BC HEALTH
Saved by @CodyyyGardner

1. Last NYE was a quiet one for @AmyMcLellan2 & I, after a busy year writing and helping @DavidHHeadley and @LizzieCurle organise @CapitalCrime1

Someone I follow on Twitter shared this story, and we jokingly said we hoped it wouldn’t be another SARS.

 2. A few days later, after watching social media footage coming out of Wuhan, I went for a meeting to plan Capital Crime 2021, and said it was likely we’d have to cancel the festival because of the emerging pandemic. My partners in crime looked at me as though I was unhinged.
3. As the situation worsened, I reconnected with people I knew from my previous life working as a consultant to the medical industry, and it became clear we were witnessing the start of a pandemic.
4. Knowing something about the history of pandemics, I was aware that early intervention, and quick and decisive action were essential. I was asked to write a report for Matt Hancock on the risks of reinfection and long-term ill health caused by coronaviruses.
5. Knowing the public health and economic costs of a pandemic, I joined people like @DrEricDing trying to raise the alarm in February, calling for decisive government action. In the report sent to Hancock, I recommended a 4-week precautionary border closure and lockdown...
6. ...to stop transmission while a robust test, trace and isolate system was established. Basically New Zealand. SARS & MERS suggested the new coronavirus would leave a trail of long-term illness in its wake & based on endemic HCoVs, reinfection was a possibility.
7. @Sir_David_King was complimentary about what I’d written, but when another scientist said, “Why would we inflict a 4-week, 50% reduction in GDP for the flu?”, as this thread highlights, I knew our national response would be directed at tackling the wrong virus. https://t.co/PatwQu233F
8. @Tim_R_Dawson saw some of my alarming tweets and asked me to write an article for @FMConservatives based on the report. This was published on 1st March.

https://t.co/aluQ78ifmA
9. Much of my 2020 was then spent trying to combat #COVID19 misinformation and raise awareness of how the government’s flawed policies could be improved.
10. Over the course of the year I’ve got to know some genuine experts, whose advocacy has been inspiring. @BillHanage has been generous with his time and insight. @dgurdasani1 is an amazing scientist and communicator. She wrangled the John Snow Memo authors...
11. ...and has been a tireless advocate for a better public health response to the pandemic. @Dr2NisreenAlwan has been a voice for those suffering from #LongCovid All of the John Snow Memo authors are worth following.
12. @florian_krammer @AliNouriPhD @EckerleIsabella @GYamey @DebbyBogaert @theresphysics @eyejosh @bealelab @devisridhar @HZiauddeen - all working tirelessly to help us better understand #COVID19 and meet the challenge it poses. Full list of authors here:

https://t.co/8mKkiAOB8C
13. I’ve been vocal on the subject of schools because I don’t like the blind risk we’re taking with children’s health and can’t believe the government hasn’t implemented public health measures recommended by the @WHO and others to protect against transmission in schools.
14. Through this I’ve become aware of other advocates on the issue of school safety. @DrZoeHyde has been a leading voice.

And @SarahDRasmussen whose threads remind me why I love maths.
15. Parents, teachers and union representatives who are trying to make schools a safer place @HoppySaul @germanacanzi @karamballes @cyclingkev @paysupplystaff @DmodosCutter @ConcernedofBri1 @ChrisDo30828241
16. I’ve been impressed by the work @NafeezAhmed @peterjukes @BylineTimes have been doing to expose the dark underbelly of the money, shadowy networks and advisers who have tried to exploit the pandemic or minimise its impact.

https://t.co/XhyeVl7Pug
17. @chrischirp @Sir_David_King @martinmckee @GabrielScally @globalhlthtwit and the other members of @IndependentSage who have given so much time and energy to try and help improve the UK pandemic response.
18. @fitterhappierAJ has been hawkish on immunity and has been proven right again and again. He’s been generous with his time and thinking.
19. And @PRussW1 has been dogged in highlighting reinfection when people were saying it was impossible. It is an important issue we still don’t know enough about.
20. @queenchristina_ @mattprescott @StefSimanowitz who’ve been generous sharing information.
21. @DrDomPimenta for his tireless communication, medical and charity work. Still in awe of your epic #COVIDIOT battles with deniers, Keto nutritionists, Gompertz curve fans and those who believed the virus had ‘gone away’.

