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. 🧵

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

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.

I posted earlier about Fake Ass getting bullied at school...
So let's take a look at some of his past tweets...the ones he forgot to delete before he became a US operative, US diplomat and clandestine....
These aren't photoshopped these are actual screenshots...

No wonder...

Here he says he was jumped...he has a way with the ladies....
He also says he never touches those girls...what did you really do Omastole, for them to jump you?
He also mentions his wrestling...

Maybe these tweets can give us a clue..
He also tells us his old school...
Linden High...New Jersey.

Linden high school...calas of 2010

For months, but especially after the new CDC school recs came out, supporters of reopening all schools now have been peddling the idea that schools across the country have been open all year successfully. This argument is used to push for ALL schools to be opened now.

A long 🧵

Though some schools in the U.S. are open & doing well with safety protocols, many places used as examples of opening success have profoundly unsafe schools & are neglecting covid safety. Some have been lucky not to have outbreaks and other issues--it's not that they're safe.

In the last few weeks, I've been in touch with teachers in Ohio, Florida, Texas, Wisconsin, New Jersey, Utah, and Pennsylvania.

(Thanks to @eduwonkette_jen @GeoRebekah and @saribethrose for the threads and forums that have helped me meet SO MANY teachers this year).

I collected the accounts of dozens of teachers. Obviously, this isn't an exhaustive list and it isn't a study! It's what teachers on the ground in some states are experiencing. And it's easy to see why so many in our profession are so frightened this year.

Here's the list:

There are currently open schools in the US that are being hailed as "successful" that have:

▪️no safety protocols at all besides contact cleaning, in some districts
▪️some districts with no mask mandate
▪️classes in windowless rooms, some with full classes of 20-30

The Google Doc where the San Francisco school board did it's research for deciding which historical figures to cancel is public, and it's hilariously bad

The best part is the "Notes" tab, where someone lays out why the stated reasons are complete BS.

Case in point: "Lowell High School must be renamed because the namesake was a racist."

Notes: "Yeeeah, no, it wasn't named after that guy at all."

(they voted to rename anyway)

Another example: "Paul Revere led the Penobscot Expedition, which led to the colonization of the Penobscot."

Notes: "What? No. The Penobscot expedition was fought against the British, in Penobscot Bay. The natives weren't involved."

(voted to rename anyway)

"Dianne Feinstein was responsible for evicting an entire Filipino neighborhood!"

Notes: "That happened in 1977. She wasn't mayor until a year later."

(voted to rename anyway)

"Abraham Lincoln executed 38 Dakota Indians!"

Notes: "The Minnesota governor was going to execute *300*. Lincoln intervened when he had no obligation to, and saved the vast majority of them."

(voted to rename anyway)

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.