Bill Hanage Profile picture
Assoc Prof at Harvard T. H. Chan School of Public Health and Gooner. Currently cosplaying Dr Rieux in some weird re-enactment of La Peste. Tweets are personal
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Aug 10 6 tweets 2 min read
This was posted while I was away, but very interesting and important work on the date the current monkeypox outbreak virus start circulating among humans - it's been a while
virological.org/t/an-apobec3-m… 1/n The outbreak virus is accumulating change that looks a bit weird - in terms of the precise 'mutations' and the rate (more than you'd expect). This is consistent with editing of the genome during infection of human cells 2/n
Aug 10 6 tweets 4 min read
Having to head to the airport early after a meeting that was marked by so many parallel sessions I wanted to go to that I had to keep hopping between them. Sorry to miss the great @NathanGrubaugh speaking ☹️ #ICEID 1/n Many standouts including a great session on misinformation featuring @PeterHotez @KatherineJWu and @cward1e and Neil Johnson 2/n
Aug 4 4 tweets 2 min read
There are several things about @mattwridley’s article that are misleading (and self contradictory) but this, for me, is the most flagrant (read on - more than 280 characters required) 1/n The left screen grab is from his article. The right is from the paper he’s criticizing - it specifically is limited to early cases *without* known links to the market. Ridley’s article ignores this
Jun 30 6 tweets 3 min read
Spent the last few days at an awesome, thoughtful meeting on pandemic data streams and modeling alongside the likes of @AnisabelBento @johnbrownstein @svscarpino @DrJayVarma and @JustinLessler. Special shout out to long time friend and colleague @SRileyIDD Lots of serious discussion and nuance - in other words the opposite of social media (as one speaker put it, "Twitter is about winning") but hopefully as I what I learned it will be reflected on here
Jun 29 8 tweets 2 min read
This article about possible long term replication of virus in some Long Covid patients is pretty good and measured, but this comment about antivirals is off base 1/n theguardian.com/society/2022/j… Firstly, in the absence of trials that demonstrate benefit, this is hypothetical – it is not a reason to not do the trials. Especially when so many are suffering from long covid (and the numbers are growing) 2/n
Jun 15 8 tweets 2 min read
So much of this is also relevant to the way people have approached the pandemic on twitter, and continue to do so as opinions become ever more polarized (and not always tethered to evidence - which makes them harder to discuss or debunk)
nytimes.com/2022/06/15/opi… 1/n I mean, just delete 'politically' from this, or replace it with 'scientifically'
2/n
May 23 5 tweets 2 min read
Despite the fact that the linked article specifically says “don’t QT” I’m quoting and RTing this because more people should read it I’ve had a number of quite sharp points of disagreement with @apsmunro but I hope we’ve each emerged from them with a better understanding of the science involved. In large part that’s down to discourse of the sort described in his post
May 19 8 tweets 2 min read
I am no kind of specific expert in monkeypox (or orthopoxviruses). That being said, given what I know about disease transmission the clusters of monkeypox infections that are turning up should be treated with the utmost seriousness 1/n We have unconnected infections in the UK, Portugal, Spain and Canada. This means community transmission, unobserved 2/n
May 16 5 tweets 2 min read
1 million US deaths into the pandemic, things seem to be perceived as quieter - but that reflects how much our frame of reference has shifted. The current weekly deaths remain historically remarkable 1/n let's have a look. This is from the @nytimes. This would translate to over 2000 deaths each week. And way more than 100k each year - how does that compare with something like flu? 2/n
Apr 30 5 tweets 1 min read
Some of the replies to this are pretty wild. Some things I thought were obvious plainly aren't so... This is not because people go on vacation. I am suggesting that the change in contact patterns as a result of kids not gathering and transmitting in schools would be expected to make a difference. Fewer contacts (to non immune people) = less transmission
Apr 29 4 tweets 2 min read
Boston wastewater watch. There was a sustained decline over the last week or so in the North System. Before getting ahead of ourselves we should remember this coincides with spring recess in the schools I don't want to over interpret that blip up in the most recent sample, but if the trend reverses transmission in K-12 education is a potential contributor. This has been the case elsewhere (eg the UK) and mitigations are less complete than previously
Apr 9 9 tweets 2 min read
