We’re in a new year and we have also entered a new phase of this pandemic. So I thought I’d start off the new year with a quick catch-up thread on the UK variant B.1.1.7 and where we are at in this pandemic.

The variant caught scientists' attention in early December based on a surge in cases around Kent and sequencing data showing it carried a host of mutations. (I wrote about this and how a quirk in the PCR is helping track it here: https://t.co/HupLMpgHPt).
CAVEAT: The pace at which we have learnt about this new variant is astonishing. But it’s important to realize that a lot of crucial lab experiments take longer. Most data now is looking at noisy epidemiological data and making inferences based on that.
Having said that: The picture is becoming clearer.
Good news first: There still is no evidence that the variant causes more severe disease or that it can reinfect people more easily or circumvent vaccine-induced immunity. Still, we need to stay vigilant.
The bad news: The evidence has only become stronger that B.1.1.7 is more transmissible and potentially a lot more transmissible than previously circulating #sarscov2. That has potentially massive consequences for the course of this pandemic.
Evidence comes from this preliminary report from @_nickdavies and others from @LSHTM for instance, showing the variant increasing in frequency across the UK. https://t.co/W8FzqvXYdZ
@_nickdavies @LSHTM "The continued rapid spread of VOC 202012/01 in England to high frequencies (50% or greater in all NHS regions as of 29 December 2020) makes it less likely that the spread of this variant is due to a founder effect or an otherwise selectively neutral effect."
@_nickdavies @LSHTM Recent report by Imperial College makes the same point:
"While rapid growth of the variant was first observed in the South East, similar growth patterns are observed later in London, East of England, and now more generally across England.”
https://t.co/QcyT8CmEb3
@_nickdavies @LSHTM Additional data from Denmark (which like UK is doing a lot of sequencing), suggests they are observing a similar pattern of the new variant spreading fast locally.
https://t.co/HMTNQLXa7R
@_nickdavies @LSHTM While the evidence is convincing that B.1.1.7 is spreading faster there are still a lot of question marks about how much faster. Given the data it’s hard to disentangle the effect of the variant spreading faster and changes in behaviour etc.
@_nickdavies @LSHTM Imperial report estimates what the variant adds to the R of #SARSCoV2 in a number of different ways. As you can see, best estimates range from 0.36 to 0.68. That would mean, on average, every person infected with B.1.1.7 infects an extra 0.36 to 0.68 persons compared to earlier
@_nickdavies @LSHTM Even if the truth turns out to be close to the lower estimates or please, please, please, below that, it is still a big effect. And remember: This is exponential growth, so the effect over time becomes massive.
I don’t think it has really sunk in, how serious this is.
@_nickdavies @LSHTM What does this mean for the pandemic?
Many countries have managed to reduce infections to low numbers by layering a lot of public health interventions on top of each other: teleworking, physical distancing, masks, no large gatherings, some kinds of shutdown etc.
@_nickdavies @LSHTM The idea was that if you do these things well enough, you get the effective reproduction number Rt below 1, so every infected person on average infects less than one other person. That means the virus does not spread and there is some wiggle room to keep schools open for instance
@_nickdavies @LSHTM That wiggle room has just become substantially smaller. If estimates are roughly right, keeping schools open is probably not possible.
Or, if you think of it in terms of the Swiss cheese model, we can afford fewer, smaller holes in the cheese.
https://t.co/FhC5Tw7qwq
@_nickdavies @LSHTM We have entered a new phase of this pandemic. On the one hand vaccinations have started, on the other hand this new variant is spreading faster, potentially causing a lot more sickness and death in a short time. Also: more people will need to be immunised to reach herd immunity.
@_nickdavies @LSHTM It’s not what anyone wants to hear, but the coming months may well be the hardest of this pandemic. If you’ve been thinking of vaccines as the light at the end of the tunnel: Yes, that light is there, as bright as ever. But the tunnel just got a bit darker and a little bit longer
@_nickdavies @LSHTM One addition: This is not the time to throw up your hands in despair and give up. Quite the opposite. We know what we need to do. We just need to do it better. This is the time to draw on whatever strength we have left and redouble our efforts to stem the spread of this virus.
@_nickdavies @LSHTM People love to say how this or that measure is "just postponing” things. Well, with vaccinations underway, “just postponing” things is exactly what we need to do. The variant is probably in many, many countries, but it is still early days and slowing it down will save lives.

More from For later read

Hi @EdinburghUni @EHRC @EHRCChair @KishwerFalkner @RJHilsenrath @trussliz @GEOgovuk

The DIVERSITY INFORMATION section in yr job application mentions 'legal equality duties'. You then ask "What is your gender identity?" with options

Female
Male
Non-binary
Not-listed
Other

1/13


'Gender identity' is not a protected characteristic under the Equality Act 2010 and is not defined in the Act.

https://t.co/qisFhCiV1u

2/13


Sex is the protected characteristic and the only two possible options for sex are 'Female' and 'Male' as defined in the Act and consistent with biology - 'non-binary' and 'other' are not valid options.

https://t.co/CEJ0gkr6nF

'Gender identity' is not a synonym for sex.

3/13


You then ask "Does your gender identity match your sex registered at birth?"

