Was really looking forward visiting @unibirmingham today with colleagues @wellcometrust to listen to research plans #Birmingham but with cough/chills/aches/etc feeling “yuk” & not wanting pass on whatever it is. Thank you for hosting colleagues today birmingham.ac.uk/research/impac… Wellcome’s plans for 2022 and beyond @wellcometrust wellcome.org/news/wellcomes…

“Improving access & affordability of lifesaving antibiotics is central to preventing avoidable suffering.” ⁦@wellcometrust⁩ ⁦@_Jeremy_Knox⁩ ⁦@TimothyJinks1⁩ ⁦@GordonDougan1⁩ ⁦@DrCharlieWeller⁩ ⁦@gardp_amr⁩ ⁦@WHO⁩ gardp.org/news-resources… Plus @wellcometrust Discovery Research all aspects curiosity, investigator/team science plus opportunities Infection Challenge Area-New targets and/or antibiotics,Stewardship Policies, Surveillance, @CARB_X, Vaccines, Diagnostics with a commitment of £16Bn wellcome.org/news/wellcomes…

1/2 Personal view 1) I'll wear mask public transport & crowded indoors 2) Enhance ventilation work places/schools/homes 3) Ensure vaccinated & boosted 4) Support employees/education stay home if symptomatic or testing positive bbc.co.uk/news/health-62… 5) Make Test-Treat accessible & available 6) Prepare now for Flu/COVID in 2022/23, support staff in and enhance capacity of NHS, Care facilities Essential services & all employment/education for higher levels of illness and disruption through 2022/2023 bbc.co.uk/news/health-62…

@jburnmurdoch @ewanbirney Underlines "Vaccine Plus" strategy & need 2nd & 3rd Generation Vaccines that are transmission blocking & reduce illness/death Plus New Therapeutics, Access Tests, & Non-Pharmacological Public Health-Test, Masks, Community Surveys, Reduce contacts if symptoms/+ve test. Ventilation @jburnmurdoch @ewanbirney Perspective @washingtonpost "What if we’re in middle not the end of pandemic?" What do we need to do & no regrets. Just hoping it is over, or only planning for some apparent easy transition to endemicity is not wise. Need to prepare for multiple scenarios. washingtonpost.com/opinions/2022/…

An honour to join @WHO @rd_blueprint Global Innovation and Forum. who.int/news-room/even… Summary of comments 1) Events in east Europe over the last 12 hours remind us all if we needed it of what an uncertain, troubled and turbulent world we live in. 2) Pay tribute to Paul Farmer who passed away this week, who made such a huge contribution to so many.

Huge respect all authors & agree with conclusions- "Entering new phase pandemic. All over world an assessment measures most suited to this phase. Top of list- Vaccination, good indoor ventilation, monitoring of SARS-Cov-2 & other possible pandemic threats. dailymaverick.co.za/article/2022-0… Every country/region will need to do this,timing will vary as pandemic waves shift globally. Personal additions - Reasonable to plan for the most likely scenario but we must also have the humility to prepare for other scenarios

Nov21 personal view "I will go to work,wear mask public transport,indoors (shops,work,cinemas etc),test regularly,fortunate to be 2x vaccinated, flu vaccine.Stay home if with symptoms. I will play sport go to gym,outdoor events,cinema,pub & restaurants

https://twitter.com/JeremyFarrar/status/1462367787960184834?s=20

21Dec21 In favour of PlanB & not more "Amid such uncertainty & with evidence of behaviour change that may help flatten or reduce transmission in lead up to Xmas reasonable to wait 24-48 hours for more data to confirm trends but if they go in the wrong direction act immediately.

There has been a lot of comment on 'in hospital with or because of COVID-19". It is a false dichotomy. Patients are not a single illness or disease, health & illness are not categorical.Having one condition,invariably influences outcome of other conditions.Multi-morbidity is real Very important to know in people with other conditions, cancer, mental health, diabetes, heart attacks, strokes, acute or chronic lung illness, is their outcome same, better or worse, because they also had COVID-19. Do other conditions decompensate as a result of having COVID-19?

Today @wellcometrust @gatesfoundation each pledged additional US$150 million to @CEPIvaccines a global partnership launched 5 years ago this week by the Govts of Norway, Germany, Japan & India, Gates Foundation, @wef & Wellcome wellcome.org/news/wellcome-… The pledges come ahead of a global replenishment conference hosted by UK Government in March 2022 to support CEPI’s visionary five-year plan to better prepare for, prevent, and equitably respond to future epidemics and pandemics.