https://t.co/qh1n147kYC
22. @DrSimonAshworth @doctor_oxford @rupert_pearse and all the frontline NHS staff at the sharp end of this pandemic. They deserve far more than claps.
23. @mirvatermos @katemeredithp @ahandvanish @LongCovidSOS @keyeri @preshitorian and many others for being voices on the issue of #LongCovid

@itosettiMD_MBA for sharing useful info (and a sense of disbelief at how some governments are failing to respond to the pandemic).
24. And so many others who’ve shared info, insight or laughs to make 2020 a little easier.

I think we’ve all had enough of this pandemic, so I really hope our governments can get a handle on things. Half measures only make things worse & the new variant will punish inaction. https://t.co/Ou2VgaG4A5
25. And looking at the relative success of eradicators such as China, New Zealand, Vietnam, and others, we may want to revise all future pandemic plans.

https://t.co/KPvONwwBqV
26. I hope 2021 is a better year for everyone and that the day will come when we can put this all behind us.

In the meantime, stay positive, keep safe and be kind to yourself and others.
27. Almost forgot @ToryFibs and @Parents_Utd who have done a great job of sharing information on schools and exposing some of the dangerous misinformation out there.

More from Adam Hamdy

Adam Hamdy
Adam Hamdy
@adamhamdy
1. I believe the government is about to make another huge mistake. Where is @UKLabour in all this? I have some questions @Keir_Starmer should be asking urgently. Please RT to raise awareness.


2. Where is the modelling or evidence to support a focused protection vaccination strategy? The government has chosen it as its preferred strategy but it must have considered other options. Will the government publish the data and the alternative options considered?

3. A responsible government will have modelling for 20%, 50% and 80% vaccine coverage, and projections for the number of infections, Long Covid and deaths in each scenario. Where are those models? On what basis has the government opted for the 20% scenario?

4. The government should also have modelled each of these scenarios against a backdrop of low, medium and high community transmission. What is the impact of each vaccination scenario against varying levels of community transmission?

5. There should also be some assessment of incidence of reinfection and likely evolution of variants given different levels of community transmission. What does this assessment tell us?
GOVERNMENT
Adam Hamdy
Adam Hamdy
@adamhamdy
1. I find it remarkable that some medics and scientists aren’t raising their voices to make children as safe as possible. The comment about children being less infectious than adults is unsupported by evidence.


2. @c_drosten has talked about this extensively and @dgurdasani1 and @DrZoeHyde have repeatedly pointed out flaws in the studies which have purported to show this. Now for the other assertion: children are very rarely ill with COVID19.

3. Children seem to suffer less with acute illness, but we have no idea of the long-term impact of infection. We do know #LongCovid affects some children. @LongCovidKids now speaks for 1,500 children struggling with a wide range of long-term symptoms.

4. 1,500 children whose parents found a small campaign group. How many more are out there? We don’t know. ONS data suggests there might be many, but the issue hasn’t been studied sufficiently well or long enough for a definitive answer.

5. Some people have talked about #COVID19 being this generation’s Polio. According to US CDC, Polio resulted in inapparent infection in more than 99% of people. Severe disease occurred in a tiny fraction of those infected. Source:
SCIENCE
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Adam Hamdy
Adam Hamdy
@adamhamdy
1. This thread has been given a new lease of life today. People keep saying, "We can't do #ZeroCovid, it doesn't fit with our way of life."

Look around.

What way of life?

The one we used to have?

The UK has been under varying degrees of restriction since March 23rd 2020.


2. Nearly a year of having our social and economic freedoms curtailed in one way or another. Nearly a year of muted economic activity. Nearly a year of mass death and disease.

#ZeroCovid doesn't fit with a way of life that doesn't exist anymore.

3. The question isn't whether it fits with our old freewheeling ways, but whether it would lead to better outcomes than the UK's current (poorly defined) strategy? Experiences in New Zealand, Australia, Vietnam, China, Taiwan and elsewhere very much suggest it would.

