Some of us warned at the time that this overselling would lead to vaccine hesitancy by undermining public trust & it did. There was no reason to oversell. Vaccines have prevented deaths in huge numbers- but there was no reason to pretend they alone were enough to protect people.

https://twitter.com/19joho/status/1708545990997815306

We were told breakthrough infections were rare- even when it was clear they weren't. We were told- vaccine immunity was long-term, even though it wasn't and even immunity against severe disease waned over time. Those who pointed this out were relentlessly attacked.

New paper showing that T cells post-COVID can attack antigens in the liver. This could be one of the causes of pediatric hepatitis of unknown etiology. Really important to study this in cases- unfortunately this hypothesis was never investigated properly

sciencedirect.com/science/articl… A recent paper showed that an HLA allele that was found in almost all cases of hepatitis is also associated with a cross-reactive T cell response to COVID. All of this evidence points to a potential role of a post-COVID dysregulated immune response in hepatitis

If you believe that a court of law is 'due process' for victims, then you believe that letting 99% of rapists go free (which are the current statistics) while re-traumatising victims is 'due process'. And that's not even against a celeb with lots of resources & a toxic fan base. Would you take this to court in these circumstances? Put your name down in public - to be vilified by people who'd support him at all costs for perpetuity? Be dragged through social media as a person who made an accusation 'for political reasons' by blue tick assholes?

Just writing about my n=1 experience of making decisions around vaccines with long COVID. Given my POTS, and auto-immune disease I agonised for months whether to take a bivalent mRNA vaccine or Novavax (I was luck to have both available) - XBB updated vax was not on the horizon🧵 I was 6 months out from my COVID infection, and wanted to give myself vaccine protection, but also didn't want to risk worsening of my LC symptoms (there is a subgroup of LC that experiences worsening of symptoms post-mRNA-vax- most temporary, some longer-term).

Really worth going through every single presentation here from ACIP- it's a rich resource of synthesis of evidence on different vaccinations, their efficacy across different age groups, in different eras. Boosters need to be widely across all ages globally
cdc.gov/vaccines/acip/… Some key ones here- showing that monovalents are really ineffective for protecting against severe disease in the current era (VE near 0). Unfortunately in most countries children haven't even received the bivalent, and are woefully underprotected (see UK, Europe, Australia!)

Here are some fallacies that I can see the usual suspects putting out on Long COVID
-"Most people recover from LC"
-"Most LC occurs in those hospitalised"
-"Vaccination has massively reduced the burden"
Thread addressing these: "Most people recover from LC"
Here's a study of patients recruited from an LC clinic where only 7.6% recovered over a 2 yr period, and their median duration of recovery was 1 year (not a quick recovery at all!)
thelancet.com/journals/lanep…

2 v. important studies on COVID and type I diabetes in children out recently in JAMA showing:
-Children infected early in life - 2x higher risk of developing auto-antibodies associated with type I diabetes
-for those infected <18 months risk was 5x higher than those not infected Examining data in >1 million children from medical records, the incidence of type I diabetes diabetes was increased 2x among those infected with COVID-19 in the first 3 months post-COVID, but risk remained elevated up to 15 months compared to those without a diagnosis of COVID.

It's interesting that groups that have gone on about the impacts of school closure say very little about the v. high rates of persistent absences (>10% of school missed) among children- mostly due to illness. 25% of children persistently absent in autumn 2022 in England Overall, termly absence rates in schools have doubled since the pre-pandemic period - if you look at the reasons for this, again it's mostly down to illness.

The minister of state and schools literally thinks that sending children to school with infection will *improve attendance*! Make it make sense!

@NickGibbUK so when a sick person comes into contact with others... more people get sick and stay at home because they are sick. See?

https://twitter.com/bphillipsonMP/status/1696238253244899696

The UK govts attitude towards children and attendance frankly borders on abuse. They want children in schools at any cost- even if they're ill. This isn't a healthy or safe environment for children. It's one of the reasons we chose to move away from the UK.

I've honestly had enough of being bullied here by 'colleagues' for just discussing evidence that should be be discussed not dismissed. The amount of bullying I've been subject to for pointing out that a genetic association is linked to two phenotypes is quite phenomenal. 🧵 I've been called 'unhinged', someone who doesn't follow 'scientific process', making 'wild' theories, 'making up stuff', spreading 'misinformation' for simply stating that an allele associated with COVID severity also associates with hepatitis & presenting a plausible hypothesis.

