Normally I enjoy the high standards of journalism in @guardian . Not today as disappointed with misleading headline that suggest infections are spreading fastest in children. It'll worry parents/teachers & I doubt most readers will unpick the

The latest REACT1 report shows prevalence of infection in ALL age groups has fallen, including children aged 5-12 from 1.59% in Round 8 to 0.86% in Round 9a. The authors of REACT1 report also (wisely) didn't try to interpret the prevalence figures.
2/
https://t.co/SR9PioFNHd
If this were a research trial you wouldn't place much weight on the age differences in % prevalence because of the wide confidence intervals, i.e. differences weren't statistically significant.
3/
I've previously tweeted on the challenges (& dangers) of interpreting surveillance data. One would need lots more contextual info to make sense of it & arrive at sound conclusions.
4/
https://t.co/CRW6uFXUdf
Undoubtedly some will extrapolate from the prevalence of infection figures in children to other settings i.e. schools based on the headline. I'd advise caution as there is a real risk of over-interpretation through extrapolation of limited data. Association is not causation.
5/
What REACT1 can’t tell us is how infectious children are or how much child infections drive the pandemic. Finding viral RNA on PCR from a child tells you nothing about how much virus they are shedding. Neither can it tell you the direction of transmisison (who infected who).
6/
Those of us in public health are well familiar with Bradford Hill criteria for causation that outlines key factors to consider. It would make sense to apply this approach to this issue.
7/
Is there CONSISTENCY? What’s been reported has been mixed, but @ECDC_EU , @CDCgov , @RCPCHtweets & other expert review groups have concluded the balance of evidence suggests kids aren't key transmitters of infection.
https://t.co/llVkHkwrRS
https://t.co/c8oOgua9FE
8/
Is the SPECIFICITY of the association or are there other confounders? Indeed the REACT1 report clearly show there are multiple other drivers such as deprivation & household size, etc...

9/
What about TEMPORAL SEQUENCE, i.e. does a rise in school outbreaks then follow a rise in community outbreaks? We aren’t seeing that.
https://t.co/VPbAmsbApG
10/
For me what also matters is PLAUSIBILITY & COHERENCE with what is known about the natural history and biology of the disease. Studies have shown that kids, being smaller, produce far fewer aerosols than adults. They also shed less virus than others.
https://t.co/Rv1e2VfJi6
11/
And also

https://t.co/GHa0FoJ34m
https://t.co/vW1b7j9p9j

And we know symptomatic persons shed more virus. So it follows that an adult is more likely to infect a child than the other way.
https://t.co/NpVoTakbzs

12/
This isn't to say that infections from children to adults don’t happen. Of course they do, but at much lower levels than the other way around. We mustn't lose sight of the fact that adults still account for the bulk of infections.

13/
We know that of all settings, household transmission is the highest risk. If infection is introduced into the household the majority of household members are likely to get infected. Community transmission matters.
https://t.co/OvWN28MZ0Y
https://t.co/fEOOvn6eE0

14/
This in no way refutes need for public health measures in schools to reduce risks of infection. Yes precautionary principle is important but need to balance both benefits & harms. Measures must be proportionate to actual (rather than perceived) risk.
https://t.co/VkugKMnS9R

15/
See also @apsmunro's excellent thread that outlines the evidence base.

https://t.co/VkugKMnS9R

More from Education

I held back from commenting overnight to chew it over, but I am still saddened by comments during a presentation I attended yesterday by Prof @trishgreenhalgh & @CIHR_IMHA.

The topic was “LongCovid, Myalgic Encephalomyelitis & More”.
I quote from memory.
1/n
#MECFS #LongCovid


The bulk of Prof @Trishgreenhalgh’s presentation was on the importance of recognising LongCovid patient’s symptoms, and pathways for patients which recognised their condition as real. So far so good.

She was asked about “Post Exertional Malaise”... 2/n

PEM has been reported by many patients, and is the hallmark symptom of ME/CFS, leading many to query whether LongCovid and ME/CFS are similar or have overlapping mechanisms.

@Trishgreenhalgh acknowledged the new @NiceComms advice for LongCovid was planned to complement... 3/n

the ME/CFS guidelines, acknowledging some similarities.

Then it all went wrong.
@TrishGreenhalgh noted the changes to the @NiceComms guidance for ME/CFS, removing support for Graded Exercise Therapy / Cognitive Behavioural Therapy. She noted there is a big debate about this. 4/n

That is correct: The BMJ published Prof Lynne Turner Stokes’ column criticising the change (Prof Turner-Stokes is a key proponent of GET/CBT, and I suspect is known to Prof @TrishGreenhalgh).

https://t.co/0enH8TFPoe

However Prof Greenhalgh then went off-piste.

5/n
It appears to be a combination of some of these factors, along with others not mentioned here. Ibn Khaldun’s analysis appears to be a good foundation to go off. [Thread]


Ibn Khaldun makes an important distinction between what he calls العُمران الحضري and العمران البدوي, which, for convenience’s sake, I’ll translate as urban civilisation and rural/Bedouin lifestyle.

He notes that the rural world is largely nomadic, and, as such, Bedouins build character traits that assist the survivalist lifestyle — e.g. the fact that they have to kill snakes that might pop up at any time during their travels helps them build courage and bravery.

The lack of stability and a proper settlement means they don’t really have the luxury of sitting down to let their minds wonder around. They thus build a preservation mindset, which manifests itself through emphasis on memorisation and transmission.

Inhabitants of urban world, on the other hand, are largely settled and established. This means they face less attacks from snakes, lions or danger of human attack from other tribes. Thus, they don’t build the courage and bravery of the Bedouins.
This seems like a positive base from which to #BuildBackBetter


https://t.co/OwpgNh8mEu


https://t.co/7eOi1Bv3bM


https://t.co/GhxVgLuWJE


https://t.co/ymHp910wrC

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I just finished Eric Adler's The Battle of the Classics, and wanted to say something about Joel Christiansen's review linked below. I am not sure what motivates the review (I speculate a bit below), but it gives a very misleading impression of the book. 1/x


The meat of the criticism is that the history Adler gives is insufficiently critical. Adler describes a few figures who had a great influence on how the modern US university was formed. It's certainly critical: it focuses on the social Darwinism of these figures. 2/x

Other insinuations and suggestions in the review seem wildly off the mark, distorted, or inappropriate-- for example, that the book is clickbaity (it is scholarly) or conservative (hardly) or connected to the events at the Capitol (give me a break). 3/x

The core question: in what sense is classics inherently racist? Classics is old. On Adler's account, it begins in ancient Rome and is revived in the Renaissance. Slavery (Christiansen's primary concern) is also very old. Let's say classics is an education for slaveowners. 4/x

It's worth remembering that literacy itself is elite throughout most of this history. Literacy is, then, also the education of slaveowners. We can honor oral and musical traditions without denying that literacy is, generally, good. 5/x