This is exciting, right?

The CDC found zero cases of onward transmission of monkeypox on flights.

So, either monkeypox doesn’t transmit on flights, or the CDC’s approach to contact tracing is broken. Which is it? (1/)

https://twitter.com/ashishkjha/status/1832061219853025358

In a recent paper, my colleagues and I assessed the effectiveness of contact tracing during the early stages of the Covid pandemic. We found that contact tracing identified 1-2% of all transmission events. (2/)

bmcpublichealth.biomedcentral.com/articles/10.11…

@KonLontos @GidMK Talk of a “plateau” of risk comes from a fundamental misunderstanding about the underlying math.

The statcan data is consistent with a fixed probability of LC per infection. Such a fixed probability will give you a curved line asymptotically approaching a plateau (1/) @KonLontos @GidMK Unfortunately, that “plateau” is not useful, because such a risk function plateaus at 100%.

@gckirchoff and I explain the math in this blog post (with an interactive tool that you can play with) (2/): thedataquill.com/posts/understa…

This has been a concern of mine for a while.

We now know that some fraction of LC patients (and sc2 infections generally) feature viral persistence. Some fraction of LC also features autoantibodies that drive symptoms.

We also know that most people will get sc2 1-2x/yr (1/)

https://twitter.com/mileswgriffis/status/1803529332578771422

An increasing fraction of the population will likely be harboring sc2 virus directly or autoantibodies. We know that viremia (virus in the bloodstream) for sc2 can be a huge issue. (2/)

Thread 5/5: You can't learn to live with a potential carcinogen by pretending the risk doesn't exist. In a recent 🧵 I showed that a mechanistic basis exists to suspect that Sc2 is a carcinogen & it'll be hard to prove this with epidemiological studies(1/)

https://x.com/arijitchakrav/status/1799685306414993755

Okay, so what do we do with that info, given that we can't run our own genotoxicity assays at home. Just ignore it? Can't live our lives in fear, right?

In this 🧵, let's discuss the practical implications of learning to live with a ubiquitous potential airborne carcinogen.(2/)

Thread #4 of 5: Suppose the 𝐂0𝕍𝕚𝖉 virus is carcinogenic. Why not wait for "real world" (epi) data to "prove" that the before we do anything? In this 🧵, let's discuss why such "calm-mongering" is a reckless choice & can lead to devastating consequences for public health. (1/) A recurrent theme during the ongoing pandemic has been the panic about public panic. @Heavyredaction & I tackled this issue last year, in an article for The Nation, making the point that Public Health spends a lot of time providing reassurances. (2/): thenation.com/article/societ…

Thread #3 of 5:

Is Sc2, the 𝐂0𝕍𝕚𝖉 virus, carcinogenic?

(If you've been scrolling through my threads on cancer the past couple of days, waiting for the other shoe to drop, here it is.) (1/) We started this conversation with what causes cancer- the TL; DR of that 🧵is - chromosomal instability (CIN) is a driving force in carcinogenesis. Events that put CIN into motion kick off a process of unbridled somatic evolution- tumor progression. (2/)

https://x.com/arijitchakrav/status/1799685306414993755

How do viruses cause cancer? (Thread #2 of a 5 part series).

There's been a fair bit of twitter-chatter about this topic lately, so let's talk about it. Understanding the process of viral carcinogenesis is key to managing the risk of viral infections. (1/) Disclosure: I'm not a viral carcinogenesis expert. I've published on cancer as part of my day job for 25+ yrs (& on The Virus That Cannot Be Named as a 'night job' for (ugh) 4+ yrs now. This experience provides me with a unique perspective on the topic. (2/)

Bit of a change of topic, but let's talk about cancer.

What causes cancer? We learned in high school that it's mutations in oncogenes- "cancer is not one disease, it's many different diseases, each driven by a different oncogenic mutation." (1/) It's an attractive paradigm, because it makes it all very simple. All you have to do is find the driver mutation for any given cancer & target it to make the cancer disappear.

Someday, the vision goes, every cancer will have a personalized cure. (2/)

@hallinen_diane @pan_accindex I think if someone’s going to make a claim like “Covid doesn’t harm your immune system”, that’s a bold claim.

If they’re wrong, the consequences will be much more severe than the unnecessary concern that would result from a false alarm. (1/) @hallinen_diane @pan_accindex The claim itself is contrarian, as it flies in the face of the established science. It’s beyond meaningful debate at this point that *some* cases of Covid -even mild ones- lead to depletion of immune system components for months (2/)

1/ Powerful testimony by @zalaly today in the Senate Hearing on Long COVID.

He makes a lot of really great points- well worth a watch!

There is no treatment for Long COVID. Recovery rates are low. (🧵👇)

https://twitter.com/luckytran/status/1748037164913267006

2/ "The best way to prevent Long COVID is to prevent COVID in the first place". He makes a compelling case that this is something that requires government action.

In the meantime, we still have some agency as individuals, too. Check out:

typingmonkeys.substack.com/p/you-dont-nee…

@sunsweptforest Exactly. The big-name journals have a huge optimism bias.

In 2020&21, we predicted the virus would quickly evolve to evade immunity, that vaccines alone wouldn’t bring the pandemic to an end, that schools would seed disease, that appeals to altruism from PH would backfire. (1/) @sunsweptforest For the first 2-3 papers, we tried our luck at the big name journals. They would sit on the manuscript for a month and then send a form-letter rejection. Meanwhile, they were fast tracking review and publication of “good news” papers on the exact same topics (2/)

This point has been before, but if you want to know what the future holds for long Covid, look to high-contact-rate professions.

