Worth stating that, while there is (significant) potential for a significant autumn/winter CoV-2 wave of *cases*, a wave in a population in which 95%+ of adults are double-dosed is different to a wave in which they are not, even w/ waning immunity & novel VOCs
- Caveats below 👇
- Does not apply if there is a *true* vaccine escape variant, the potential of which is unknown, but seems relatively small 🤞
- Immunity to infection/infectiousness definitely does/will wane, altho by how much & exact time-scales is currently unknown & will differ in different demographics, & v unknown what this means (quantitatively) for severe disease (although less likely to be impacted so much).
Really beginning to question the scientific integrity of those who state with certainty that the restrictive interventions they favour 'work' for net-PH benefit, while any attempts to actually study &/or optimise implementation of more focussed PH interventions are unethical.
Would also remind people that we have all been living through one local, national, and global 'experiment' over the past year, with a package of blunt interventions of completely unknown (cost)-effectiveness and many collateral (known and unknown) harms.
If there is a way to reduce these harms without increasing transmission through daily testing of contacts, which modelling/logic suggests can work, then it is worth evaluating through (high-quality) pilots.
There are no easy answers here, and everything is trade-offs. But if every pilot and attempt to understand ways to improve the situation & reduce total harms now we are in the vaccination era results in outcries of unethical study, we are unlikely to get very far.
1) LFDs can be a very useful PH tool 2) People in the testing industry make a lot of money 3) The tests aren't being used in a particularly (cost) effective/efficient programme 4) DHSC are not evaluating them anywhere near well enough..
5) Misinformation around (LFD) testing, promoted by prominent academics in the media and certain newspapers, has, and continues to, erode trust in testing and public health, impacting on uptake and therefore impeding pandemic responses.
6) Seemingly subtle differences in transmission control can have significant net health/societal benefit at certain key points of the epidemic (e.g., when R close to 1, and/or in a tight race between mass vaccination & reopening with VOCs circulating).
The problem with models forecasting late into 2021/early 2022, with implications for challenging winter waves, etc, is that there is still evolutionary space for the virus to become more transmissible &/or acquire further (partial) vaccine resistance.
Therefore, these forecasts will soon become somewhat redundant imho.
The most optimal strategy is still to keep prevalence low with focussed and effective evidence-based interventions, balancing harms & not losing focus, & take each day, week, month as it comes...
The fine margins on this are just crazy. Note this is illustrative data, but (illustratively), R(t) dropping by 0.1 per day due to vaccination = no exit wave, while R(t) dropping by 0.05 per day = large exit wave.
@chrischirp Quite - hence my gazillion tweets over last 8 months on implementation, equitable and focussed testing, testing fatigue, maximising benefit from finite resources, symptoms, credible incentives, and support to isolate.
@chrischirp Despite the 24/7 COVID news cycle, constant lockdown vs no lockdown debates, & in-depth reviews of variants & attempts to explain molecular biology to the British public, there has been a distinct lack of comms on the practical steps which members of the public can take... ->
@chrischirp -> to reduce their risk of catching & spreading COVID before being fully vaccinated.
Encouraging self-symptom screening (WHO definition) before leaving the house, meeting up outdoors/opening windows, rapid testing 2x week (or before you meet people).
Mask requirements for teachers & staff members & improved ventilation are important strategies in addition to vaccination of teachers & staff members that elementary schools could implement as part of a multicomponent approach to provide safer, in-person learning environments.
Of interest in this analysis is that this real world analysis by @CDCgov found relative risk of COVID transmission when students required to wear masks vs when optional was 0.79 (not a huge reduction) and confidence intervals crossed 1 (0.50-1.08).
The testing *programme* in its entirety, not just having tests themselves, are what really matter.
L'pool results suggest mass testing in this format (w/o support to isolate which reduced uptake in communities where needed most) was unable to prevent a sig wave while society open
Altho v complex data-set to disentangle, & confounded a lot by Lpool being in T2 rather than T3 (due to earlier gains from mass testing) resulting in much seeding of cases (& B117) to the region, does suggest such mass testing unable to prevent sig wave while society more open.
Genuinely can't tell whether this language is a coordinated effort by @UKLabour to amplify the nationalist 'leaky border' anti-immigration/anti-foreigner hype in an attempt to win back votes, or whether this is just where so-called 'progressive' politics finds itself in 2021.
We are already seeing R & prevalence rise in certain regions, esp in the NW & elsewhere. Where there is greater socio-economic deprivation, less people WFH, inequities in vaccine accessibility & uptake, & waning immunity, the potential of R(t) is greater.
"It is now generally accepted that SARS-CoV-2 can be spread by aerosols as well as larger droplets from the upper respiratory tract, although the relative importance of aerosol transmission remains incompletely answered."
"This view of aerosol generation subsequently led to a dichotomisation that categorised all medical activities into either AGPs, where potentially infectious aerosols are generated, vs everything else, where risk of potentially infectious aerosol is presumed negligible."
Through exploring the exhibit, users get a sense of the different approaches public organizations took to spread information about AIDS. "It's a fundamental question of public health," says Brier.
"Do you spread information by scaring people, do you do it by trying to tap into pleasure or do you do it by recognizing that people’s behavior isn’t just about their individual will but a whole different set of circumstances?"