ɪᴀɴ ᴍ. ᴍᴀᴄᴋᴀʏ, ᴘʜᴅ 🦠🤧🧬🥼🦟🧻🧙‍♂️ Profile picture
virologist. husband. dad. reader. writer. fixer. bad typist. learner. in no order. facts referenced. opinions mine alone. not medical advice or endorsement.
Ross Grayson, MPH, CIH Profile picture Mcrhoc Profile picture DocM55 Profile picture mike norrie Profile picture President Elect Rick Scheck Profile picture 18 added to My Authors
24 Sep
If you're baking a cake, maybe one you haven't tried before, do you set the oven at a temperature, cook it for exactly xyz minutes, then turn the oven off, pull the cake out and eat it? Or do you leave the oven on while you check the cake is baked, and if it isn't leave it in?
In PCR'land we don't take our tubes out & test them, but we "set and forget" to a MAX baking time (=total number of cycles; at 40-50). We come back at the end & see the results. Virus positive samples show up *before* the run is completely finished (15-30 cycles, with some later)
In the real-world RT-PCR result below you can see a bunch of positive curves for flu (the negatives are the flat lines underneath the red threshold).
Doesn't matter what the final cycle number is (how long the oven was on), just that it allows all the ingredients to be cooked.
Read 6 tweets
18 Sep
A short thread on blocking to maintain your own mental health from others' aggression, bullying, anger, stupidity, trolling, disingenuity and abuse (of course, you can always log off social media to get a break from its negativity)
You don't have to follow me.
You don't have to read my ramblings.
You don't have to tell me what you think.
If you don't like what I'm writing, stop reading or block me.
I promise I won't mind. I probably won't even notice.
I don't owe you my time. I'm not your punching bag or assistant. I don't have to answer or tolerate your rude, trolling, maliciously deceptive questions or debate you because you want it. I'm here at my own cost for my own reasons.
Read 7 tweets
10 Sep
The first year of COVID-19 in Australia: direct and indirect health effects

aihw.gov.au/reports/burden…
A reminder of how vaccine development has been speeding up - but scicne and medicine did especially amazingly for this pandemic. A new benchmark?
A nice reminder that while most of COVID-19 is mild and moderate, a sizable portion is not at all - from hospitals through to death.
Polio was a rare outcome from poliovirus infection - but it wasn't something anyone wanted.
Vaccines work in these severe outcomes spaces.
Read 18 tweets
7 Sep
In Australia we are talking about lifting some restrictions once 70% of the eligible population is fully vaccinated ("double-dosed"); more will lift at 80%.
It's important to be fully aware that "70% of" anything often doesn't look like this - one homogenous group all at the same level.
Here the shape might be Australia, or all people, or one jurisdiction (e.g. a State, territory, building) or an age band (e.g. 16-25 year olds).
Overall, these two groups could, as an average of both ("=all of Australia"?), be considered vaccinated to a level of 70%.
And yet one group hasn't even cracked 70% fully vaccinated.
Read 5 tweets
28 Aug
In Victoria's (Aus) Wave 2 in 2020, there was a lag to hospitalisations (blue) following the initial wave of detections (orange). A small portion of those went to ICU and some died (black line). But in the current New South Wale's Wave 2...
...the daily number of COVID-19 cases hospitalised doesn't show that lag.
Is this due to a different policy for faster admission of cases, or home hospitalisation from the outset, or something else in NSW compared to VIC?

NSW sure got the testing amped up early on (green line)
I have no idea if there's a well-known & simple reason for this.

Chime in if you know it.

