Policymakers shouldn’t be trying to manage COVID-19 as if it were seasonal influenza. It’s not and never will be. SARS-CoV-2’s greater transmissibility leads to faster viral evolution. This means waves of disease throughout the year, rather than a single winter COVID season. 🧵 Thanks to vaccination, COVID-19 is far less deadly than it used to be. But a virus doesn’t have to put people in hospital to be disruptive. Leaving aside the issue of long COVID, frequent waves of infection will grind down economic productivity.

(1/6) Respiratory viruses are much more likely to spread indoors than outdoors, but outdoor super-spreading events can still occur if the conditions are right.

A new study describes a SARS-CoV-2 outbreak affecting 131 people at a night market. 🧵 (2/6) The outbreak happened when a family of 3 people infected with the omicron BA.5.2 variant visited a night market in Zhejiang Province, China, in July 2022. They spent 1 hour and 4 minutes at the market.

Could future vaccines be administered via a patch? Researchers have developed skin patches containing tiny “microneedles” made of sugar and salt which dissolve on contact with skin, painlessly administering a vaccine in the process. 🧵
asm.org/Articles/2022/… A key advantage of this technology is that a vaccine patch can induce a special kind of immunity in the skin, known as mucosal immunity, which can prevent infection and transmission. Injectable vaccines may only prevent severe disease.

Imagine if you could rapidly detect COVID-19 in public places by testing the air. Now you can! Researchers have developed a groundbreaking new air monitor that can detect the presence of an infected person in as little as 5 minutes. 🧵
nature.com/articles/s4146… The compact device, which measures 12 x 10 x 10 inches, has a sensitivity of ~80% and can detect as few as 7 viral RNA copies per cubic metre of air with a resolution of 5 minutes.

And now for something completely different.

Someone I know is a musician & recently released their first album. I think it’s pretty cool, and if you like rock, maybe you will too. 🤘🎸

You can stream the album here: ditto.fm/blonde-zombie-…

Read on to see reviews. 🧵
#NewMusic Australia’s The Hard Rock Show called it “a really good, solid album - well worth your time.”

A representative survey of US adults in mid-2022 found that 7% had long COVID (4-week definition; using questions developed by the UK’s Office for National Statistics).

One-quarter of these people said their daily activities were impacted “a lot”. 🧵
🔗 academic.oup.com/cid/advance-ar… Around the same time in the UK, 2.8% of people aged 2 years and older were estimated to be living with long COVID.

🔗 ons.gov.uk/peoplepopulati…

I've not commented on this study so far, because it's uncertain what the findings mean. But I've seen some commentary that's definitely wrong and causing a lot of unnecessary concern. Further study is needed, but here's why I don't think people should be worried. 🧵

https://twitter.com/kischober/status/1606002981513662478

First, this isn't a phenomenon specific to mRNA vaccines or even to SARS-CoV-2/COVID-19.

It has been observed in combinations of whooping cough (pertussis), diphtheria, and tetanus vaccination.

These routine childhood vaccines are safe.
sciencedirect.com/science/articl…

China’s decision to not just abandon zero COVID but to embrace an extreme “let it rip” policy is a catastrophe for both the Chinese people and the world. It will leave millions dead or disabled, badly damage the global economy, and may spawn dangerous new coronavirus variants. 🧵 The scale of the disaster is hard to imagine. There are an estimated 1,000,000 new infections and 5,000 deaths each day.

Not that you'd know this from the official statistics, which are no longer reported daily. The official death toll stands at 5,242.
dw.com/en/china-stops…

A danger of giving up trying to control SARS-CoV-2 is that we increase the probability of a low likelihood but high impact event occurring. One such risk is recombination between SARS-CoV-2 & MERS. This could theoretically occur if someone were coinfected with these two viruses. MERS has a case fatality rate of 36%, while SARS-CoV-2 is highly transmissible. A recombinant that shared some of these properties could potentially be catastrophic.

I stress this is only a theoretical risk, but scientists have warned of this possibility.
atlantis-press.com/journals/jegh/…

An important new retrospective study of people who tested positive for COVID-19 in Ontario, Canada between the start of the pandemic and early 2021, has found that about 1% of these experience substantial post-infection morbidity. 🧵
cmaj.ca/content/194/40… In early 2022, about 45% of Canadians had a recent SARS-CoV-2 infection.

The authors write that over the next year, about 1% of these people will likely be admitted to hospital roughly 1 week longer than those who didn’t have COVID-19.

A recent review into Australia’s response to COVID-19 contained some material on children and schools that is either wrong or misleading.

Notably, the review cited controversial research by one of the 47 original signatories to the notorious Great Barrington Declaration. #auspol First, the review wrongly claims schools “were not high-transmission environments”.

