This brief thread is very specifically for journalists: some follow me & maybe still drop in?
We need to talk about how COVID burden/outcome measures are reported.
Counting hospital admissions & deaths WAS appropriate in 2020-21.
Now those stats badly misinform. Why?
1/6
Until Omicron, our frame was a respiratory virus that infected & killed rapidly.
Low population immunity and limited understanding of what the virus does to the body, meant that incidence rate, ICU capacity, and deaths told us when things were better or worse.
Not now.
2/6
B/c COVID is a whole-body disease w/ vascular, neurological, immune, & endocrine harms.
Less *acute respiratory* harm now, b/c:
a. the most vulnerable already died
b. we have some population immunity
c. Omicron is less severe than Delta
Much more diffuse harms instead ...
3/6
By reporting deaths and hospitalizations data, COVID continues to get framed as a problem only for really vulnerable people. "Just like flu". :(
So, no masking, no precautions, low XBB vaccination, and no thoughts about COVID harms. Politicians may like this but I don't.
4/6
I need you to report on the rise of vascular disease & death that happens in younger people months post acute.
I need you to report on kids disabled by COVID.
And FFS, we need real investigation into attributable elevated excess mortality and declining life expectancy.
5/6
Who is going bother with indoor air quality when the media focuses on what COVID isn't doing, instead of talking about what it IS doing?
There is a lot of Long COVID research coming out. Don't let it gather dust on the shelf. This is too important to be incurious.
Please.
6/6
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I have been inadvertently quiet here for months. A few reasons for that, some fun, some not.
But I'm now 3 weeks into my sabbatical, clearing room for more thinking time.
This includes reflecting on what I'm actually trying to accomplish in the late pandemic era.
1/5
Having been a public epidemiologist since 2020, I think I can boil it down to a need to analyze and talk about things that need to be said, but that aren't being said.
In the first three years, that totaled nearly than 3,000 interviews with journalists.
Yes, I counted.
2/5
But over the last 1-2 years, there has seemed less that needed saying that isn't already being said on this platform and elsewhere by very capable people. That is awesome.
(Although I do wish the media were more engaged in issues like air quality and safe public spaces.)
3/5
A cathartic thread about the perils of doing public science communication during a pandemic.
Yesterday, I was notified that I have been granted the teaching stream equivalent of tenure at the University of Toronto where I teach.
This is on my list of major life events.
1/10
I'm thrilled, of course. But this thread isn't about that, it's about the danger of being blunt while precarious, and being unable to properly defend myself.
COVID did *not* make promotion easier. (It did influence my pedagogy narrative, and delayed my review by a year.)
2/10
I accrued a lot of hateful complaints to both my Deans. Sometimes because I was impolite, or because I was right, or because of a fight.
It also needs to be said that my colleagues who are women or/and people of colour get hate much MUCH worse. But still.
Why there is no uniform case definition for Long COVID.
Why we use a variable symptom laundry list, many of which are non-specific.
The second part of this thread considers the negative consequences of this knowledge deficit.
2/19
With a defined disease, we know four things: cause, mechanism, progression, and symptoms. We use these to craft a case definition, which is the yardstick used to diagnose new cases.
With Long COVID, we actually don't know any of these. Let's start with cause ...
An expansive musing thread on mask non-use, which I am now calling "mask akinesia".
Every class I teach, I walk in with my mask and my Aranet4 CO2 detector, to measure air quality. I'm lucky: the rooms I teach in are always below 800ppm and often below 700ppm.
1/20
I make a show of measuring air quality with my mask on.
I often remind them that the air is excellent but that doesn't lower the risk from people sitting immediately around them.
~4% of my students wear masks. ~30% have missed class because of COVID, some cough in class.
2/20
One day, CO2 was 1800ppm, too high! Two of 3 air exchangers weren't operating. I told the class that the air wasn't safe, and to put on a mask if they had one.
They heard me and looked concerned. And nobody moved.
It seems pretty hard to have vaccine conversations these days. I do anyway.
There is a whole ton of misunderstanding out there. Even among people I know who are smart and usually aware.
Public misunderstanding happens when public health stops communicating.
2/8
I believe that it is collective societal trauma that is making it hard for people to acknowledge COVID now, let alone to take simple steps, like improving air quality, to be healthier.
But that's a piss-poor excuse for public health not even trying.
3/8