Dr Greg Kelly Profile picture
Aug 23 7 tweets 2 min read
Important clarification re. repeat #COVID19 infections

No doubt a repeat infection is worse than no repeat infection - EVERY time carries risk of bad outcome.

What is still debated is whether an infection makes bad outcome from future infection more or less likely. Brief🧵
The fact the second point is being debated should not distract you from the first. Even if you've been infected one or more times you should try to protect yourself from another.
Earlier, some thought 1 infection=absolute long term protection. Definitely wrong

Science not settled on whether 1 infection provides degree of overall protection or is in fact harmful, which there is increasing evidence to support

Key: protect yourself from next infection
As Dr Sharkawy points out here, there is evidence that serial vaccination is protective, but NOT serial infection
Like most things in the real world, I suspect that the answer is both "it depends" and "reduce transmission"
In a #lowcovid situation with slow viral evolution & long time btw infections prev infection may be somewhat protective

In current #highcovid situation w rapid viral evolution & immune evasion prev infection does not seem to be protective & may worsen chance of bad outcome

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More from @drgregkelly

Aug 15
The 5 Fs of getting effective masks on the faces of your loved ones for #COVID19 protection in the real world

1 - Filtration
2 - Fit
3 - Feel
4 - Fashion
5 - Finances
1, Filtration

Refers to the % of potential covid containing particles (i.e aerosols) the mask material filters out. Cloth & surgical masks are unrated, untested & unpredictable but let’s be generous & say they filter 50%
But…because cloth and surgical masks are not designed or tested to filter reliably these numbers are highly variable - a well fitted surgical mask might be 80%, a poorly fitted cloth one 10%. There’s no real way to know
Read 17 tweets
Jul 2
This should be a proper “oops” moment in our #COVID19 response, and quite possibly an “oh shit” one

Here is real world data confirming earlier predictions that the time between covid waves would progressively decrease

Why is this so concerning? 🧵
Briefly, waves grow when each infected person infects average > 1 person & end when each infects < 1 bc people got infected & either develop some immunity to that variant, die,or behaviour changes

Vax contribute to baseline immunity (that’s good) but prob too slow to affect wave
A new wave occurs when a new variant that is different enough from previous appears - which means that the average immunity is low enough (plus behaviour permits) each infected person to infect on average > 1 person, that wave ends as above
Read 8 tweets
Jun 30
It's dawning on me we're no longer fighting #COVID19 - we're fighting innumerable covids that are evolving along uncountable parallel evolutionary paths from original Wuhan strain

My non-viral-evolution-expert thoughts:🧵

Human time is meaningless to the virus - it's all about:
1) the number of generations since the original strain AND
2) each innumerable branch of SARS-CoV-2 phylogenetic tree evolving independently

Parallel processing - why our human-speed responses keep falling short
In addition, viral recombination events (not sure how common they are with this virus in particular but anything with a non zero likelihood will happen eventually with this many chances) could allow skipping 'ahead in time'
Read 7 tweets
Jun 18
Surely first time in history where 1-2% of such large, mobile, populations is getting infected with same virus EVERY WEEK

Given each infected person makes almost 1 trillion viral copies the opportunities for the virus to evolve are enormous & explain ongoing #COVID19 burden
Viral copy numbers here

ncbi.nlm.nih.gov/pmc/articles/P…
Such staggeringly large numbers mean that even the lowest probability worst case scenarios could eventually happen e.g SARS-CoV-2 combining with something with a much higher fatality rate like MERS.
Read 4 tweets
Jun 15
Thread on 2 months of use of a discreet home made portable HEPA filter aka "Pram-PAPR" using unmodified off-the-shelf equipment to put a layer of #COVID19 protection around our 6 month old baby
Despite some misinformed or misguided commentary earlier it is now apparent that #COVID19 is a potentially serious, even fatal, disease in all ages

Despite this, options to protect young children remain very limited
I'm aware of the enormous privilege that it takes to protect our baby from #COVID19 in this way and that this approach is neither equitable nor sustainable - it is FAR BETTER to reduce transmission & ensure a safe environment for all

Having said that - what were our options?
Read 18 tweets
May 27
We have genuinely tried "living with covid" in highly vaxed pop & is proving unsustainable for health system & economy

Time to try "living w less covid?"

NOTHING in "vax only" strategy game changer in near term. Boosters marginal at pop level, better (mucosal) vax uncertain 🧵
Our strategy in face of unsustainable situation seems to be:
1. Doubling down on what's not working (vax, necessary but not sufficient)
2. Hoping better versions of (1) come soon &
3. Changing testing / reporting & a PR campaign to convince everyone that things are actually fine
Of course, things substantially better than pre vaccines. Refrigerated trucks, mass graves & lockdowns are a thing of the past
Read 9 tweets

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