There seems to be a sense building that there’s a lot of missed BA.2 infections, because lots of people are getting symptoms but never testing positive for covid. I am hence here to remind you that other respiratory viruses exist and will cause more infections as people relax 1/n I’ve been sick the last week with sore throat, cough, congestion, headache myalgia etc (not anosmia unless you count my nose being too blocked to breathe through it). Do I think it’s covid? No 2/n
Apr 8 18 tweets 6 min read
BA.2 has ended the plateau of daily cases in the North East US. We can't be sure what the next month or so will hold, but I expect a bump in infections that may not be as large as many fear - although it could be at least locally serious. Here's why 1/n nytimes.com/live/2022/04/0… First thing is - BA.2 is once again *even more contagious* than what went before. This should not be unexpected, if it were less so we wouldn't be seeing it. While it's not clear how much is down to intrinsic factors vs sidestepping immunity, it's probably a bit of both 2/n
Apr 6 4 tweets 2 min read
Following attempts to 'move past' the pandemic, healthcare in the UK is compromised - again (even if with lower vaccination rates it could easily be so much worse)
theguardian.com/world/2022/apr… you don't need to be a zerocovid hawk to think that stopping funding for the genuinely world beating #REACT study at the point when the highest prevalence has been recorded is shortsighted
Mar 23 7 tweets 4 min read
Before and after photos of the TB hospital in Chernihiv, Ukraine, shared by a colleague of @jenkinshelen recently evacuated from Kyiv. The war will impact the treatment of many infectious diseases, but TB is especially important 1/n Ukraine and other parts of the former Soviet Union have very high rates of multi drug resistant TB. Failure to treat this adequately will lead to more infections, and if you don't want covid you *really* don't want MDRTB 2/n
Mar 11 8 tweets 2 min read
Here’s a question from a friend of a friend in the U.K. what follows is what I would personally do - it is in no way official advice 1/n Simplest thing is isolate for ages. In reality you probably want to live your life. This is where mild interventions like masks and rapid antigen tests are your friend 2/n
Feb 26 6 tweets 2 min read
Some people are interpreting this as praising the US response. It isn't. It is pointing out that as with many things there are successes and failures. And people who have made sacrifices for fellow human beings should know they have not been in vain 1/n Some per-capita mortalities to date (all stats from worldometers.info/coronavirus/ and all per million). Note that this is very crude and a proper analysis should account for years of life lost, excess over expected accounting for age etc but this is what we have 2/n
Feb 26 8 tweets 3 min read
It is fair to say that the pandemic has not been handled well. But can we get a sense of how much worse it could have been? Yes we can, at least roughly, by comparing per-capita mortality in different places to date. The results are quite striking 1/n Take Peru. The JHU dashboard records 210,229 pandemic deaths so far. In a population of nearly 39 million. If that were repeated in the US, we would have been looking at more than 2 million pandemic deaths so far. Instead we have seen roughly half that 2/n coronavirus.jhu.edu/map.html
Feb 21 4 tweets 2 min read
“It took me a relatively short time in Haiti to discover that I could never serve as a dispassionate reporter or chronicler of misery. I am only on the side of the destitute sick and have never sought to represent myself as some sort of neutral party.” Dr Paul Farmer. 1959-2022 I saw rumours of the loss of Paul Farmer early this morning, and sadly they have been confirmed. I know so many who have been inspired by his example nytimes.com/2022/02/21/obi…
Feb 16 13 tweets 4 min read
Vaccines that protect against severe illness and death have been available for more than a year. In this we estimate conservatively that in the US ~135,000 lost their lives to covid over the Delta wave for lack of vaccination medrxiv.org/content/10.110… 1/n Because vaccines were not immediately available to all we only look at 5/30/21 to 12/4/21, after which omicron rapidly took over and the situation changed (again). By the start of that time even I (youngish, not in a priority group) was vaccinated 2/n
Feb 4 10 tweets 2 min read
I’ve been thinking the last few days how it’s hard for non-specialists, watching a twitter spat between apparent experts, to know who to believe. Here are a few things I bear in mind when following people outside my own field. A far from exhaustive list 1/n The person who posts the most is not necessarily the one with the most or the best evidence. They may simply be the person with the most time. Once I'm done with this I will be making my kids dinner and spending time with them, so don't expect me to notice twitter😊 2/n