Data copied from covidlive.com.au
Read 7 tweets
11 Aug
This animal reservoir thing is not a factor in SARS-CoV-2 - the animal providing the virus opportunities, is us.
RVs, RSV - they don't have animal reservoirs. *We* are their reservoirs. So it seems like this person has no understanding of endemic respiratory viruses.
Summer respiratory viruses? Um. Summer flu? Every year. Enteroviruses which are in fact also spread by a respiratory route? Did this person miss the global bounce back of RSV as the world came out of Wave 1 COVID-19 lockdowns? That's traditionally not a summer virus.
Read 6 tweets
8 Aug
What would I do? Okay. Keeping in mind I'm not in the room, not an Epi and I don't run this stuff. So a big pinch of salt.
But to answer this question for people angry at me for negatively pointing out that NSW is putting the rest of Australia at risk..
..because they started too slow (my key point, which doesn't help now, I know).
I'd reset.
I'd look at what the most stringent of the "Lockdown" rollouts from anywhere in NZ and Aus (planned or enacted) is, add anything more that can be added, ensure food and money can get to..
..those who will suffer most, and roll that out across all of NSW at once, all the same. And lots of different Comms. There is more that can be added if today's Penrith additions are a guide. So do that. Set a new benchmark. And this has to be done before any more of those..
Read 10 tweets
7 Aug
🦠13 new linked cases in QLD
🦠total now at 102
🦠40,835 tests in past 24h
🦠will see household (HH) cases continue - so long as they are not one the community, this is good
🦠10,091 heroes in quarantine right now -
🦠Supermarket deliveries seeing high demand for groceries - their staff are also in quarantine;2-3d delays. Plan ahead. Use family and friends. Uber Eats partnering with IGA
🦠Shop alone - don't all go together
🦠CHO wants more testing Cairns
🦠Premier out of quarantine tomorrow after Japan Olympic trip (thx Dr Miles for holding the fort)
🦠
Read 8 tweets
6 Aug
Putting too many eggs in the vaccination basket in order to prevent a local *transmission* has issues.
One is, what happens when, like the US, people stop getting vaccinated at the initial most enthusiastic initial rates?
cdc.gov/coronavirus/20…
What happens is massive exponential rise in cases and hospitalisations in that location because of too few/weak NPIs in place due to the earlier narratives which paraphrase as "we can live with it".
Another issue for interrupting transmission is it takes time to build up full immunity-even with shortened dosing intervals between doses. Yes, one dose makes a difference & is better than none. Get vaccinated if you can & if supply allows it & your GP has addressed your concerns
Read 7 tweets
1 Aug
🦠9 (all linked) new Delta cases in Brisbane over last 24h
🦠Not found the source of the medical student tutor who infected the ISHS schoolgirl's household
🦠Intermediary link between 2cases from overseas flight 29th June from Singapore & 1st ISHS case, not been made
🦠Genomics shows the exact same variant in all those cases
🦠Sunshine Coast is being looked at hard as a likely source.
🦠Largest single-day new Qld case tally in almost 12 months. [message to take this seriously is being pushed hard]
🦠Five schools at risk now – all have different arrangements
🦠New cluster linked to a Karate school at Ironside
🦠Only 11,468 tests yesterday-this is NOT ENOUGH for this urgent need
🦠"NSW is doing 100,000 a day – let's see how we can go" – CHO on testing numbers
Read 5 tweets
26 Jul
Some international Tweeps seem to think *Australia* has lost its control over COVID-19. The map below shows Australian States and Territories. The yellow bit is where all the cases you're hearing about (100-200 per day) are from.
Hopefully, they'll regain control in coming weeks Image
The rest of Australia continues to manage cases at the border or is getting on top of some local community spread as usual.
Vaccination is ongoing but not at the rate many of us would like to see it. There are multiple reasons underlying that, principally issues with mRNA supply.
Our earliest "sovereign" vaccine had issues as it produced an HIV diagnostic cross-reaction. Our second most backed vaccine generated safety signals which - in the absence of community COVID-19 - created a risk imbalance due to TTS.
Read 7 tweets
21 Jun
Impressively easy to get a test this morning at a Queensland Health testing facility. Found it online. No GP referral needed. Helpful people everywhere. All happened quickly and efficiently. Throat and both nostrils.
Waiting on that result with all those privileged expectations....
*Sampling facility 🙄
Read 4 tweets
19 Jun
Yes, & if I *chose* to do these sports, I'd be *choosing* to take the risk.
I *chose* not to partake in any of those.
🎶One of these things is not like the other🎵
Until recently, those of my age couldn't make a *choice* even though there were options.
This a poor comparison
And admission: I don't have my own horse in this game because I was vaccinated with Pfizer in March as a frontline worker. I use my age (50 - still!!) as a example
This is a better comparison because I can't control getting homicided or car accidented.
However, I can *choose* not to stand in the rain during a lightning storm, and I'm a pretty good (& infrequent) swimmer.
But this is just about deaths? Why control the narrative that way?
Read 13 tweets
17 Jun
Concerns over risk of rare heart condition from COVID-19 vaccine in young men /via @globeandmail theglobeandmail.com/canada/article…
Myocarditis and Pericarditis Following mRNA COVID-19 Vaccination
-US CDC
cdc.gov/coronavirus/20…
COVID-19 Vaccine Safety Updates - June 10 2021
-US FDA
fda.gov/media/150054/d…
Read 6 tweets
9 Jun
It will be interesting to see *how* new Qld case(s) - if not a false positive - is linked to Melbourne's existing clusters and what role the 4 days in NSW play.

