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Dec 31, 2022 • 25 tweets • 17 min read
(1) How will states stop SARS?

We covered the problem; let's explain the solution next year to help people

These elements sustain the pandemic:

(a) Airborne transmission
(b) Immunodeficiency
(c) Lack of leadership

Walensky speaks the truth. CDC can't control (c). #SIDU 221231 ImageImage
(a) airborne spread is known and we have solutions: Check ✅

(b) immunodeficiency/#LeonardiEffect are deniable. Read @RealCheckMarker @fitterhappierAJ

It's dynamic: no solutions but (a) will work. Check ✅

(c) Unaccountable leadership is the problem. ⛔️
@RealCheckMarker @fitterhappierAJ (3) Now reframe the question

How can states stop (a) airborne spread and (b) individual and population-level immunodeficiency to end the pandemic with the tools available (WHO IHR 2005)?

What is the alternative (BATNA) if they don't?

Here the solution:

(4) Brief thread, we already discussed this:
(5) This argument relies on central assumptions that have been poorly explained in public

Most people rely on news, hearsay or others' summaries; few read the primary literature

This includes virologists, who have proven wrong and unqualified to address public health re: SARS
(6) This is how we keep making costly mistakes. When I expected it would take us only months to learn in April 2020, I was overly optimistic.
(7) SARS is a notifiable event under IHR 2005. WHO was almost certainly notified of index case(s) in 2019

What member states decided to break with the precedent of SARS 2003, H1N1 2009, MERS, to "Let 'er RIP"?

Who knew what when? cdc.gov/ncezid/who-we-…

(8) Despite 319,000 scientific papers written within three years, the above is barely discussed outside our bubbles icite.od.nih.gov/covid19/search

No parliamentary investigation. Nothing.

@Harvard2H onlinelibrary.wiley.com/doi/10.1002/bi…

Doesn't this strike you as surreal?

How is this real life? ImageImageImage
@Harvard2H (8) #XBB15 evolved similar ace2 binding affinity in New York as BA.2.75

XBB.1.5 now achieves what @fitterhappierAJ called "ungodly" levels of transduction efficiency

We are not "living with SARS CoV 2"; we are training a formidable form of intelligence

Image
Background:
(9) How will states change trajectory?

To me as political scientist, it's a transdisciplinary question, more than law, science, econ etc. All academic fields need to learn to talk outside silos

We failed in 2019-2022; thoughts and prayers for 2023-2026👍
(10) Why the void of leadership in states?

Many know the above or more. Yet as long as the public live in denial and any anger that surfaces can be misdirected at WHO, who can’t defend itself, or others like China, they know they will get away with doing the bare minimum or less Image
(11) Two rare points on HEPA filters

(a) RH should be 40-60%. It’s as important as filtration

Here mine - nighttable for scale

(b) They will absolutely not end the pandemic, never mind what engineers tell you. Recall, planes have excellent HEPA filters! Image
Second, masks and HEPA filters are powerful communications devices, beyond any mechanics

Most find it hard to imagine alternative ways of life. Seeing solutions makes it easier

Give them time and live the example. This is the leadership we need now as we head for severe trauma
(12) What is the alternative to a negotiated agreement (BATNA)?

Can we run the healthcare system at 120% until 2026?

Eventually HCWs, lawyers or parents will offer leadership and strike to force change

This counts as optimism in the time of SARS. Be well & safe everyone, ❤️🙏 ImageImage
I feel like everyone should know this. If you don’t know the most basic facts a out HIV and SARS incidence in your country, voilà in large part of the world it’s not yet too late to cram it in before the nouvel an! Happy NY 😈🥳
(13) spectacular. I shared the first, but the second one is new. Read to enter the year in style

Spoiler: Impact of four mutations & SAg in CoV-2 unclear but yes, Long Covid and Long SARS are the same!

Well written & easy to read, nature.com/articles/s4141… academic.oup.com/ooim/article/3… Image
“The most important lesson of SARS 2003 was implementing the ‘precautionary principle’: ‘Where there is reasonable evidence of an impending threat to public harm, it is inappropriate to require proof of causation beyond a reasonable doubt before taking steps to avert the threat.”
The #PrecautionaryPrinciple will be key. John Patcai says so not because he’s a prophet (the job is taken by @fitterhappierAJ @RealCheckMarker), but because he has a brain to think and tongue to speak

It doesn’t take much!