4/13


Again, 'gender identity' is not a protected characteristic under the Equality Act 2010 and is not defined in the Act.

https://t.co/qisFhCiV1u

5/13
#IDTwitter #IDFellows
Introducing our new series: “IDFN top 10 articles every fellow should read”🔖

#1: SAB management
by @mmcclean1 @LeMiguelChavez
Reviewers @KaBourgi, @IgeGeorgeMD, @Courtcita, @MDdreamchaser

We know is subjective & expect feedback/future improvements 👇

1. Clinical management of Staphylococcus aureus bacteremia: a review.
https://t.co/9tBCtp9mlP
👉 A must read written by Holland et al. where they review the evidence of the management of SAB.

2. Impact of Infectious Disease Consultation on Quality of Care, Mortality, and Length of Stay in Staphylococcus aureus Bacteremia: Results From a Large Multicenter Cohort Study.
https://t.co/XujO68pCuH
👉ID consult associated with reduced inpatient mortality.

3. Predicting Risk of Endocarditis Using a Clinical Tool (PREDICT): Scoring System to Guide Use of Echocardiography in the Management of Staphylococcus aureus Bacteremia
https://t.co/otcA1pxjAw
👉Predictive risk factors for infective endocarditis, and thus the need for TEE.

4. The Cefazolin Inoculum Effect Is Associated With Increased Mortality in Methicillin-Susceptible Staphylococcus aureus Bacteremia.
https://t.co/CQZiryVWZz
👉Presence of cefazolin inoculum effect in the infecting isolate was associated with an increase 30-day mortality.
I should mention, this is why I keep talking about this. Because I know so many people who legally CAN'T.

How do I know they have NDAs, if they can't talk legally about them? Because they trusted me with their secrets... after I said something. That's how they knew I was safe.


Some of the people who have reached out to me privately have been sitting with the pain of what happened to them and the regret that they signed for YEARS. But at the time, it didn't seem like they had any other option BUT to sign.

I do not blame *anyone* for signing an NDA, especially when it's attached to a financial lifeline. When you feel like your family's wellbeing is at stake, you'll do anything -- even sign away your own voice -- to provide for them. That's not a "choice"; that's survival.

And yes, many of the people whose stories I now know were pressured into signing an NDA by my husband's ex-employer. Some of whom I *never* would have guessed. People I thought "left well." Turns out, they've just been *very* good at abiding by the terms of their NDA.

(And others who have reached out had similar experiences with other Christian orgs. Turns out abuse, and the use of NDAs to cover up that abuse, is rampant in a LOT of places.)

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#ஆதித்தியஹ்ருதயம் ஸ்தோத்திரம்
இது சூரிய குலத்தில் உதித்த இராமபிரானுக்கு தமிழ் முனிவர் அகத்தியர் உபதேசித்ததாக வால்மீகி இராமாயணத்தில் வருகிறது. ஆதித்ய ஹ்ருதயத்தைத் தினமும் ஓதினால் பெரும் பயன் பெறலாம் என மகான்களும் ஞானிகளும் காலம் காலமாகக் கூறி வருகின்றனர். ராம-ராவண யுத்தத்தை


தேவர்களுடன் சேர்ந்து பார்க்க வந்திருந்த அகத்தியர், அப்போது போரினால் களைத்து, கவலையுடன் காணப்பட்ட ராமபிரானை அணுகி, மனிதர்களிலேயே சிறந்தவனான ராமா போரில் எந்த மந்திரத்தைப் பாராயணம் செய்தால் எல்லா பகைவர்களையும் வெல்ல முடியுமோ அந்த ரகசிய மந்திரத்தை, வேதத்தில் சொல்லப்பட்டுள்ளதை உனக்கு

நான் உபதேசிக்கிறேன், கேள் என்று கூறி உபதேசித்தார். முதல் இரு சுலோகங்கள் சூழ்நிலையை விவரிக்கின்றன. மூன்றாவது சுலோகம் அகத்தியர் இராமபிரானை விளித்துக் கூறுவதாக அமைந்திருக்கிறது. நான்காவது சுலோகம் முதல் முப்பதாம் சுலோகம் வரை ஆதித்ய ஹ்ருதயம் என்னும் நூல். முப்பத்தி ஒன்றாம் சுலோகம்

இந்தத் துதியால் மகிழ்ந்த சூரியன் இராமனை வாழ்த்துவதைக் கூறுவதாக அமைந்திருக்கிறது.
ஐந்தாவது ஸ்லோகம்:
ஸர்வ மங்கள் மாங்கல்யம் ஸர்வ பாப ப்ரநாசனம்
சிந்தா சோக ப்ரசமனம் ஆயுர் வர்த்தனம் உத்தமம்
பொருள்: இந்த அதித்ய ஹ்ருதயம் என்ற துதி மங்களங்களில் சிறந்தது, பாவங்களையும் கவலைகளையும்


குழப்பங்களையும் நீக்குவது, வாழ்நாளை நீட்டிப்பது, மிகவும் சிறந்தது. இதயத்தில் வசிக்கும் பகவானுடைய அனுக்ரகத்தை அளிப்பதாகும்.
முழு ஸ்லோக லிங்க் பொருளுடன் இங்கே உள்ளது
https://t.co/Q3qm1TfPmk
சூரியன் உலக இயக்கத்திற்கு மிக முக்கியமானவர். சூரிய சக்தியால்தான் ஜீவராசிகள், பயிர்கள்