So, lots about @WHO calling an end to the #PHEIC
First, this is a response, and it has a defined set of criteria. Whether or not these are met doesn't actually mean that #COVID isn't a pandemic, it's an interpretation of guidance and is pretty arbitrary, really.
Second, and this
really IS important...whether or not the WHO, mainstream/social media, or any other form of messaging put this across properly, national governments will have been briefed IN FULL, AHEAD of time, with the five pillars of the ongoing response in black and white, LARGE FONT etc...
Third, that certain Governments refuse to heed these recommendations, or even bother to review their own policies on how they're handling things is down to them, NOBODY else.
My opinion, fwiw, is that this is an abdication of public health responsibility that, as usual, affects
those least able to cope most...
Fourth, and it's upsetting to have to say this, to play on the stepping down on the PHEIC as a means of saying it's all over, but then NOT accept these recommendations, is just abject hypocrisy. You can't, and should not, have it both ways folks.
Finally, and this probably includes me and many of us, but the lack of massive spikes of infection, or settling into "normal/predictable" patterns that we're more used to...not that it's happening yet for SARS2, should NOT mean that we just switch off and accept things. The whole
"just the flu" 🦬💩 speaks volumes, seeing as even seasonal influenza is a killer for some, and H5N1 is knocking on the door...we should be striving to bring down excess deaths, not lying back pleased as punch because they are the same as a few years ago. We do this for non-
communicable diseases, why less so for infections?
The ridiculous tropes around endemicity began in 2021, possibly earlier in certain preprints 🤪, which was not only incorrect, but deliberately equated to benign...
The pandemic is certainly in a new phase for many, but not for
all, which is something the government is supposed to take the initiative on, on our behalf. Yes, the usual comparison to roads and smoking etc., but just think what could be achieved if we were more proactive? Respiratory virus disease is something that CAN be mitigated against
without impinging on some people's perception of "freedom" or meaning harsh restrictions. The benefits beyond COVID could be huge, for other diseases (esp with advances in vaccines), pollution, productivity, etc. Yes, investment is needed, but the pay off would be incredible...
Moreover, the tragedy of #LongCovidKids and #LongCovid remains, more research is needed, but prevention is ALWAYS better than cure...something that perhaps our vaccine strategy ought to reflect? 🤦♂️
We also need investment in Therapeutics as well as vaccines, and we should be
planning for the NEXT pandemic, not falsely patting politicians on the shoulder for a job/party/VIP contract/Testandtrace well done...
I AM going to end with a cliche, but I don't care cos I don't think anyone has ever put it better...(the original, that is, note the source 🤪)
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I'm not going to go into details, mainly cos it makes me so angry to sit reading it for any length of time.
Also, the bespoke model leaves me dumbfounded. What follows are generalisations, mainly because this is basically an iteration of the 23 model, where this attrition began.
First, yet again, the focus, or rather the most favourable cost-effectiveness, is avoiding deaths and acute hospitalisation.
Of course, this is critical, especially as we still do nothing to mitigate uncontrolled prevalence, and I include effective vaccination in this regard.
We have a very safe, efficacious paediatric SARS2 mRNA vax, used 6m+.
Reduced dose and age minimises small risk of myocarditis seen in adolescents.
This sobering study by @katebrown220, @chrischirp et al shows 6m+ kids are always at risk from acute COVID.
Maternal antibodies should help protect newborns during the first 6m of life, but this is optimal when mums are vaxd during pregnancy. Sadly, this only happens if your term coincides with a booster campaign 🙄, which is just plain daft. Highlighted many times by @VikiLovesFACS
The first exposure to a pathogen is always the highest risk, no matter what age it occurs.
Whilst kids tend to develop severe symptoms less frequently than adults, this is the wrong comparison and does NOT mean they are invulnerable.
Both short term and long term problems arise.
Sorry, looooong thread, but hopefully done soon!
Where was I?
So, let's say the small elite team of virus particles has survived the journey and landed where they want to be...
First, they will encounter innate barriers, eg mucus, which they must cross to physically reach a cell.
There will also be complement, mucosal antibodies (if host is immune), and these can both inactivate and clump viruses together such that phagocytic cells literally eat them up!
So, many of the hurdles from the way out also hit on the way in, and this time, numbers are limiting.
So, viruses need to infect their target cell as quickly as possible before they succumb to defenses.
This mainly depends on the affinity of the viral attachment protein for the cellular receptor used to gain entry. But you have to both unlock the door AND walk through it...
Lots of good debate about virus transmission, yet it's dwarfed by mis/disinformation and lack of nuance, allowing eejits to dismiss the precautionary principle, or, worse, re-run 1980s bigotted attitudes🤬
Viruses don't fit easily into boxes. So, nuances of transmission, a 🧵
I will focus on the example of airborne transmission, but the underlying principles apply to all modes of infection.
Caveat: I research the start/end of the transmission process, but the middle bit is not my forte, so forgive omissions/errors!🙏
See @ukhadds for added nuance!
Right, so I would define transmission as the transfer of sufficient infectious virus from a site of infection or environmental source to an individual, followed by the successful establishment of a productive infection (ie the completion of the life cycle) within the new host.
🚨Anti-vaxxers are twisting a study into mRNA armageddon.
TLDR, all this study says is IF certain groups experienced an adverse event COINCIDENT with vax, then it was more likely to be myocarditis than if taking a different drug🤦♂️
It's behind a pay wall, so will keep brief to save anyone having to read it to stave off the various nutters quoting bizarrely inflated risks of death etc...#LiedSuddenly
Expect it may feature in certain press and on a "patriotic" news channel before long 😉
So, in brief:
1. This is data from JADER, the Japanese equivalent of VAERS, yellow card etc.
Reports of adverse events COINCIDENT with a medicine are made by healthcare workers, pharma, public etc.
Main point, it's a sentinel system used to spot patterns, cases need verifying.
Some issues here...putting it mildly. 1. These are NOT the only high-risk groups. @CDCgov recommend >50s and children as a minimum. 2. This is an influenza strategy, we are NOT in the same place with SARS2 by a country mile. 3. Vax status by age is worrying, 1/3 u40s no vax 😬
4. % of kids u12 vaxd was only ~10% in 22/23 b4 offer was stopped... 5. We age, folks die, and are born. The % population covered by the emergency programme is therefore dwindling across all ages. 6. Yes, our protection vs severe COVID lasts way longer than vs infection, but...
7. Recent study in @JAMA_current shows more recent, better matched vax is better at keeping folks out of hospital. 8. Vax 4 just vulnerable helps en masse, sure, but many r unlikely to make a good response. 9. Poor responders amidst high prevalence will erode protection quickly.