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Dr Satoshi Akima FRACP 『秋間聰』 Profile picture
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Dec 23 • 8 tweets • 3 min read
I wrote this before the ending of China's #zeroCOVID policy but it has become even more prescient in its relevance today. It was controversial to write that lockdown is “ineffectual”. I meant not that it doesn't work but that there are severe limits to its social tolerability. 🧵
As lockdown is inefficient, it is tempting to overuse it. Once *overused* it leads to social unrest and a reduction in trust in government. This makes it crucial to rapidly transition to socially non-disruptive mode-of-transmission-specific interventions.
What I said was contentious then but if China couldn't sustain lockdowns, nobody could. Lockdown is a temporary band-aid solution reducing close contact—which isn't a mode of transmission. It is vital to have a mode-of-transmission-specific exit strategy.
The full horror of ripping off the band-aid without an exit strategy will extract a grave toll on a world economy dependent on Chinese manufacturing. Moreover, it will be an unspeakable humanitarian catastrophe. japantimes.co.jp/news/2022/12/2…
Yet as often in history, this outcome was never a fated inevitability. It did not have to end this way. With deep manufacturing capacity, they could have created a ventilation-infrastructure stimulus project, supported by the issuance of N95-level respirators a class above KN95s
They had the centralised capacity of a command economy to act as a technocracy that ensured manufacturing sector workers could soldier on without falling ill in their crowded factories, generating income for their motherland without a collapse in productivity. Image
China has embarked on vast infrastructure stimulus programmes before, making it perplexing to think why, just when it was so crucial, they could not have made a key investment in worker health and safety to keep their factories operational.
They say never let a good crisis go to waste. China could have led the world as London did in creating sewerage systems to lead the world out of the cholera pandemics of the 19th century. China has thrown to waste its one chance at moral, social and scientific world leadership.

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More from @ToshiAkima

Dr Satoshi Akima FRACP 『秋間聰』 Profile picture
Dec 25
Breaking! Japanese newspaper @mainichi reports that as of November, the Chinese government has BANNED genomic sequencing of new COVID variants. About 250 million people, or about 18% of the population, have been infected in China between December 1–20. mainichi.jp/articles/20221…
Story courtesy of @SuzanneK23
The unchecked spread of SARS-CoV-2 through the Chinese population will explosively generate novel variants that follow the evolutionary principle of the “survival of the fittest”, pouring accelerant onto the pandemic. We fly blindfolded into the inferno
Read 4 tweets
Dr Satoshi Akima FRACP 『秋間聰』 Profile picture
Dec 17
Now the suspicion has proven correct that the Loeb et al trial of N95s in @AnnalsofIM had its methods tampered with partway through, we need to reexamine the issue of the methodology of fit testing.🧵
The issue of the obscurely outlined methodology for the fit testing was previously explored in this thread. But the time has come to revisit this issue now
The KEY difference between a surgical mask and N95 respirator is NOT the filtration efficacy. The main difference lies in the quality of the *fit* without any air leakage. An N95 needs a Fit Factor of 100 to pass, whereas a surgical mask may only have a Fit Factor of about 5
Read 18 tweets
Dr Satoshi Akima FRACP 『秋間聰』 Profile picture
Dec 17
1. @DFisman shows that, as suspected, the protocol of the Loeb et al @AnnalsofIM N95 trial was changed partway through the study period. The opening Methods section and the Study Protocol in the appended Supplementary Material section outline methods for two different trials.
2. The main Methods section implies that participants wore their N95 respirators continuously, including in non-patient-facing settings like meetings, teaching sessions, as well as during patient contact, whether COVID was suspected or not.
3. The way responses from subjects are reported implies the subjects were asked if they “always/sometimes/never” wore goggles/face shields, gowns, and gloves—even in meetings and with non-COVID cases.
Read 8 tweets
Dr Satoshi Akima FRACP 『秋間聰』 Profile picture
Dec 15
Decoding the “immunity debt” propaganda. It means that if there is a surfeit of infection, this can only have resulted from there previously having been insufficient infections. The solution to excess infections is always more infections.🧵
It also means that medical science is futile. Any attempt to prevent infection only ever leads to worse infections. The only valid way to prevent infection is to increase infections. If this fails, it can only be because you did not increase the number of infections enough!
Masks inhibit the development of immunity against future infections by preventing the immune system from being trained by multiple exposures to respiratory microbes. The net result is more infection than ever before. Better to ditch masks to be exposed to more infections.
Read 12 tweets
Dr Satoshi Akima FRACP 『秋間聰』 Profile picture
Dec 14
If you believe this nonsense about evolution being transformed by Hope and Faith into “the survival of the mildest”, you might as well believe in fairies and unicorns🌈🦄. Ignore what the Queensland Ouija board says, for evolution remains all about the survival of the fittest. 🧵
The evolutionary pace of SARS-CoV-2 is accelerating. Genetic diversity is a strength, not a weakness, because out of diversity will emerge the winning mutation that will be the hit which gives rise to the true successor of Omicron BA.1. From @TRyanGregory
The more you let rip with COVID, the more copies of the virus circulate, adapting to its host. And the more genetic diversity you beget, the more you increase the chance of giving rise to the next Chosen One that slays all predecessors. And we chose it to be that way.
Read 4 tweets
Dr Satoshi Akima FRACP 『秋間聰』 Profile picture
Dec 11
Back we all go to Medieval proteomics, genomics, and epigenomic mapping. It just keeps going backwards. Real “modernity” it seems is these RCTs things where we watch people die in the experiment—now that's real progress!
The aim of biotech should be the gradual phasing out of RCTs in the future, as molecular medicine advances, and drug development made more like aerospace engineering, where no RCTs are used. What is science if not rational-mechanistic?
RCTs are not rational-mechanistic but empirical-statistical inductive methodologies. Without a doubt, COVID has been a molecular revolution, and the statistical number-crunching desk scientists are feeling left behind by bench science.
Read 7 tweets

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