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Prof Brendan Crabb Profile picture
Prof Brendan Crabb
@CrabbBrendan
Medical researcher & Director & CEO @BurnetInstitute & Chair @ausglobalhealth & @PacificFriends | also @BrendanCrabbAC & https://t.co/5BaDvLZ2Tw
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Mar 28 • 6 tweets • 2 min read
This is a landmark paper on the path to better indoor air quality. Outdoor air, the water we drink and food we eat is regulated by standards that protect us from harms. This is not the case for the air we breathe indoors where we spend 90% of our time. This is the most definitive blueprint for change yet. The time to act is now. In doing so, we will be healthier now, and we will better prepared for future airborne pandemics. Here's a commentary on the work.

leeds.ac.uk/main-index/new…
Sep 24, 2023 • 9 tweets • 2 min read
Bouhaddou et al is a tour de force; a major advance in understanding how SARS-CoV2 evolves to do so well in humans. 1/

SARS-CoV-2 variants evolve convergent strategies to remodel the host response: Cell cell.com/cell/fulltext/… While it's well established well SARS-CoV-2 evolves its spike protein to avoid antibody-based immunity, this shows how it also evolves changes in other viral proteins to avoid an earlier, less specific, but crucial arm of our immune defenses; the ‘innate’ immune response. 2/
Aug 18, 2023 • 9 tweets • 2 min read
As we watch all watch highly divergent BA.2.86 closely (will it take off and be a new variant of concern, the first since omicron? It is looking quite possible) there’s a regular line being used with all new lineages about ‘no evidence of increased virulence’, 1/ ...which implies comfort with the current severity of omicron, and also with the power of ‘hybrid’ immunity (a mixture of vaccine- & infection-based immunity) keeping things at bay. It is true that things could be worse, but to me at least they are not good as they are. 2/
May 31, 2023 • 6 tweets • 2 min read
Here's a twitter A to the Q in the headline. First, with testing low, hospitalization figures are the best indicator. These are on the increase, & concerning is that this is off a high base. In short, we look to be facing a similar C0VID burden now to other bad stages. 1/ Image Second, it's not a 'winter' disease, we had 3-4 waves in 2022. That said, there is reason to be extra concerned when spending more time in shared indoor spaces. With other respiratory infections also on the rise (see @MackayIM), it looks a rough few months ahead. 2/
May 8, 2023 • 6 tweets • 2 min read
While this sends the wrong message, I suspect it will mean little. What WHO was doing in the emergency response was no longer making a difference in most places. The battle to take CVID as seriously as it deserves to be was lost a long time ago. 1/

who.int/director-gener… Fact is, we have a major ongoing new cause of death that is in the range of 5-10% more people dying than previously, & chronic conditions that WHO itself just said last week is in the order of hundreds of millions of people, 1 in every 10 infections 2/
Mar 2, 2023 • 4 tweets • 2 min read
As testing declines, & we understand more about delayed COVID mortality, important to look at XS deaths to measure the ongoing mortality impact of COVID-19. Here's two dramatic examples of the widening gulf bw C19 & XS deaths, but it's true everywhere as I've shown previously.
Jan 4, 2023 • 4 tweets • 1 min read
Please please don’t think you’re bullet proof if you’ve been infected before. Far from it, please consider yourself as susceptible as anyone else no matter what your prior exposure. 1/

abc.net.au/news/2023-01-0… Yes, immunity to infection is real. The reason you get better after being infected, the reason waves disappear, & indeed a key reason new variants arise is because infection confers a degree of immune protection - it’s a powerful force, no argument there. 2/
Jan 2, 2023 • 5 tweets • 2 min read
A reminder of where to focus our COVID attention. Australia currently likely has 0.4-1.1m people with COVID, some 4-10x the actual case numbers. This means virtually every family will be effected in this wave. 1/

Current wave is comparable to the previous 3 faced in 2022. Our hospitals under serious strain, many emergency depts esp, ~4,000 in hospital for COVID (previous peak 5,500), death toll large (likely ~50+ per day but won’t know for sure for months), LC likely in 5% cases 2/
Oct 30, 2022 • 7 tweets • 2 min read
COVID is killing thousands of Australians who would have otherwise lived, likely to be 20-30,000 by year's end. This fig shows that, after saving lives in 2020 (another story), once this line crossed the zero in late 2021, we were in ‘excess’ territory. 1/ Only shown to June 26, this ABS report has more recent data showing that XS deaths continue unabated abs.gov.au/statistics/hea…