In the UK, the Guardian noted the shortage of workers specifically in this category (1/)

https://twitter.com/1goodtern/status/1723966195701801101

If you think of high-contact-rate professions in the US, ones where people are likely to come in contact with Covid, what are they? Childcare workers, bus drivers, nurses, pharmacists, prison guards, for example? (2/)

Grimly fascinating thread on the way in which the murderous Tory response to covid was shaped by advisors who believe in (surprise, surprise!) eugenics (1/)

https://twitter.com/0bj3ctivity/status/1720765016998113521

“Covid is just nature’s way of dealing with old people”. Can’t make this shit up. It explains why, as groups like ours were warning about the negative consequences of a negligent covid policy, governments such as UK were actively pursuing such policies (2/)

Taking Paxlovid in this study was associated with a minuscule reduction in risk of long Covid. Note that the article is written in a way to make that less obvious. (1/) cidrap.umn.edu/covid-19/resea… While the article is focused on inequity, the magnitude of the effect size (reduction in LC risk upon taking Paxlovid) is so small that you have to squint to see it (2/)

@white_bite @xabitron1 @G_Commish @NjbBari3 @DavidJoffe64 @PDAquinas @0bj3ctivity @LauraMiers @HarrySpoelstra @MeetJess @ejustin46 @elisaperego78 @1goodtern @RadCentrism @AndrewEwing11 @outbreakupdates @AltenbergLee @C_A_Gustave @Alitis__ @CarlvKeirsbilck @TRyanGregory @kasza_leslie @SGriffin_Lab @fitterhappierAJ @tohmes1 @DrJohnHhess Umm. I see it very differently, I guess. The confusion arises from the difference in evidentiary standards required to call something a “probable carcinogen” vs a “possible” or “known” carcinogen (1/) @white_bite @xabitron1 @G_Commish @NjbBari3 @DavidJoffe64 @PDAquinas @0bj3ctivity @LauraMiers @HarrySpoelstra @MeetJess @ejustin46 @elisaperego78 @1goodtern @RadCentrism @AndrewEwing11 @outbreakupdates @AltenbergLee @C_A_Gustave @Alitis__ @CarlvKeirsbilck @TRyanGregory @kasza_leslie @SGriffin_Lab @fitterhappierAJ @tohmes1 @DrJohnHhess We know that sc2 causes DNA double strand breaks and chromosomal instability. Any agent that causes those outcomes is carcinogenic, provided that the dose used in the studies is relevant to human exposures in the real world (2/)

@NatanMitch @jvipondmd At some point it dawned on me- pro-covid “experts” whose predictions constantly fail to come true aren’t platformed despite their poor track record, but *because* of it. (1/) @NatanMitch @jvipondmd We’re approaching the fourth year of a pandemic where the public health strategy is to do pretty much nothing and wait for “thin out the herd” immunity. The notion is that if you wait long enough, the virus will no longer be a threat.(2/)

Okay, let’s talk about “learning loss”. (H/t @McKinsey)

US high school test scores (ACT) are out - they’ve fallen steeply for the 4th year in a row. Now at their lowest level in 30yrs.

Let’s look at the data & the media narrative and weigh potential explanations, shall we? (1/) So, first, the data. (H/t @wabbit011235813 )

The little red mark on the graph is 2020. As you can see, for 25 yrs (1995-2029), scores were stable, bouncing around the 21 mark.

There was a slight dip in 2019, and then Covid hit. Since then, scores have been in free fall. (2/)

@RPLerias In our experience, this has been happening from the beginning of the pandemic.

In Sep ‘20, we submitted a manuscript to Science predicting rapid evolution of neutralizing antibody evasion. They sat on it for a month before issuing a desk rejection (1/): journals.plos.org/plosone/articl… @RPLerias Of course, this was the same journal that published papers making wild assertions about T cells and vaccinal immunity during that period (2/): science.org/doi/10.1126/sc…

Quite a bit of the mainstream coverage of things like vaccines is actually disinformation. Take, for example, this article on covid boosters (1/) time.com/6317294/which-… It makes a lot of strong claims about T cell immunity, using weasel words like “studies support” (not weasel words, if you link to the actual studies that you think do support your claim, otherwise they’re just “some people say” (2/)

Comments like this betray a fundamental misunderstanding about clinical trials.

In drug discovery, preclinical results don’t translate readily- that’s why we do trials. Because every drug has (health) costs associated with it, the side effects (1/)

https://twitter.com/lizhighleyman/status/1705360500329197692

Masks are not drugs (neither are seatbelts, parachutes and fire extinguishers). They are subject to the laws of physics, not biology. They have no side-effects (comically spurious, retracted publications about carbon dioxide poisoning notwithstanding). You don’t need a trial (2/)

@PaulRoundy1 @mehdirhasan @BallouxFrancois Pandemics can last for decades. They end when a specific set of epidemiological criteria have been met, not when people have the feeling that they are over (2/): ncbi.nlm.nih.gov/pmc/articles/P… @PaulRoundy1 @mehdirhasan @BallouxFrancois This pandemic will end when we have suppressed SC2 to the point where viral evo is slow enough that our countermeasures work stably against it, and covid becomes a predictable and manageable disease. We are *nowhere* near that point at present (3/)