Agree Mark Woolhouse @EdinburghUni as @WHO said many times "Lockdowns aren’t public health policy. They signify failure public health policy”. But to learn lessons will mean policy decisions earlier & public health interventions to prevent need lockdowns theguardian.com/world/2022/jan… In many countries hard to see that with such strong political opposition to evidence from data, classic public health interventions, utility of masks, testing physical distancing and clinical trial data for drugs that work & those that do not, & in some safety & efficacy vaccines

Sept21 "Going into pandemic hard enough coming out of it even harder. We don’t just go from a no-vaccine state & horror to a status quo" - I think that remains true & will in 2022. Also remains true that until we change this globally we all remain at risk. science.org/content/articl… Starting with an initial focus on UK and a personal perspective. On 21Dec2021 with Christmas I thought it reasonable in UK to "to wait 24-48 hours for more data to confirm trends but if they go in the wrong direction crucial to act immediately"

https://twitter.com/JeremyFarrar/status/1473346469164089344?s=20

1/6 Health impact v high transmission obvious. But If transmission isn’t slowed could see profound impacts across sectors;education,hospitality,public transport,police,supply chains & critical national infrastructure if infections prevent people working mol.im/a/10331733 2/6 Some have portrayed this as a health vs economic issue - it is not. It is both. Impossible to have a functional economy in the middle of an uncontrolled, high transmission pandemic that causes illness, time off work & hospitalisations.

Situation changing very rapidly in few days since this was written now clear now that omicron has higher transmission. Likely to be dominant variant in U.K. as well as SA in 2021. Transmission more than severity the key driver of impact on health systems science.org/content/articl… Please all countries watch what is happening in SA & U.K. It is probable that omicron will become the dominant variant, globally with significantly higher transmission & some degree of immune escape. Nowhere is exceptional. Omicron will not be the last variant.

As a new variant many issues to resolve amid uncertainty. Having great public health & science people, teams, infrastructure & close links into informed policy makers committed to sharing evidence is crucial. Fortunately all that is true in South Africa.They need all our support Many things to learn & watch for - a non-exhaustive list 1/ The epidemiology (is transmission increasing, is it’s geographic footprint widening, are there secondary cases distant from the original epicentre, is the infectious period the same, infectiousness, viral load etc)

New Covid variant with 32 mutations spreading in South Africa is ‘reason for concern’ telegraph.co.uk/global-health/… South Africa needs to be praised, offered whatever support is needed & acknowledged for the quality & speed of the public health & genomic science in SA, sharing the data immediately, supporting the region & the world. Not criticised, have sanctions or other restrictions imposed

Will be surge in infections, we go into autumn/winter with 1:70-1:80 people infected. Vaccines have amazingly weakened link btw infections & illness/hospitalisations but not broken it. No one wants to reimpose restrictions but we face a challenging winter theguardian.com/world/2021/aug… Time for informed public debate possible scenarios, options for policies, implications health & NHS, education, jobs, economy & all sectors society. Pandemic not going away, will be high transmission, infections, illness, deaths.What balance & trade offs are we willing to accept?

I am delighted to say Spike-The Virus vs the People is released today. It is a very personal perspective of an unprecedented period in human history, the challenges & some remarkable successes & inspirational people & to offer a view for future action co-authored @anjahuja . 1/n All our thoughts are with the millions of families around the world who have lost loved ones and those who continue to be affected by the tragedy that has unfolded. 2/

Indonesia,Cambodia,Russia,Iran all facing devastating waves pandemic, driven by Delta variant. Most world facing similar situation. Without access vaccines Delta variant will spread further with inevitable loss life,disruption education, economies, trade. theguardian.com/world/live/202… Could be first time in history that more people will die after vaccine is available than before. Vaccinating everyone in a few countries & essentially none in others is creating a fragmented, more inequitable world. It will also facilitate new variants which will spread globally

Impact of Delta variant, family member out with small group friends week ago all now positive. Message now “identified you as contact of someone who recently tested positive for COVID-19. It is your legal duty to stay at home & self-isolate until 4 July (including this date)” Fortunately household 2x vaccinated. So lucky have access vaccines. U.K. roll out vaccines so far prevent illness/hospitalisations/deaths. Delta variant becoming/is now dominant global virus further terrible waves inevitable all countries with no access or limited uptake vaccines

Vaccines are remarkably safe & effective & increasing evidence they decouple link between transmission infections & illness. So although infections may rise, we will not see associated rise illness & hospitalisation. That is early data & 20M in UK had 2 vaccines many have not In favour of plans for a phased,cautious lifting current restrictions, pausing until next step in June & assessing data;transmission, infections,cases & illness & hospitalisation including variants. I am optimistic vaccines/natural infection have decoupled infections from illness

Inspiring article please read ⁦@FT⁩ Gets to heart science.Importance years investment discovery science do not know that where it will lead,global partners,public/philanthropic/industry funds,inspired people & teams beyond edge knowledge. Serendipity ft.com/content/b29780… Also how discovery science can be translated & enhance all our lives. But although science can & has delivered, it is not enough. It has to reach people who want & need it. It needs health services,policy, diplomats,politicians,Govts,MFI to fund & ensure it is equitably shared.