While it feels like a somewhat posthumous statement to make, having been quite inactive recently, I think it's time to retire the twitter handle here.

There's a good few reasons for this - mostly personal, but two other reasons, one of which I think is important. Firstly, I always set out to try and be data driven in this account broadly speaking - and COVID data has largely dried up at this point.

But this comes to the second important point, no surprise to most. COVID is simply not the issue it was. Hell, it's barely even top 10.

I'm seeing an increasing number of bad takes, mainly on the fringes so far, of "negative VE" meaning that people vaccinated are *more likely* to be infected with COVID.

This is entirely untrue. First again a reminder what VE means. It is a measure of the *relative risk* of infection in vaccinated, relative to unvaccinated - specifically, it is 1-RR.

Very simply it's a number counting exercise put into a basic formula.

OK....*deep breath*

My initial assessment of this study.

Note that this may be a little disjointed as having to do it faster than I have in the past.

https://twitter.com/MichaelSFuhrer/status/1735803629498671599

Firstly, lets just very quickly put to bed the *applicability* of this study - i.e. what groups this may end up being deemed to be applicable to.

This is fundamentally a very narrow group. 8.5% were in long term care, 38.8% had cancer, 67% had chronic lung disease.

Theres a lot of chatter, from various angles, around the messaging from CDC here - namely, the COVID vaccine doesn't reduce transmission (and secondary, that maybe a better message would have been around reducing disease).

I am quite conflicted on this.

https://twitter.com/CDCgov/status/1733881531729351042

Firstly, given the public perception around COVID vaccines and transmission, I think that *regardless*, this wasn't great PH messaging.

But, I also think that this is nuanced, and I dont think a "reducing disease" message would have been better - in fact, it could be worse.

Lets just be really clear about this.

When we look at population level, COVID is *not* infecting people 2 to 3 times per year or more, it has *never* infected people 2-3 times per year or more, nor is it going to.

We have *evidence* for this. Understanding the average frequency of infection is actually remarkably simple in theory.

All we need is to know prevalence in population, in terms of percentage testing positive, and duration of positivity per infection.

Theres a study doing the rounds which basically shows that Long COVID is statistically no more likely in COVID positive than COVID negative people.

jamanetwork.com/journals/jaman…

The study is decent but I think being misrepresented somewhat. A few thoughts. 1) COVID negative is about as good a way as we have to establish a control group, but it's by no means comprehensive. Even with seroconversion, some in the control group will have had COVID. This would narrow the gap between ORs.

Just to illustrate the point re: VE and interpretation, I've quickly whipped up the below plot showing how absolute risk varies as VE increases (I've chosen 5% baseline absolute risk here but the plot is *identical* bar the figures on the Y scale for any other figure). While the relationship is linear, you can see with the blue lines which represent each halving of risk, the relationship with %age decrease in risk is not, which ends up in a lot of "bunching" at the bottom.

Same info on a log plot however much better represents this:

Utterly unscientific poll, just curious (and please just give your "gut" answer).

Vaccine A is described as 90% effective. Vaccine B is described as 80% effective.

How much less effective is vaccine B than vaccine A? And a follow up for people so inclined. Same question, but vaccine A is 60% effective and vaccine B is 30% effective.

Haven't done much on ADHD for a while so...I want to talk about ADHD and relationships, and in particular my personal lived experience. (note - some of this could be ADHD, some of it could be just me! Sample size of 1.)

Relationships with ADHD are *hard*.

1/n Problem is that if I was to sum it up, ADHD makes you a very inherently selfish and/or introverted person (although introverted here means something quite specific).

Not in terms of intent, but in terms of presentation and action, and hence perception. 2/n

Well... This is hugely disappointing.

Wholly appreciate this is for most now a niche requirement, but it still carries significant value in understanding COVID rates but also viral infection rates more generally over time (especially after recent foray into flu/RSV).

https://twitter.com/janemerrick23/status/1633871268587110400

I'll take this opportunity to, once again, applaud the outstanding work performed by the whole @ONS team - always, but especially during the pandemic.

We are disappointed by the CIS being paused precisely because it was so superb. 👏👏👏

Oh wow. Great analysis @PaulMainwood.

@kallmemeg @Jean__Fisch

https://twitter.com/PaulMainwood/status/1625960257246617602

Of particular interest here is actually the Delta period for me. I've seen this a few times on my own analyses in the past, but that reinfection rate is much higher than has previously been believed (if indeed it's correct).

@Jean__Fisch @kallmemeg @MichaelSFuhrer ONS just dropped another dataset... cumulative estimate of attack rate and infections until 11/11/22.

ons.gov.uk/peoplepopulati… Intriguing as the levels are lower than I'd expect ..

82% and 170% respectively. Seems challenging to understand this level in line with the release last week eyeballing it.

So...ONS estimates that in the UK BA.4/5 infected almost 50% of the population.

Wow. Full ONS analysis here. Some interesting outcomes.

ons.gov.uk/peoplepopulati…

So there's been a lot of debate here about what proportion of infections now are first infections vs reinfections.

I've picked apart one source of data on this (ONS infection survey) and the results are pretty shocking and against most of our priors.

Quick thread. ONS doesn't publish directly reinfection rates. It does publish various other data, such as risk of reinfection per 100,000 risk days - hard to interpret and understand - see here for how they can be misinterpreted, including by me (chart here is wrong!!).

https://twitter.com/OmicronData/status/1621928677851144193?s=20&t=MpkovZyoHuKS_fGW01lawg

I'm in the same boat as Paul here, and using the same strategy come to the same conclusion.

COVID right now doesn't worry me (in the strictest sense of the word - it's still a concern). H5N1 does.

Will try and pull together some of the best info I've found.

https://twitter.com/PaulMainwood/status/1621136263213613058

https://twitter.com/zeynep/status/1621565175416426498?t=uabK4ZHIPs86Zn7cp6IZcg&s=19

Interesting to note that in the UK, flu ICU admissions just overtook COVID ICU admissions for the first time in at least a year, and almost certainly for the first time since the pandemic began.

https://t.co/oLHA9LwytJgov.uk/government/sta…
(sorry, England, not UK)

(Follow on thread - read below thread first) - So, how can these factors skew how ADHD can be perceived in the general populace?

The answer, in truth, is simple.

https://twitter.com/OmicronData/status/1521069251326525442?s=20&t=wTC1kLC4ZNqZpG2N8BvXkA

You are disproportionately much more likely to see someone on the more positive end of the scale of outcomes. This is a survivorship bias.

This manifests in big obvious ways, and also in small ways.

So in continuing the topic of #ADHD, lets expand on the time management element I started to refer to below. This causes far greater issues than just the immediate and direct elements mentioned in my prior thread.

https://twitter.com/OmicronData/status/1520719749881253889?s=20&t=hncfdfl1EexZvolQi_LvHQ

If you lack a concept of time, you also lack a concept of the future. This results, as Dr Barkley would refer to it, as a "temporal myopia" or "time blindness". Your time horizon (which in your adulthood is typically 8-12 weeks) is one of now, and now only. What does this mean?