BC GOVERNMENT
Saved by @CodyyyGardner

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.
It also means that we will almost certainly breach NHS capacity (if we haven't already), because the situation will worsen at least for the next couple of weeks. And that is if we take decisive action TODAY.

What is decisive action?
Data from the last lockdown, and what we know about the new variant strain makes clear that current restrictions are not sufficient. They were not sufficient to contain increases in cases in SE England then, and we haven't seen any plateauing of cases despite tier 4 restrictions.
While tier 4 restrictions have only been in place for a limited period of time, previous experience from lockdown suggests this won't be enough, and given the current situation, we don't have time to squander time to see if these have the desired effect or not.
Even flattening the curve isn't sufficient- given current rates of transmission. We need to go hard and fast. The speed at which we reduce transmission will determine the number of lives saved. The evidence that schools have contributed to transmission is incontrovertible.
Highest rates of infection in primary & secondary school children. Rises in infection in these age groups during lockdown. Yet, we've done nothing to address this. Shutting down schools now could save thousands of lives. I know shutting schools isn't what anyone wants to do.
I understand the hugely damaging impact on children, and families. But scientists, parents, teachers have all been asking for schools to be made safer for months, and the government did nothing. Now we're at a point, where if we don't do this, thousands more will die.
This isn't an exaggeration. This is sadly where we are. With this more transmissible strain, we need all measures possible to control spread. Half-way measures won't be enough. We've already squandered away valuable time.
Let's also remember that this variant is rapidly increasing in frequency in other parts of the UK now, including Wales. We know that increases in R directly correlate with variant frequency. We can expect the exponential rate of growth to increase even further, given this.
This means the doubling time isn't likely to remain constant- it's likely to increase over time if we don't act. Every day of inaction costs hundreds of lives in the future. If the government doesn't act now, its policy is equivalent to accepting mass infection & mass death.
Can't possibly overemphasise the urgency here.
When will government act on this? Both SAGE & @IndependentSage have urged urgent action.

Are we prepared to do nothing, and watch helplessly while thousands die of negligence?
Sorry, just want to mention that in the earlier tweet, I meant doubling time is likely to decrease *not* increase over time (in line with increase in R) - thanks to @RodneyP72773409 and @GeorgeChiesa for pointing this out.

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Deepti Gurdasani
Deepti Gurdasani
@dgurdasani1
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.
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Deepti Gurdasani
Deepti Gurdasani
@dgurdasani1
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
GOVERNMENT
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Deepti Gurdasani
Deepti Gurdasani
@dgurdasani1
Thread on the recent report on the possible risk of increased death associated with the new UK variant (B117)- with a discussion of the evidence around this, and what this means.

First, there is strong evidence to support increased transmissibility of B117 - current estimates of increased transmissibility range between 30-70% - from epidemiological evidence examining the differential rate of growth of B117 with respect to other variants & increase in R

There is also evidence from PHE contact studies that the risk of transmission from those carrying the B117 variant is ~50% greater than with other non-B117 variants.

Increased transmissibility, even if a variant has the same fatality rate can increase deaths substantially, because the rate of growth of cases is higher- & more cases means more deaths.

Increased fatality rates also increase deaths- but do so


So how was risk of death with the variant studied?
We don't routinely sequence all samples for the virus. We've found that the variant has a particular deletion which means that some PCR tests on samples with the variant give a different read-out when the variant is present.
SOCIETY
Deepti Gurdasani
Deepti Gurdasani
@dgurdasani1
This is the exact problem with our government's thinking & response- despite this strategy of 'tolerating deaths' and half-way measures having spectacularly failed, it's quite amazing that our govt still hasn't learned anything, & continues to promote a policy of death. Thread


Had we adopted an elimination strategy early on, rather than one of tolerating a certain level of infection, we wouldn't be here now. The reason we're here is because the govt never committed to elimination.