couriermail.com.au/coronavirus/co…
Case is residing in Caloundra. Arrived here 5th June. Tetsed y'day, confirmed today as a positive case.
Travelled with partner, leaving Melb 1st June. Multiple exposure sites (of course there's a Bunnings!), will be listed qld.gov.au/health/conditi…
If you've been to these sites, please come forward and get tested.
6 close contacts so far - partner already tested, negative, initially
Read 4 tweets
4 Jun
Overly inflammatory headlines aside (no strong evidence for this age-specific spread I believe) - this is some very bad luck to now have B.1.617.2 (Delta, a VOC) on top of B.1.617.1 (Kappa, a VUI) get out of hotel quarantine & into the community at the same time.
Other sites in Australia have hosted Delta variant infected people including NSW, VIC, QLD, WA and the NT
Read 7 tweets
24 May
@4corners notes Australia's strategy to vaccinate has been shrouded in secrecy.
#fourcorners
Interesting watching a GP basically tell an elderly person, don't worry about clots, when they asked what to do if that happens
#4corners.
Pfizer contacted Aus for "informal" discussions in a June 2020. No deal until Nov 2020.
AZ was a known platform, simple cold chain.
SciTAG met in mid-Aug to review the landscape.
C'wealth kept vaccine planning to itself, States lacking info
#4corners
Read 10 tweets
25 Apr
With recent reminders of ever -present epidemic of death & disruption caused by domestic violence, it's a good feeling to be able to help out a little today. Our family is helping furnish a new DV sanctuary house for a mum & her young kids. Somewhere to be safe & call their own. Image
As a kid, I grew up around one scary male parent, had 2 "fathers" & saw the impact of alcohol & toxic male anger time & time again. I especially identify with the kids in these relationships. And I marvel at the strength of the Mums.
Organisations like Friends with Dignity @friendswdignity seek donations of goods & time, cash and corporate sponsorship.
If interested in helping, see their website
friendswithdignity.org.au
Read 12 tweets
26 Mar
💨Genomics to follow later today
💨Source not yet clear
💨1 person per 2m2 indoor
💨Outdoor we ko is low risk
💨Get back into social distancing habits
💨Reminder to stay home if sick (this case did👍)
💨Contact tracing underway
💨Sooner we know and find the earliest cases the sooner we get on top
💨Symptoms on Monday
Read 4 tweets
15 Mar
I kept a vaccination shirt in the office for this day. Image
First dose done. Amazing to see so much science in such a small volume. ❤️ Image
4h later - not feeling anything so far. Will keep you uptodate
Read 4 tweets
13 Feb
Seattle’s Leaders Let Scientists Take the Lead. New York’s Did Not
-an old read but was still on my phone. This in particular..
"the researchers, in quiet violation of C.D.C. guidance, had jury-rigged a coronavirus test in their lab"
newyorker.com/magazine/2020/… via @NewYorker
As Australia gets closer to setting up its own CDC it should be written into its DNA that it will never, NEVER be able to prevent or overrule or control the abilities of regional expertise to rapid, flexibly & independently develop & use tests.
That agile independence was one of the key first tools that set successful countries like us apart from others. That changed shortly after as other things distinguished us. But one of the first and best successes was our expert lab network's ability
Read 4 tweets