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Patrick Kearns Profile picture
Patrick Kearns
@kearnsneuro
Clinician scientist. Epi 🌏 | Neurology 🧠 | Bio 🔬 ECAT/Wellcome PhD student in @chromatinlab @MRC_HGU I study how viruses cause immunopathologies.
Sue Strong @strong_sue@mastodon.sdf.org 🇺🇦 Profile picture 2 subscribed
Jul 19, 2022 • 7 tweets • 3 min read
@Nurledge Once it has been peer reviewed I will do a non-jargon summary. In this manuscript we identify a particular target on the virus associated with severe covid, and the pattern of the antibodies to it is suggests a particular immune process is going on (T independent B activation). @Nurledge We think this might be at least part of the reason why some people get the horrible immunopathology we call COVID-19 (but more work needed to confirm/refute.) If so, we think that this is a promising vaccine target for peptide-conjugate vaccines to prevent immunopathology.
May 12, 2022 • 25 tweets • 5 min read
Re. paed hepatitis.

Hard to interpret % Adenovirus (Adv) PCR from whole blood in kids without knowing the proportion who would be positive in healthy controls. It will be high.

Adv are common and cause relatively persistent infections.

Short 🧵 1/ Also notable that this paediatric hepatitis is likely to be immune mediated (or toxin related) and not a direct viral cytopathy. 2/
Mar 20, 2022 • 40 tweets • 9 min read
New paper from me on Epstein Barr Virus (EBV) and Multiple Sclerosis (MS)

🚨WARNING: shameless self-advertisement 🧵

How can MS be a viral illness and a complex genetic disorder at the same time?

frontiersin.org/articles/10.33… In this paper I tried to explore how some common misconceptions may have arisen:

- MS is a complex genetic disorder, so cannot also be a viral illness. ❌

- EBV is associated with MS, but the evidence doesn’t suggest a causal relationship. ❌
Feb 21, 2022 • 11 tweets • 14 min read
@ENirenberg @pjie2 @jbloom_lab @LongDesertTrain @ProfessorRees Sorry for slowness, I was on call at the weekend. Here's a few but really it's just an absence of seasonal CoVs as major problems for these patients (so there's not a lot of literature on Seasonal CoVs).

thelancet.com/journals/lance…
nature.com/articles/bmt20…
ncbi.nlm.nih.gov/pmc/articles/P… @ENirenberg @pjie2 @jbloom_lab @LongDesertTrain @ProfessorRees Lots of caveats. Anti-CD52 depletes mature B and T cells and re-visiting the childhood vaccination after is typical. Although some caveats there. Not completely immunonaive after treatment.
Feb 3, 2022 • 10 tweets • 3 min read
Hard disagree with the very persistent idea that getting lots of common infections under your belt is good for you.

It's a pervasive hypothesis that has very little data to support it and a lot of data to contradict the predictions it makes. First, the commonness of a virus is chiefly a sociological/epidemiological phenomenon. Viruses that were once common in childhood like measles, polio and smallpox, and viruses that are still common like EBV/CMV/RSV/SARS2 can and do have serious consequences.
Jan 13, 2022 • 9 tweets • 3 min read
Phenomenal paper just published in Science persuasively demonstrating that EBV causes most if not all multiple sclerosis.

Phenomenal epidemiological design and technical achievement. 👏

science.org/doi/10.1126/sc… The association is extraordinarily strong, EBV specific, and temporal. Key evidence that the association is causation. How could you explain this if EBV wasn't causing the vast majority of MS?
Jun 2, 2021 • 33 tweets • 9 min read
Some charts and thoughts....

Scotland has now almost completely vaccinated over 65s. With astonishing uptake.

Charts courtesy of:

travellingtabby.com/scotland-coron… Makes you proud. On the one hand there's plenty of people in Scotland who are a bit daft. But when it comes to collective good, like getting a vaccine during a pandemic, for example, we see 100% with a first dose and 99% with a second dose in the 70-74 category.
Jun 1, 2021 • 4 tweets • 1 min read
Now that we have beta (B.1.351) SARS-2 the betacoronavirus, lets hope that we never see a recombination event with another genus. Say Phi Epsilon the VOC that arises when alpha (B.1.1.7) SARS-2 (the betacoronavirus called alpha, not the genus) recombined with an actual alpha CoV. 😵‍💫🥴
Feb 14, 2021 • 26 tweets • 6 min read
Unpleasant to watch the pile on from UK academics about this tweet. I'm on call and can't get back to sleep so a rant is in order...