We eased lockdown in May when infection levels were much higher than when other countries in Europe did this. The govt was warned about this, but did this to 'help the economy'. Not only did this lead us into the 2nd wave, the need for further lockdowns harmed the economy further

It's very clear from global evidence that we cannot 'tolerate a level of community transmission' and maintain 'R at or just below 1', which has been our governments policy for a long time. This isn't sustainable & very rapidly gets out of control, leading to exponential rises

Coupled with late action to contain these surges, not only does this lead to many more deaths, and much more morbidity with Long COVID, it also creates a fertile ground for viral mutations to accumulate with a greater risk of adaptation, which is exactly what happened in the UK
GOVERNMENT
Deepti Gurdasani
Deepti Gurdasani
@dgurdasani1
Brief thread to debunk the repeated claims we hear about transmission not happening 'within school walls', infection in school children being 'a reflection of infection from the community', and 'primary school children less likely to get infected and contribute to transmission'.

I've heard a lot of scientists claim these three - including most recently the chief advisor to the CDC, where the claim that most transmission doesn't happen within the walls of schools. There is strong evidence to rebut this claim. Let's look at


Let's look at the trends of infection in different age groups in England first- as reported by the ONS. Being a random survey of infection in the community, this doesn't suffer from the biases of symptom-based testing, particularly important in children who are often asymptomatic

A few things to note:
1. The infection rates among primary & secondary school children closely follow school openings, closures & levels of attendance. E.g. We see a dip in infections following Oct half-term, followed by a rise after school reopening.


We see steep drops in both primary & secondary school groups after end of term (18th December), but these drops plateau out in primary school children, where attendance has been >20% after re-opening in January (by contrast with 2ndary schools where this is ~5%).
SOCIETY

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(Thread) Mid-2020 GITMO Update: Arrests, Indictments, & Executions


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Tyler Rogoway
Tyler Rogoway
@Aviation_Intel
Let me take a stab at this after years of reporting on Marine One, HMX-1, Continuity of Government, etc. None of this is definitive, but it could help explain what folks are seeing:

1.) HMX-1, which flies the VH-3D and VH-60N 'White Top' helicopters used to move... 1/X


the President and VP around, those helos being called Marine One or Two when either is onboard, need to train. The urban landing zones, including WH and VP Residence, are not simple to get in and out of. So, crews need some currency training. They are not just tasked with... 2/X

moving POTUS and VP to get them around the region and to Andrews AFB for long-haul flights, they are essential to Continuity of Government operations. This means that if a threat were to emerge, they need to be ready to snatch POTUS and VP in minutes. This is partially... 3/X

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2.) Considering what happened last week, including mobs of Trump supporters screaming in unison to hang the VP for doing what the constitution states, absolutely despicable in every way, security has been tightened just as it has been all over. Using the helicopters instead.. 5/X
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(((EugeneFreedman)))
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@EugeneFreedman
This NYT interview with Dr. Fauci blows the biggest hole possible in @Ken_Rosenthal's reporting from 10 days ago.

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"in time to start the season."

Within a day or two the Union had its own meeting with government officials. That was already reported, although perhaps not as widely as the original pieces claiming the Union didn't want to talk to government officials. In a previous thread 3/

I explained that the Union did not want to be on the same call with management because it would lead to the parties posturing on the call, rather than having an honest discussion with the experts, including Fauci. The Union never avoided the discussion, it just wanted 4/

a separate discussion, not a negotiation in front of COVID experts.

But, this interview undermines the original reporting further.

Fauci told the NYT:

The only thing I said was that, from a public health standpoint, it looks like the cases — if you look at the plotting of 5/
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BLMChicago
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A lot is happening in Chicago. Mayor Lori Lightfoot Emanuel gave over 65% of CARES Act money to CPD. Today, the Office of Inspector General released their report on the uprisings where it is revealed how Lori is directly responsible for the brutality.

Page 55 documents how during the May 30th protests, CPD refused a person their seizure medication, watched them collapse and threatened another detainee with violence if they moved, presumably to assist the person having a seizure. Footage then records a cop threatening rape.


When Lori demanded the bridges be raised, it forced CDOT to call off duty employees. This was a move they were surprised to receive since it is rarely done. The raising of bridges was considered during the NATO protests in 2010 and was ultimately rejected as ‘ineffective’.


The raising of the bridges created the conditions where police battered people including lifting one person by his neck and throwing him to the ground before dragging him through horse manure.


In the same footage as the person having a seizure, CPD responds to another officer saying they should “shoot the occupants of the vehicle in the head”.
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