But international data clearly show schools played an important role in amplifying the pandemic, if mitigation measures such as improved ventilation were not in place.
science.org/doi/10.1126/sc…

A recent re-analysis of 2 randomised trials conducted before the pandemic found that a carrageenan-containing nasal spray shortened the duration of common colds caused by the OC43 or 229E coronaviruses. 🧵
bpspubs.onlinelibrary.wiley.com/doi/10.1002/pr… This is biologically plausible, because carrageenan (found in a type of red seaweed known as Irish Moss) has been shown to have antiviral properties in the laboratory - including against SARS-CoV-2.

A study of the hepatitis cases seen in Israel reveals they were likely a delayed consequence of COVID-19.

The average delay was 74 days (range 21-130). This is almost certainly why we’ve mostly seen negative COVID-19 PCR tests in affected kids.

No adenovirus found in liver.🧵 The authors describe 5 children with hepatitis.

Four children previously had mild COVID-19, for which they tested positive by PCR at that time.

One child had a positive antibody test for SARS-CoV-2 during the hepatitis investigation, indicating previous asymptomatic COVID-19.

@dtjohnso: I couldn’t reply for some reason so I’m writing this. You’re sort of on the right track, except new variants essentially mean immunity (to infection) is probably short-lived for many. (Immunity to severe disease thankfully is holding up better).

https://twitter.com/dtjohnso/status/1516799564304588802?s=21&t=o0GhdT8bkr_8u9fMcVOWng

This means that all bets are off when it comes to herd immunity, and a good chunk of the population will probably always be vulnerable at any given moment (unless we can develop better vaccines). But we can still try to keep transmission low with better ventilation and the like.

Groundbreaking new research shows a far-UVC (ultraviolet light) air purification system can reduce levels of an airborne pathogen by 98% within minutes.

This is equivalent to an incredible 184 air changes per hour - better than even HEPA air cleaners.
nature.com/articles/s4159… Researchers continually released aerosolised Staphylococcus aureus bacteria into a room ventilated with 3 air changes per hour.

This bacteria is harder to kill with UV light than either influenza or the coronaviruses that cause the common cold, making it a tough challenge.

I did an interview the other day in which I was asked when WA’s omicron wave will peak. Naturally, it’s something most people want to know, but in retrospect I think it’s the wrong question. Instead, we should ask how we can minimise the impact of the current and future waves. The omicron wave won’t be the last. Why would it be? Look at the UK: the first wave of the original strain was followed by the alpha variant, then the delta variant, omicron BA.1, and now omicron BA.2. An average of ~100 people continue to die per day.
coronavirus.data.gov.uk

Younger kids now have to wear masks in Perth. How are they coping?

👧 “Really excited, ‘cause I quite like wearing a mask.”

🧒 “I’m kind of fine with it, but the mask is kind of sweaty on the inside.”

If this is the worst TV could find, I’d say most kids are doing just fine. Most of the concern around children and masks is unfounded. If you explain why masks are needed in age-appropriate language, most kids will want to do the right thing and protect themselves and others.

Kids have a strong sense of fairness that many adults have sadly lost.

A new study supported by the CDC shows that in 2021, there was more COVID-19 in US schools than the general community (see lines on the left).

But when masks were introduced at school, cases in schools plummeted (see lines on the right).
cdc.gov/mmwr/volumes/7… Both students and staff members were more likely to have COVID-19 than the general community, as shown in this graph (depicting the ratio of school to community cases).

The closer the curves are to 1 on the horizontal axis, the closer schools matched the general community.

Today, Western Australia ended the border controls that have kept its people safe for two years. During that time, only 10 people died from COVID-19, making the state’s response one of the world’s best. Unfortunately, the emergence of the omicron variant finally made Western Australia’s elimination strategy unviable.

Nonetheless, the Government continues to follow a suppression strategy for now. Better vaccines may make this easier in future.

Is the pandemic really over? What’s likely to happen over the next 12-18 months? The UK’s Scientific Advisory Group for Emergencies (SAGE) outline four possible scenarios ranging from optimistic to pessimistic.

Here’s what they describe…🧵
gov.uk/government/pub… In the best case scenario, the vaccines retain their effectiveness against new variants (which do not show increased transmissibility or severity). Antiviral drugs stop people from getting really sick and these drugs remain effective. Only minor seasonal/regional outbreaks occur.

COVID-19 can cause lasting damage to the cardiovascular system, even in “mild” cases that didn’t require hospitalisation during the acute phase of infection.

A new study shows we’re going to see more heart disease, strokes, blood clots & other problems.🧵
nature.com/articles/s4159… The authors have a warning for governments letting the virus spread:

“Governments and health systems around the world should be prepared to deal with the likely significant contribution of the COVID-19 pandemic to a rise in the burden of cardiovascular diseases.” (Continued 👇.)