1/ I was asked to write an editorial on face masks for kids in educational settings

My conclusion?

We need to stop masking children in educational settings because, after nearly 3 years of the pandemic, there is no robust evidence of benefit

Short🧵

👉 sciencedirect.com/science/articl…
2/ My editorial accompanies a study that re-analyses a recent US CDC study and finds no benefit of masking kids against #covid19 when the analysis was extended to a larger more representative geographical region & over a longer time period

👉 journalofinfection.com/article/S0163-…
3/ The authors found no randomized controlled trials on masks & kids. They also summarize the confounders & biases of published observational studies & show how these biases might lead to perceived benefit of masking kids when in fact there is none 👉 journalofinfection.com/article/S0163-…
4/ What we decide now about masking kids will have far-reaching consequences beyond the pandemic - there are already calls for more invasive masking of kids despite no evidence of benefit. Many are advocating indefinite masking - for new variants, seasonal viruses, monkeypox, etc
5/ In conclusion, we need to make educational settings safer for staff & kids - larger premises, smaller class sizes, cleaner environment, better ventilation, improved outdoor facilities - but other interventions should only be implemented after evidence of clear benefit …/End

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More from @ShamezLadhani

Aug 19
1/ Our new preprint on Long Covid & Kids:

TOPLINE: Teenagers who had parents with long covid were significantly more likely to report long covid symptoms at 6 months after a positive OR negative SARS-CoV-2 PCR-test (CLoCK study)

Surprised?…🧵

👉 papers.ssrn.com/sol3/papers.cf…
2/ We have been following up a national cohort of 11-17 yr-olds with PCR-confirmed #SARSCoV2 infection alongside teens with a negative PCR-test matched by age, sex, geographical area & month of test since Sep 2020 as part of the CLoCk study in England

👉 bmjopen.bmj.com/content/11/8/e…
3/ Among PCR-positive teens, 19.1% (1,207/6,334) reported having a parent with ongoing problems after #COVID19 - of these, 33.3% (402/1,207) reported ongoing symptoms at 6 months after their PCR test vs 22.6% (1,156/5,127) of teens whose parents did not have ongoing symptoms
Read 9 tweets
Aug 3
1/ Our preprint on immune responses of kids to #SARSCoV2 #Omicron is online

Top line: Primary Omicron infection induces poor antibody responses in unvaccinated kids, but robust T cell responses which will protect against severe #COVID19 in the future🧵

👉biorxiv.org/content/10.110…
2/ We determined the variant-specific antibody and cellular immune response following Omicron infection in children aged 6-14 years and related this to prior SARS-CoV-2 infection and vaccination status.
3/ We found that primary Omicron infection elicited weak antibody responses & only 53% of kids developed detectable neutralising antibodies, which means that kids who got omicron infection for the first time may not be well-protected against against future #SARSCoV2 infections
Read 8 tweets
Jul 5
1/ Many parents are still concerned about long covid in kids:

If you want to know where we really are with long covid in kids then take a few mins to read this short, honest, down-to-earth editorial by a Danish paediatrician in @LancetChildAdol …🧵

👉 thelancet.com/journals/lanch…
2/ Early in the pandemic, following long covid reports in adults, studies focused on asking parents & their kids about symptoms experienced after #COVID19. Most kids had common, non-specific symptoms that commonly come and go over time, often nothing to do with covid
3/ Believe it or not, there are >200 different symptoms attributed to long covid, some completely biologically implausible. This is not helpful, making it difficult to identify, support & treat the few who are genuinely suffering long-lasting effects:

👉 ama-assn.org/delivering-car…
Read 12 tweets
Jul 2
1/ I was asked by @TheLancet to write an editorial on #COVID19 vaccines for 5-11 year-olds: 6 months on, what have we learnt?

Importantly, what is the endgame?
Preventing infections? Severe disease? Long covid? And at what cost?

My tuppence worth …🧵

👉thelancet.com/journals/lance…
2/ My editorial was based on an Italian study on #COVID19 vaccines for 5-11y during Jan-Apr 2022:

VE ⬇️ from 65% (95% CI 62–68) in the 2 weeks after 2 doses to 12% (8–16) by 28-34 days

VE against hospitalisation was 41·1% (22·2–55·4) after 2 doses

👉 thelancet.com/journals/lance…
3/ This risk of severe #COVID19 in 5-11y was based on 644 hospitalisations (15 ICU, 2 died) which translated to:

- hospitalisation risk 0.08%
(84/100,000 infections)
- ICU risk 0.002%
(2/100,000)
- fatality risk 0.0003%
(0·3/100,000)

👉 I mean, how low can you go?🤷🏻‍♂️
Read 13 tweets
Jun 8
1/ Our preprint on #COVID19 & childhood deaths during the first 2 pandemic years in England 👉papers.ssrn.com/sol3/papers.cf…

Top line: Among ~12 million <20 year-olds, there were 81 #covid deaths (infection fatality rate, 0.70/100,000 infections) - that’s less than 1 in 100,000 …🧵
2/ We followed up all deaths within 100 days of confirmed #SARSCoV2 infection in children & young people (CYP) aged <20 years in England during 2021 & 2022, using national databases, surveillance questionnaires, post-mortem reports and clinician interviews
3/ We identified 185 deaths during the 22-month follow-up: of these, 81 (44%) were due to COVID (see methods)

Death due to #COVID19 was independently associated with older age (aOR 1.06, 95%CI 1.01-1.11, p=0.02) and underlying comorbidities (aOR 2.52, 95%CI 1.27-5.01, p=0.008)
Read 8 tweets
Apr 7
1/ Unlike adults, the majority of kids hospitalised with #SARSCoV2 do *not* have severe #Covid

In London we found only 10% of kids hospitalised with a +ve #sarscov2 PCR-test had severe #COVID19, mainly during the alpha wave

Here’s our preprint…🧵

👉 papers.ssrn.com/sol3/papers.cf…
2/ We reviewed medical records of 0-18 year-old admitted to a large London teaching hospital over 14 months, covering alpha, delta & omicron waves. PIMS-TS excluded because diagnosis does not require positive virus test. There were 150 kids hospitalised between 01Dec20 & 31Jan22
3/ We found only 10% of 0-18 year-olds hospitalised with #sarscov2 had severe #COVID19 - mainly during the alpha variant wave (67%) & in older kids (60% were 12-18 years) & with serious underlying conditions (73%, mainly immunosuppression). Half required ICU; they all recovered
Read 8 tweets

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