Scotland moves to 'Beyond 0' on 9 August. Some measures remain in place: face coverings indoors, test/trace/isolate (isolate if test positive, contacts can be released from isolation with double vax & neg PCR test), home working when possible, & local outbreak response.
Schools will retain same mitigations for start of school year (for 6 weeks & then reviewed) including ventilation & CO2 monitors. But full bubbles no longer asked to isolate- more targeted approach to avoid disruption. Caution due to mixing of large groups of unvaccinated kids.
Mixed feelings about nightclubs re-opening. Great for socializing/mental health/jobs, but high-risk environment for transmission. Have to continue to encourage younger people to get vaccinated & only go out if feeling well. Stay home if symptomatic (no coughing in the club).
Seeing lots of unhelpful panic over today’s numbers. Obviously caution needed but most important marker is whether link between cases and moderate to severe disease being broken. This is a different wave than previous ones. We are in new territory.
More here. I’m very concerned about South Asia, Latin America & Sub-Saharan Africa now. They’re in crisis and serious trouble. Not enough vaccines, not enough oxygen & hospital beds & no economic support for people to stay home.
Even New Zealand now going same way given vaccines. They avoided the death & repeated lockdowns that Europe had, but now need sustainable exit. Bloomfield: ‘There’s no doubt that having as much of the population vaccinated as possible is key to us being able to open the border.”
Happy Mon!☀️Instead of arguing about lockdown (it’s been a harsh year), we need to prepare for future pandemics: stop spillover of viruses from animals to humans, ⬆️ vaccine manufacturing capacity globally & prepare to move from sequencing to jabs in arms within a few months.
Lockdowns have been a last resort measure to keep health services from collapsing. No one wants restrictions given the high social & economic cost they carry. So how do we prepare for future pandemics so we don't need lockdown/release cycles, like they've been used in the West?
We need to reduce: number of people who are susceptible to a new pathogen (which leads to exponential growth) & hospitalizations/severe disease (which strains health services). Invest in science for solutions to both of these. We need rapid diagnostics, vaccines, & therapeutics.
Vaccines are our best route out of restrictions & can do the heavy lifting. Lockdowns are caused bc of the hospitalisation rate of this virus & the large # of susceptible people -> leads to exponential growth in cases & stretched health services. Vaccines address both. (thread)
Israel is a glimpse of the future & how to lift restrictions sustainably & let people mix -> vaccinate about 85% of over-16 population, start vaccinating children when approval given & build up testing (PCR, lateral flow & wastewater) to keep on top of outbreaks that emerge.
European countries & US sitting on unused AZ supply. They should give these doses abroad to countries that need & will use them. Supply is the biggest bottleneck now to getting vaccines out- not money or logistics. Vaccinating the world will help stop the emergence of variants.
If it's raining outside but modelling tells you it's sunny, do you believe what you can see and the clear data? Triangulation of modelling, observational data, & common sense is vital. More complex doesn't mean more accurate. bmj.com/content/369/bm…
If you have very few people testing positive, positivity is <0.5%, genetic sequencing shows that 1st strains were eliminated, what does this tell you about level of COVID? Or believe complex, untransparent mathematical models w/ predetermined assumptions? heraldscotland.com/news/18931916.…
Some modellers also saying last Jan 2020 that 80% of Chinese population would get COVID-19 and this would be uncontrollable. Guess what? China controlled it. So did Taiwan, Singapore, Hong Kong, S. Korea, Australia, NZ -> the list goes on. Public health measures can and do work.
Scientists investigating whether it's possible to be re-infected with a new variant of SARS-CoV-2 in S. Africa. Antibodies from previous infection didn't recognise new variant in 21/44 cases but 🤞 T-cells might. Precarious position & points towards need for max suppression.
Good news: we know how to control COVID. Countries have done it. We need: restrictions until #s low & buy-in of population that there's a plan, robust test/trace/isolate, and very tight border restrictions. Clear COVID, open domestic economy fully & firefight as outbreaks arise.
Countries that have the resources & political will should clearly eliminate COVID-19. Living with this virus is too dangerous to health & too destructive to the economy and society. Time to pivot from flu plan onto SARS plan. Better now than in a year's time.
Scotland going into strict restrictions tonight for Jan to handle new variant. Children under 12 still allowed to play outside in larger groups and are excluded from 2 person outside limit for meetings.
Schools remain online learning for Jan (except for vulnerable/key worker kids) bc of substantial community transmission (& need to drive this lower) & considerable uncertainty & data gaps about role of children in transmission of new variant. Precautionary approach.
If you want schools back open for in-person learning, please please abide by restrictions so that we can all work together to get community transmission down.
Happy Sunday! ❄️ Bad news: this new variant is spreading quickly & our current restrictions don’t seem to be enough. Xmas & NYE going to make it worse. Please be cautious & keep distancing/avoid indoor/crowded places!! Just need to get through this hardest period until Spring.
We all want schools open. But the challenge is keeping schools open with high transmission. Cases will keep arising in schools & bubbles sent home repeatedly. That’s not sustainable education. We all have to work together to break chains of transmission & get our numbers down.
What should govt be doing? Clear messaging is the start and using the tools we have: vaccines, mass testing, supported isolation, enhanced restrictions with economic support, pausing schools (except for certain groups) for 2-3 week to assess latest evidence & travel restrictions.
Happy Monday! ☀️ This is truly the worst time & normal to feel low- new variant spreading quickly, depths of winter, NHS under pressure. But we will get through with vaccines, testing, weather change in Spring & Summer, & continuing to look out for each other. Better days ahead!
If nothing else maybe European countries will realise by March that the East Asia & Pacific model of managing this crisis is optimal and pivot towards that. They’ve had a year to learn by then. All other roads have led to worse health & economic outcomes.
And in less than a year from detecting a novel virus, we have multiple tests, effective therapeutics & at least 3 vaccines. 👏 Just imagine where we will be in a year from now? It is not hopeless at all- loads of progress has been made. Delaying infections now makes sense.
This view completely misses that lockdown is caused by the high hospitalisation rate of Covid & pressure on health services. Which is also young people ill. And that the case fatality rate can jump to 10% if people, young or old, can’t get medical care like fluids or oxygen.
Happy Friday! ☀️ More good news: Moderna vaccine about to be approved in US & EU. Who would have thought we'd have at least 3 (!) effective & safe vaccines less than a year from identifying completely new virus (SARS-CoV-2)? Science is amazing. bbc.co.uk/news/world-us-…
Still big unknowns: 1. Do these vaccines stop transmission (people being infectious) or just severe COVID-19? 2. How long do they provide immunity for? 3. Will this become a yearly vaccination project for entire populations? 4. Do they prevent Long Covid (morbidity)?
With talk of mutation/strains, scientists concerned about: 1. Will new strain spread faster making suppression harder? 2. Will new strain have worse health outcomes? 3. Will new strain evade vaccine &/or naturally induced antibodies/t-cells?
We don't yet have answers to these.
Keep being asked questions about meeting/travel over the holidays that people want to hear an emotionally reassuring & comforting answer. I can't do that as a public health scientist right now & have to be straight, even if unpopular.
COVID doesn't care that it's Christmas or Thanksgiving. It spreads in indoor, poorly ventilated settings esp households. If you want to safely see family, check local prevalence, get outside for walks, ventilate indoor settings & isolate for 2 weeks before seeing vulnerable ppl.
You can also get tested (Boots, etc) before seeing family/travel but virus incubation period makes this tricky. Could test negative and be infectious & positive the next day. 2 negative tests several days apart can help mitigate risk.
Top German scientists: 1. Herd immunity not possible bc immunity too short. 2. Not feasible to go 'shield vulnerable' approach bc impossible to fully identify & isolate them. 3. Potential serious, long-term damage to young/healthy also from this virus. mpg.de/15426163/stell…
They suggest that what works is: 1. Test/trace/isolate 2. Mask-wearing 3. Distancing 4. Travel restrictions 5. Identifying & stopping super-spreading events. 5. Good guidance to public on what is risky & not.
Receiving notes from those w/ risk factors (asthma, overweight, hypertension, cancer survivors, diabetes) or elderly who are saddened by their lives being portrayed as worthless (ie acceptable loss, would die anyways). Please remember this is not the view of the silent majority.
Things not looking good in the UK (massive understatement). We all need to act like we could have COVID-19 & minimise close physical contact with those outside our household. Need to avoid awful decisions about COVID v non COVID harm.
And if hospitals start filling up with patients arriving needing emergency care, going to put other NHS services at risk. Everyone loses if numbers continue to increase.
I won’t say much more bc I’m sure everyone is sick of my repeating of the same message for months now. But I truly hope we will not pay for all the summer holidays abroad with winter lockdowns. nytimes.com/2020/08/14/opi…
Questions I get from young people: 1. Am I immune from this virus? -> No, you are likely to have mild symptoms, but this is a nasty virus & you could face a long recovery. You don't want to get COVID- you could have an underlying health issues you don't know about. (1/n)
2. Should I just get infected & get an 'immunity passport'? -> We still don't know how long immunity lasts, & there have been some instances of documented re-infection. We don't yet know if 2nd time will be asymptomatic re-infection or more severe & how rare/common it is. (2/n).
3. If only young people are getting COVID, then what's the problem? -> No country has been able to fully shield the elderly/vulnerable as they live with us & among us. Vulnerable young = hypertension, diabetes, asthma, overweight, cancer survivors, immuno-compromised. (3/n)
On a panel & was asked if COVID-19 will help world prepare for the 'real' big one. I actually think SARS-CoV-2 is the big 'Disease X' experts warned about. We shouldn't underestimate the current crisis which has no simple solution.
If it were as lethal as MERS (33% CFR) then all gov'ts would aim to eliminate. If it had similar health outcomes to flu then gov'ts let it go. It falls in-between leading to muddled strategies, conflicted scientific advice & in the process, economy/health both taking a hit.
The challenge is to re-open economy/society while controlling COVID-19. Robust test/trace/isolate supported by face coverings, hygiene & border checks can help. But 'super-spreading' events still a big challenge. E.g. 91 people testing positive from night at club in Barcelona.
To re-open safely, universities have to: 1. Test all students on arrival & 5 days later 2. Mandatory use of face coverings 3. Ventilation of classrooms 4. Ensure monitoring of students during quarantine with app & check-ins (to ensure compliance) 5. Clear outbreak response plan.
Latest alleged comments by Pompeo (US Sec of State) in the UK are blame-shifting- Trump administration rattled by upcoming 2020 Elections with its appalling COVID-19 response resulting in a high number of cases, deaths & unemployment. Are these attacks on WHO fair? (thread)
WHO was established in 1948 as the chief director and coordinator of international health work in the United Nations. It has 3 functions with outbreaks.
First, its International Health Regulations require countries to report outbreaks (China did on 30th Dec), share this info with the world (5th Jan) & it can raise the highest level of alarm-PHEIC (30th Jan). At that point up to countries to prepare (or not to prepare)
I look at what’s happening in several U.S. states including my home state Florida; I look at Israel and Spain and Iran and...and I know that everyone wants the economy to go full steam ahead in the UK. But I fear we will be in another lockdown within months, if not weeks.
Why would the UK be any different? This is what I asked myself also on Feb & March when the UK stayed fully open while others moved in opposite direction. Eliminate the virus over the summer then open up safely. Otherwise enter winter & flu season in a dangerous halfway house.
I know the economy is suffering & jobs are being lost. I recognise the toll that lockdown has taken and I’m not ‘pro-lockdown’ at all. In fact my worry is about a second lockdown & how to avoid this happening. Lockdown/release cycles will destroy society & the economy.