masks worn properly & indoor ventilation upgrades to remove airborne virus

44) In #hospitals, uninfected patients rarely get #COVID from other patients who have virus

A: Unfortunately, studies show #hospital patients spread #COVID because many ventilation systems were not designed to stop spread of #aerosols — especially when hospitals overcrowded
In many #hospitals documented transmissions at peak periods have between 10-15% of patients enter #COVID19 -free & die or leave infected

45) Outdoor #SportingEvents & concerts are mostly safe.
It is hard to get infected w #COVID while outdoors

A: Crowded outdoor spaces more dangerous than uncrowded indoor spaces
#COVID19 is an #aerosol & acts like cigarette smoke or perfume aroma
If every 5th stadium attendee were smoking cigar, you would quickly smell it
You can get #COVID19 outdoors just as easily as you can smell a cigar from 20 feet away
46) It takes being w someone 10-15 mins to inhale enough #virus to get sick with #COVID19

A: #Omicron can infect you in <1 min
You can be infected <15 secs if you are in small room w unmasked people, & if you are not properly masked yourself
Viruses exploit every opportunity
47) We have now reached pt where so many people have had #COVID19 & so many people have been vaccinated that we have developed #HerdImmunity or at least strong resistance

A: No such thing as #HerdImmunity to a #coronavirus
Best we have is #HerdResistance, & that steadily fades as efficacy of #vaccinations declines over time
Only 6% of world has had #COVID & ~50% of world currently 2-dose #vaccinated, but #booster rates are low & everyone may be vulnerable at some level to #NextVariant
#Alpha, #Beta, #Gamma, #Delta, #Omicron — herd immunity was a wish not a plan

#Reinfection with new strains may not provide any added #resistance but rather damage your immune system over & over again to increase your risk of harm

48) Countries that had very few #COVID restrictions did just as well as other countries that had much tighter restrictions, so #mandates & #restrictions really were not worth it
A: #USA imposed light/inconsistent protective measures & has experienced #COVID death rate 10x higher per million than #SouthKorea, which imposed strict measures.
#US fatalities were 2,908 per million
#Korea’s were 223 per million
Policy that #PersonalResponsibility was better than KN95 mask mandates is not supported by data
Even in a free country, people are not allowed to choose

which traffic lights to obey or

their blood alcohol level when driving

49) We cannot afford to hurt our #economy & make everyone worse off just because #COVID is still threat to limited part of population
We need to make smart trade-offs.

A: We do not keep businesses open without sensible precautions for everyone...
...if we can do so while protecting children
#SaveTheEconomy or defend against #COVID is false choice
Reasonable & effective precautions such as #masks & #AirFilters are readily available
If we protect workers from long-term effects of 2nd-hand smoke, we can & should protect them from much more likely impact of 2nd-hand #COVID19

We can do both things well & it does not need to be expensive/burdensome

50) I am wearing a #mask. All #masks are pretty much the same

A: #Masks are like bulletproof vests
You don’t wear vest made of tinfoil & you don’t wear bulletproof tie
Masks are real medical equipment
To stop #COVID you need a #KN95/#N95 mask
Cloth or standard surgical masks are 90% ineffective against viruses

And +1) If reported cases dropping in my area, I can rely on that number to give me good sense of my personal risk of getting infected with #COVID19

A: “Confirmed” case counts, which are what gets reported, often do not include #HomeTests which can be 2-5x greater
People who have no symptoms are never counted
Many areas now doing far less testing, so they “find” far fewer cases to report-why #TestPositivity rates matter.
For all these reasons, case counts often poor indicator of your risk of getting #COVID19
Hospitalization figures more reliable, but lag 10+ days from infection dates
Reported deaths lag 20+ days or more.
Means that any rise in cases or hospitalizations are only #TipOfIceberg

We tried to sum up in one short report -

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