Read the report, or read at least the executive summary ImageImageImage
(13/13) Casual climate reminder: just as soon as we end SARS, we will face climate and ecological breakdown, so tend to recommend not losing too much sleep over “back to normal” fantasies, they are gone forever

Ending the year on 16°C - the interesting question is what’s ahead! Image
(14/13) hot damn

If you haven’t woken to the climate emergency, SARS at any point bores you, AND you want to work on global problems that will determine our collective futures: here’s a good starting point

Thanks all, also for all the kind personal messages. Much appreciated 💜
(15) background on XBB, grandfather of XBB.1.5, by Sato lab
(16) Climate outlook RCP45 and RCP85 in 2050 & 2100. I think @KrVaSt is correct in saying current climate models don’t reflect nonlinear ice sheet disintegration & ocean-atmosphere coupling well. @ZLabe may draw graphs to illustrate 💜

Good new year all! ImageImageImageImage
To calibrate: Compare ECMWF, a 4th Gen standard reanalysis model, for 1950, 1988 and 2021, with 2021 in RCP85 climatereanalyzer.org/reanalysis/mon… ImageImageImageImage
Update by @sgascoin earth.nullschool.net/#current/ocean… Image

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More from @_ppmv

Paul Maidowski Profile picture
Jan 9
On climate and SARS, I don't think reduced visibility helps anyone right now; will leave my account unlocked for now. So the band plays on, Image
And the dolphins jump into the sun. Image
If everyone can catch up with Dr. Hansen's latest preprint and ask policymakers what they intend to do about that - and about not all of us catching SARS all the time -, both might help.
Read 4 tweets
Paul Maidowski Profile picture
Jan 9
I mentioned SARS/MERS-CoV (1) persist in the renal epithelium in 1 in 3 patients until cells regenerate after 500-787 days; (2) are airborne; (3) draw down rather than build immunity; (4) infections drive mutations and should stop; (5) HIV medicine may help patients access care.
None of this new (to attentive readers) or even controversial. Yet it attracted an outsize crowd of fools and personal insults by at least one researcher, so I deleted the post. I gain nothing from useless controversy, it's just distraction. Good luck out there,
Did media and policymakers reconcile the contradiction yet that they believe Drosten just told them "the pandemic is over" in the same interview in which he told them in a deadpan way that unvaccinated children at 30 may have the immune system of an 80 yo.
Read 5 tweets
Paul Maidowski Profile picture
Jan 8
Public Health Harry Potter

🤝

Invisibility cloak

Threads by @RealCheckMarker, or more SARS experts (?), are hidden. Like @NoyesJHumphrey previously. Bad sign - recall, it was a notable warning 👇 re #BQ* #XBB15) ImageImage
1. Aviation. I think calling for point-of-entry screening, if needed isolation/quarantine as century old public health measures, to ensure international travelers don’t spread VoC at the current unmitigated rate, alone can be enough to be hidden/suspended.
2. Superbugs. While I don’t know what bug plagues Twitter, here a brief thread worth rereading. threadreaderapp.com/thread/1597581…
Read 7 tweets
Paul Maidowski Profile picture
Jan 8
Good question. We will make progress on mindbreaking questions only if experts laserfocus. I’ll add that viral persistence of up to 500-787 days in renal epithelial cells in 1 in 3 infected, PLUS policy of constant reinfection forever, mean any argument on reconstruction is void. Image
Public health has been silenced. Else we would have been warned in time. This article on SARS-acquired immune system damage dates 10 May 2020; we all knew by then. I applaud everyone’s pedagogical tact. As we enter the fourth year, denial is unsustainable.
SARS is a notifiable event under WHO IHR 2005 for good reason. Assume any index case(s) in 2019 were reported to WHO, because they must. The rest is global health politics, not science.

washingtonpost.com/health/2020/05…
Read 8 tweets
Paul Maidowski Profile picture
Jan 8
“Herd”, “hybrid” or “vaccine” immunity are fantasy. The way out of the pandemic is to eradicate the pathogen - like we did for SARS 2003.

It shouldn’t take a Master’s in IR or political science to see that continuity is no option for states. 1/2
Details.
Vaccines have delivered what they can. Do we need better ones? Absolutely. Will better ones end the pandemic? No, because if we abuse them, SARS-CoV-2 will just mutate around them sooner or later. The present high incidence is unsustainable.
Read 6 tweets
Paul Maidowski Profile picture
Jan 6
We shared pandemic information in high frequency and intensity. Governments and even media shared less. Why?

Because the alternative to international cooperation in the face of a highly transmissible, mutating virus, is isolation.

thetyee.ca/Analysis/2022/…
thetyee.ca/Analysis/2022/… Image
I may reach 50,000 people; government and media millions. Not all need all information (twitter is disinformation AND science-heavy, hence the schizophrenic vibe here)

Yet even basic warnings don't reach "the public" (I like the Chinese term, 老百姓）

Eg
To put it positively, we have a real challenge ahead.
Read 13 tweets

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