Most seem to be missing the Prof's point. The situ is more like measles than flu. The vaccines are spectacularly good. More like measles than flu. A relatively large group of these academic critics seem to have moved dizzingly quickly from asserting that vaccine escape isn't really much of a thing to asserting that of course vaccine escape is inevitable and makes attempting elimination futile for coronaviruses.
Feb 12, 2021 • 6 tweets • 1 min read
I think this is very true. We're all so sick of the pandemic that counting to 10 and re-reading/watching whilst deliberately adopting the most charitable interpretation is also helpful. That said, I do think that for obvious reasons, reasonably plausible but terribly unpleasant scenarios don't tend to get outlined beyond a certain modest badness.

I think the missing scenarios we don't talk about where things get a lot worse skew perceptions of cost:benefit.
Jan 28, 2021 • 10 tweets • 3 min read
The important point made here 👇 about symptom-triggered testing bias has been highlighted before many times, since early 2020, but seems only in Winter was it widely appreciated how important it is. Interesting thread from @jo_jenkinson. Children clearly play their role in transmission and it is obvious that empirical estimates of this will tend to be biased downwards.

Both absolutely and relative to other demographics, because they are much more likely to be asymptomatic and missed.

Jan 12, 2021 • 37 tweets • 12 min read
Short vaccine 🧵:

mRNA vaccines
(Pfizer vs Moderna)

*are very different to*

Adenovirus virus vector vaccines
(Oxford AZ and Johnson&Johnson).

This will matter a lot.

Dosing schedule of one, should not influence the other.

Quick explainer thread. mRNA:

The mRNA vaccines are essentially a transient lipid transfection (nucleic acid parcelled in fats).

If you injected just mRNA, it would get degraded very quickly and wouldn't get into cells. But packaged in the right kind of lipids it can get through the cell membranes. Image
Jan 4, 2021 • 21 tweets • 4 min read
It is trying when mathematicians declare condescendingly that there is no point doing things because their models tell them so. Well maybe some of the assumptions don't hold up. How did that work out for the no additional risk from large events and no point in border controls... During wave 1 cases fell very fast, faster than I think most people were expecting. Particularly in Scotland. Rt was probably ~0.5 until we started easing off.
Jan 2, 2021 • 6 tweets • 3 min read
Why are healthcare workers and the elderly prioritized for vaccines? Well, for different reasons.

Those reasons matter. If you want to go for partial immunization in the elderly I see the strong case that this will protect more people from severe disease. But for HCWs 👇this👇 For the love of God you need the sterilizing immunity in your HCWs to be as good as possible. Reduce their symptom burden but leave them able to be infected and transmit and you risk vulnerable patients, the immunosuppressed, HCWs' families, and open a door to vaccine resistance.
Jan 1, 2021 • 21 tweets • 4 min read
I'm deeply concerned about a strategy to half dose the Pfizer vaccine for the coming months. Particularly in front line HCWs. The rationale, trying to max the number of people protected is clear and defensible but this is really risky. 1/ For reducing severe cases there is no question that getting as many people as possible a 1st dose makes sense. For that reason, I think this strategy may make sense for those at⬆️risk of severe COVID (e.g. elderly/LTC). *IFF* they are also at low risk of onward transmission. 2/
May 6, 2020 • 15 tweets • 4 min read
1/ I've no admiration for the UK over-reliance on modelling to excuse against early and decisive action, and, have at times found Ferguson personally frustrating with regard to this (e.g. confident claims that there was no excess risk in sporting fixtures vs watching in a pub).. 2/ So understand the background frustration at him personally and think it is the correct course of action that he has resigned.
Apr 22, 2020 • 31 tweets • 15 min read
1. @itv's @Peston has been holding feet to flames about the UK's lack of #TestingForCovid19 and shares this per capita league table. UK comes last, amongst 20 countries. But he's getting flak themed: "what's the point in testing "mild" cases"? 2. Speaking as a doctor in the @NHS, and with public health training, I can't see any way to exit lockdown without a BIG increase in public health infrastructure. I think community testing is a key part of that. #TestTestTest