When you feel entitled to a reply rather than a QT after accusing a colleague of spreading misinformation without providing any evidence for it, and inciting a pile-on on them. And then play victim. DARVO at its best.

https://twitter.com/jillahjillah/status/1683854898021154817

If you make false allegations about me, I will respond and ask for receipts, so have them ready, or don't make accusations you can't back up. I'm not going to lie down and take lazy ad hominems, and be polite about it. Don't ask others to behave a certain way after you bully them

If you were on both papers, it's truly bizarre that you don't actually discuss this as an important avenue for investigation, given your own findings- rather misinterpreting what I said to suggest it's misinformation. Let me present you with quotes from your own study below 🧵

https://twitter.com/jillahjillah/status/1682616955302469632

Your paper literally says "HLA-DRB1*04:01 enhances the effect of HLA-B*15:01." and that HLA-B1501 is associated with "T cell cross-reactivity and pre-existing immunity" and asymptomaticity. HLA-DRB1*04:01 is the same allele associated with hepatitis & lies on the haplotype.

Important study- superspreading can occur oudoors. This is why it's worth masking outdoors in conditions like this, because it's all about context- crowding means higher levels of aerosols, and spread can still happen outdoors if aerosols don't disperse quickly enough.

https://twitter.com/DrZoeHyde/status/1683109881455452160

Identifying such patterns of transmission is rare- not because it's necessarily v. uncommon, but because they require extensive surveillance, including outdoor surveillance, and environments where cases aren't very large in number and testing is good so sources can be identified.

New study in @Nature out yesterday, showing that HLA-B*15:01 and HLA-DRB1*04:01 are associated with strong T cell responses against SARS-CoV-2 & asymptomaticity- guess what other phenotype HLA-DRB1*04:01 has been associated with? Unknown fulminant hepatitis in children.🧵 Remember all those studies in Nature, showing that unknown hepatitis in children was potentially down to a genetic association (and was attributed to Adv)- well the allele that 12/13 cases in one study carried is also related to strong T cell responses to SARS-CoV-2

Our @bmj_latest paper led by @HarrisonDWilde out TLDR;
-21000 hosp admissions from COVID (caused or contributed) in children- England from July 2020-Feb 2022
-children<5 yrs & ethnic minorities most at risk
-admissions⬆️during omicron
- 38% would've been classified as CV by JCVI In this piece of work, a panel of paeds experts meticulously developed criteria for hospital admissions that were either directly caused by COVID, or that COVID contributed to. Unsurprisingly, 76% of all hosp admissions with COVID in children were *from* COVID - 21,000

The burden of evidence should always be on what goes against the precautionary principle- as the default assumption is that precautions are needed in a pandemic. Using precautions in an uncertain situation without clear evidence isn't the same as removing them without evidence 🧵 One is far more harmful than the other. Similarly putting out misinformation about vaccines & minimising the impact of COVID is in no way the same as the 'alarmism' some people like to talk about. Ultimately the harm is asymmetric - it's far more when people aren't protected.

Let's be clear- when MSM talks about a “crack down” on support for sick & disabled people - what they really mean is that they are okay to let disabled people suffer poverty, indignity and death (what do they think will happen without support) because their lives have less value. I'm utterly fed up of the abelism we constantly encounter everywhere and everyday. Everyone is literally one illness away from being disabled. Stop othering people who're disabled- and dehumanising us. Our lives are no less valuable.

Update on what I'm going to now call long COVID symptoms- as it's been 3.5 months since my infection - so am well past the acute stage now. For those who've been following- I've been struggling with breathlessness, chest pain and brain fog post-COVID 🧵 What I've found really debilitating over the past few months is intermittent breathlessness - which occurs on walking, climbing steps, and sometimes just standing up, or walking around the house. It's often accompanied by palpitations (can feel my heart racing), and chest pain.

"continues to follow national guidance"- which is not based on science. The purpose of national guidance should've been to protect patients- rather it protects institutions harming patients by exposing them to a virus associated with ~6-10% mortality for hosp acquired infection.

https://twitter.com/Logical1966/status/1664008352739864582

Imagine being admitted to hospital having no choice - because you need urgent treatment and then getting an infection associated with such high mortality for in-patients. Sadly this isn't hypothetical- it's happened to so many patients already. And the cull continues.

I've been thinking a lot about where a lot of the awareness & engagement on long COVID is coming from. While some scientists have played an important role, it's been grassroots advocacy from those with lived experience that's making a difference. We need to learn from this. 🧵 This has often also historically been the case- patients with ME/CFS have long fought for research and treatments and recognition of the biological complexity of these syndromes because they've been largely failed by the medical and scientific community.

Large study from the US showing higher risk of RSV infections and bronchiolitis post-COVID in a matched cohort of children who had COVID pre August 2022 in late 2022 - suggesting that this may have contributed to the large wave of RSV in children in 2022🧵
medrxiv.org/content/10.110… Many countries have shown disrupted patterns of respiratory infections during 2020-2022- with massively suppressed resp infection in 2020 (due to mitigations), followed by disrupted seasonality in 2021, and very high infection rates in 2022. Here's the US pattern: