We've been falsely told 'schools are safe', 'don't drive community transmission', & teachers don't have a higher risk of infection repeatedly by govt & their advisors- to justify some of the most negligent policies in history. 🧵

I'm honestly at a loss as to understanding what our government is thinking & what evidence they're considering in enacting gravely negligent policies that will almost certainly lead to tens of thousands of deaths in the coming weeks. Thread.

To recap - NHS capacity is critical in many places. Hospitals have reported oxygen shortages, and doctors are talking about having to choose who to put on ventilatory support. We have rapidly rising case numbers, >50,000 daily reported cases & 981 deaths reported yesterday.

Let's remember that the impact of socialising over christmas hasn't even begun to show in our numbers yet. And that hospitalisations are indicative of infections that happened ~2-3 wks ago (since then we have been seeing exponential rises in cases).

This means even if we act today, and bring R to below 1 right now, hospitalisations will continue to rise for another 2 wks or so - in line with exponential rises in cases over the past 2 weeks. And deaths will continue to rise for 2-4 wks after we act.

Given current doubling periods, this means very conservatively, 20-30,000 deaths over the next 4 weeks or so, which we sadly can't do anything about now, because most of those who will die during this period have already been infected.

I've been seeing a lot of discussion around the dosage gaps recommended by government for the Astra/Oxford & Pfizer/BioNTech vaccines. My thoughts on the potential benefits & risks of such an approach, and the need for much greater transparency around these decisions. Thread.

The UK govt announced recently that both the Oxford & BioNTech vaccines would be now administered with a gap of between 4-12 weeks (so prioritise administration of first dose, given limited resources).

What is the basis of this?

The basis that's been discussed seems to be that
1) the first dose is likely to confer some degree of protection against disease, so better to roll this out as fast as possible, and
2) that for Oxford/Astra efficacy may be higher when the gap between doses is greater.

I discuss some of the technical details around the Oxford trial below for those interested in these. If you'd just like a summary of this, please skip to the summary tweet titled 'SUMMARY'.

What does published evidence show? The Astra/Oxford data are a bit messy because of protocol changes during the trial. This is because the trial was originally planned as a single dose trial, but a booster dose was added when developers realised that this would likely help.

My thoughts on the govt announcement yesterday regarding a new viral strain potentially driving an increase in cases in London. The claim, at least from listening to the daily briefing seems to be based on the strain increasing in frequency more recently. 1/N

Cases have been rising exponentially in England- much of the increase being attributed to the South, although declines have slowed even in the North following easing of lockdown. Much of this is anticipated, and expected, given the behaviour of the virus. 2/N

SARS-CoV-2, like any other viruses mutates as it multiplies (albeit slower than influenza). Mutations occur randomly and most are 'neutral' - i.e. have little to no effect on transmission, ability to evade the natural or vaccine-related immune response

Having said that, few mutations have been shown to be less likely to be neutralised by plasma from patients infected by the usual (wild-type) virus. Whether this translates to a lower response to vaccines or higher risk of re-infection is unclear at the moment.

Also worth noting that just because a variant becomes more frequent in a region doesn't necessarily mean it offers a fitness advantage to the virus. Many mutations rise to different frequencies in different regions due to random processes. The frequency of strains varies globally

Now, what exactly is an applied epidemiologist, and why are they needed? In the late 90s- early 2000's there were a series of articles in AJPH, AJE, JECH, and IJE dedicated to answering these questions. I'll focus on Stephen Thacker's review.

He states, “The applied epidemiologist is by definition an activist, moving rapidly from findings to policy, putting epi knowledge to good use. The 21st century epi must do all these things while maintaining a foundation of high-quality epi research and practice.”

Susser warns the field of what he considers “the black box paradigm… the current international focus on risk factor epidemiology.” He advocates for expanding our academic training to include socializing epis to “keep the improvement of the public’s health as a primary value”

Morabia argued that epidemiology has historically found its balance in the tension between the search for causal relations and the improvement of public health; overemphasis on either perspective puts epidemiology at risk of losing its value.

How does this play out in real life? I’ve been an applied epi for 13 years, working mainly in local, state, and federal health agencies. My work has focused on conducting cool analysis that lead to policy or systemic change.

I've been serving on grad admissions committees at MIT for 5 years - in EECS and Media Lab

If you want to get into a PhD at a place like MIT, here's a thread with some advice based on my observations

1/13

1. Grades do matter, especially in courses that are important for your chosen field

2. Research matters, even more than grades

3. Publications matter, but letters of recommendation matter even more

4. Your statement of purpose should be the cherry on top of the cake

2/13

When I say grades matter, it doesn't mean that you need 100/100 or A+ in every course. It does mean that you are expected to have strong competence (close to straight A/A+/A-) in technical courses relevant to your field of interest

3/13

While grades show competence, a PhD is about research. So, the more your application demonstrates research potential, the higher your chances for acceptance. It's not about the number of papers (if any), but about the quality of research you pursue

4/13

This is why the best evaluation of research potential often comes from letters of recommendation (LoRs)

Letters shed light on technical competence, creativity, work ethic, & personal interaction. All of which are important for a successful PhD

5/13

Unexpected #Etymology

Words you wouldn't guess are etymologically linked.

An ongoing, continually updated thread 👇🏻

Medicine and remedy both come from the Latin verb medeor, meaning to heal.

Medicine comes from the Old French medecine, from the Latin medicina meaning medicine.

Remedy comes from the Old French remede, from the Latin

Feminism, fawn and fetus both come from the PIE root *dʰeh₁(y)-, meaning to nurse or

Pine (tree) & Piñata (papier-mâché container) both come from the Latin pinus—meaning pine.

Piñata (Spanish), came from piña meaning pineapple, as the paper-covered box resembles one. Piña comes from the Latin pinea meaning pinecone (derived from

Whiskey and wash both come from the Proto-Indo-Euro root meaning "water; wet."

Whiskey (Irish uisce beatha & Scottish uisge-beatha) literally means "water of life."

Wash cames from the Middle English weschen, meaning "to

So I woke up today to learn that the @A2SchoolsSuper has called a snow day. After a four-day weekend. And with tomorrow an "asynchronous" day (i.e., no real school again).

Which might sound reasonable after a storm, except -- there IS no in-person school in Ann Arbor.

In her email, @A2SchoolsSuper said that COVID-19 means "we have missed many of the simple joys that make our time together memorable."

Simple joys? You mean, like seeing friends? Actually learning in a classroom? Heck, like learning at all?

Or having your parents not be quivering messes because they haven't had their kids in school for nearly a year and are at the ends of their ropes? Or not waking up in the middle of the night worrying if the district is ALSO going to limit or suspend in-person school for the fall?

She writes: "Snow days are opportunities for children, young people, and adults to play in the snow, read books, take a break, and enjoy the winter season." You know what adults can't do that? Adults who work. And yes, this burden fall primarily on moms.

Also, we just had a four day weekend! My kids have played in the snow! They've read books! THEY'VE HAD A BREAK.

They don't need those things right now. They need school. We need school.