We had 2,500 XS deaths in July alone. 2/
Oct 23, 2022 • 4 tweets • 3 min read
For those wondering, data is accumulating that 4-5% of omicron cases in triple vaccinated people experience #LongCOVID - see

thelancet.com/journals/lance…

ons.gov.uk/peoplepopulati…

1/ And understand that self reporting is incredible accurate - @VirusesImmunity estimates it to be 94% in her and @PutrinoLab 's landmark biomarker work. 2/

medrxiv.org/content/10.110…
Oct 21, 2022 • 5 tweets • 2 min read
The scale is breathtaking, as is our nonchalance towards it. Key points:
(1) On track for 20-30,000 deaths more than usual in 2022
(2) COVID causing ~50%, the rest also likely COVID as in Singapore
(3) Last wave our worst
(4) These are true XS, ie, no 'catch up' on previous years A national day of mourning in their honour is necessary.
Oct 20, 2022 • 4 tweets • 2 min read
Grateful to Peter Shergold & his 3 colleagues for their COVID review "Fault Lines" released today. I have only just seen the report & so am not yet in a position to comment in detail. But I do love the 'dedication' & wish we were hearing more like that. 1/
independentcovidreview.com Image At a glance, although there are some key conclusions I have some issue with, I do acknowledge it's impossible in a report like this to satisfy everyone. Most importantly, it's difficult not to be impressed by this list of recommendations. 2/ Image
Sep 18, 2022 • 4 tweets • 1 min read
Imp. paper. Imprinting is not new but powerfully shown here. Means that not only does SARS-Cov-2 continue to evolve to escape protective antibodies, newer variants are less effective at generating broad-based protective antibodies, making life easier for the next variant. 1/ They conclude "Together, our results suggest herd immunity established by natural infection could hardly stop RBD (receptor binding domain) evolution & end the pandemic, & vaccine boosters using BA.5 may not provide sufficiently broad protection against emerging sub-variants 2/
Jul 28, 2022 • 8 tweets • 2 min read
I’m relieved & moved by what I see of the new federal govt; vision, strength openness, empathy, respect have returned. Which makes the tolerance of COVID’s phenomenal impact, that especially targets our most vulnerable people, all the harder to reconcile. #COVI19Aus. 1/ It’s not that nothing is happening. HM Butler, a person I respect greatly, has put COVID on the agenda, the AHPPC published a strong update & it was terrific to have intervention on isolation payments. But COVID is still treated nowhere near the national emergency it is. 2/
Apr 20, 2022 • 10 tweets • 2 min read
A thread on easing of public health interventions. In short, debating individual public health measures is not where to start the conversation. It is not very meaningful if the overall strategy is unclear. Most importantly, how much value do we put on reducing transmission? 1/ Clearly it’s good for health to have less COVID but what about the operations of aged care, health care, business in general, retail, travel, hospitality, schools? Are more or less infected people good for their operation? 2/
Mar 28, 2022 • 4 tweets • 1 min read
The notion that there’s nothing we can do as the Qld CHO & many other advocate - that everyone getting infected, regularly & repeatedly, is ok & desirable so some magically benign endemicity will be achieved - is flawed. It is not scientifically sound. 1/ It’s not just untrue (COVID transmission can be reduced with vax, high-quality masks, airborne mitigation & iso of infected people & close contacts) but dangerous; esp. to huge numbers of vulnerable people & unvaccinated kids, & also to acute & long-term health of everyone. 2/
Mar 11, 2022 • 4 tweets • 2 min read
Brilliant analysis on the death toll for the pandemic's first 2 years. As thought, excess deaths ~3x more than confirmed COVID deaths at 18.2 million people. Greater than the effect of the BIG 3 (HIV, TB and malaria combined). Still ongoing of course. 1/

thelancet.com/journals/lance… Tragic as it is for the world, from a parochial Oz point of view this highlights an extraordinary success over this period. For example, had we had the same rate as the US (~1.2m people died there), Australia would have had ~100,000 additional deaths 2/
Feb 22, 2022 • 4 tweets • 1 min read
I do understand wrestling with mask mandates in various settings, & for different mask strategies in times of lower transmission vs times of higher threat. But in the midst of a pandemic as we still are, reducing requirement for their use is nothing to celebrate. 1/ There will be more transmission as a result, and so more illness & death. I have said before that we may have a longer term baseline COVID mortality (ie, not counting peaks with new variants) of 40 or so per day given what is being tolerated in other comparable countries. 2/
Feb 11, 2022 • 8 tweets • 2 min read
Record COVID cases & deaths (with figures for long COVID and excess deaths still to come), code brown, elective surgery ban, delays on ambulances, a whole health system - primary & tertiary - under enormous strain, vulnerable people & communities at serious risk. 1/ To understand COVID impact you can cherry pick the stat you like (eg, case fatality rate), or use a complicated, moving target measure (eg, ICU), or explain away deaths (aged, underlying conditions), or normalize (just like flu), 2/
Dec 25, 2021 • 5 tweets • 2 min read
Powerful, well referenced piece.

The ‘mild’ narrative has dogged the response from day 1 & with omicron was premature, not correct & dangerous; delaying action & promoting spread. 1/

theatlantic.com/health/archive… There is much more in this piece including why the ‘plus’ in vaccinesPlus is crucial (ie, current vaccines are not enough, although next-Gen vaccines might be), & how inequity is so central to the pandemic. 2/
Dec 12, 2021 • 5 tweets • 1 min read
History has shown us that head-in-the-sand, rose-colored narratives don't work on covid. From the ‘it’s a bad flu’ beginning they have prolonged and worsened the pandemic. 1/ Underplaying the uncertain curve-ball that omicron presents threatens to stymie the accelerated & equitable vaccines-plus response we need to turn the ongoing pandemic around. 2/