Authors Bill Hanage

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Bill Hanage
Bill Hanage
@BillHanage
I’ve thought long and hard about this. There is a constellation of circumstantial evidence around the most recently identified variant P.1, and what has been happening in Manaus, Brazil which makes me very seriously concerned. A thread 🧵

First Manaus has already been very hard hit by the pandemic. News reports in earlier stages told of rushed burials and bodies piling up

The crucial thing was the rapid rates of transmission, not really mitigated by ‘flattening the curve’ any. total per capita mortality was not as high as might be expected elsewhere, but only because the age structure of the population in Manaus skews young

(I just did the calculation, the numbers of deaths are quite consistent with independent estimates of age stratified IFRs as per

By October 2020, 76% of the population were estimated to have been infected. This is based on a convenience sample of antibodies found in blood donors. I don’t like convenience samples and the true figure might well be lower, but not a lot lower
WORLD
Bill Hanage
Bill Hanage
@BillHanage
Some recent credible studies from the UK suggest that the variant B.1.1.7 which was first detected there is not only more transmissible but associated with greater severity, measured by deaths. A thread 1/n

The studies on which this is based are summarized in this document. Notably, it is not founded on one study, but several. They incorporate different data, methods and different biases and they are all imperfect, but they point in the same direction. https://t.co/W7fwAxlNrQ 2/n

The upshot is that people infected with B.1.1.7 are about one third more likely to die than similar people infected with the pre-existing viral lineages. There is a LOT of uncertainty around that number. For a lot of reasons. But some increase (even if small) seems legit 3/n

This is consistent with early statements that there was not a large change in virulence. You would not expect to detect a 30% increase from the data available early on (I seem to remember saying there might be some change but not enough to be detected by the current data) 4/n

Of course, if a large number become infected, then a 30% increase really really matters in terms of the absolute numbers of deaths. Instead of the 400k + deaths in the US, we would have 520k+ were they due to a virus like this (<-toy example please don't quote out of context) 5/n
ALL
Bill Hanage
Bill Hanage
@BillHanage
My announcement that I was running with a mask got a LOT of comment (from all sides) earlier. It’s in response to changes in the state of the pandemic and the transmissibility of the virus. Worth unpacking 1/goodness knows


First I posted the photo after a couple of interviews this week in which mask use outside was discussed in the context of surging infections due to the variant B.1.1.7. Here's one


And then this with RTE where were talked about mask use in the context of the situation in the Republic of Ireland, where cases are surging. I commented that I run with a mask. Hence the


Some asked “why are you doing this outside?” – I know where they’re coming from. Risk of transmission is MUCH lower outside. If all contacts were outside there probably would not *be* a pandemic. But it's also not nil


and remember this is also about solidarity. Seeing a person wearing a mask is a sign that they are looking out for you and not just themselves, because masks greatly reduce the risk of transmission
SOCIETY