4. #ZeroCovid isn't about what's possible. It's about what's necessary. Decide what's necessary and figure out a way to make it possible. We can't force travellers to quarantine in hotels for two weeks? Why not? Taiwan does. And if that's what's necessary, why aren't we doing it?

5. I've heard some odd things said about #ZeroCovid

Simple-minded clod Matt Hancock said Zero Covid is impossible because no country has had zero cases.

Zero Covid sets out an ambition. It signals a country treats any infections as serious
SOCIETY
Adam Hamdy
Adam Hamdy
@adamhamdy
1. The problem facing Europe & the US isn't a scientific one. Scientists have been clear for months: public health and economic & social wellbeing are best served by policies that supress the virus. The #JohnSnowMemo cites evidence that makes this

2. Some media commentators seek to present the issue of how to respond to the virus in simplistic terms: Lockdown vs Herd Immunity. This a mischaracterisation. The countries that have tackled #COVID-19 best have used a range of public health


3. Almost every scientist acknowledges lockdown equals failure. It is a sign governments have failed to implement the measures needed to allow life to be lived more or less as normal, without risking exponential growth in transmission.

4. There is an active misinformation campaign that is being aided and abetted by certain sections of the media and some politicians. The campaign would have us believe that if we open up and shield the vulnerable, all will be well. This approach has been derided as inhumane...

5. ...by the WHO, and ridiculous by Dr Fauci for many reasons. It is based on faulty logic, and the proponents of this approach have submitted no evidence that it can be achieved nor any practical examples of how they would do so.
SOCIETY
Adam Hamdy
Adam Hamdy
@adamhamdy
1. THE PLAN

We see countries like China & New Zealand succeed by implementing border controls and wonder why our government didn’t do the same. Unfortunately, it’s been following the 2011 influenza pandemic plan, which says...


2. China & New Zealand have international travel (limited in the case of New Zealand) and freight, and rather than delay their peaks, their border controls have helped keep cases to a minimum. Border controls might not work in a flu pandemic, but they worked for #COVID19.

3. Countries that have done well against #COVID19 have high adherence to mask wearing. The pandemic plan tells us the British people won’t bother wearing masks over time so let’s no bother asking them to, eh.


4. Mass super spreading events have been shown to play a significant role in the transmission of #COVID19.

But the pandemic plan tells us they don’t play a role (perhaps the source of Jenny Harries’ comments about Cheltenham?) and therefore the government will not restrict them


5. I call this the white flag clause. Surrender was built into the assumptions behind our pandemic response. The success of other countries has proved this clause completely wrong.
TRAVEL

More from Health

Gadi Schwartz
Gadi Schwartz
@GadiNBC
ADHD, a thread (1)
If you have #ADHD & are struggling please know you’re not alone. This week on @Overview, we're talking about living w/ ADHD & Anxiety during the pandemic & many the stigmas & misconceptions that making things worse.

I was diagnosed w/ ADHD when I was 7. And in so many ways it’s been a blessing. I love my energy, the hyper-focus, the calm I feel in chaos, the ability to & feel emotions so intensely. It’s allowed me to to see the world differently be in a constant state of wonder.(2)

But realizing all that has been a long, difficult journey so figured I’d share some of my own struggles as well as the resources from @HowtoADHD because Jessica's channel has been a game-changer for me.(3)

First off, #ADHD Attention Deficit Hyperactivity Disorder is a dumb description. It implies a deficit in attention & always hyper people. ADHD is a spectrum, & what we all have in common isn’t that we can’t pay attention. It’s that we have trouble controlling our attention.(4)

There are amazing analogies out there, like trying to watch 6 TV’s at once when someone else controls the remote. Or like driving a race car on city streets and spinning out whenever you try to turn.
HEALTH
James Salazar
James Salazar
@JamesSalazarMD
In medicine, reckoning with racism includes reappraising the very syntax we use every day. Proud to add my voice w/ @J_Ikeme and @RWGrantMD in this @JAMAInternMed pub addressing:

Does race/ethnicity belong in the first line of the patient

Some background: I’ve struggled with this question since early in medical school

Medical syntax is designed to communicate information in a predictable sequence with key elements prioritized to facilitate efficient communication and formation of an assessment and plan

2/

From preclinical lectures to Qbank questions to clerkship rotations, race/ethnicity was often prioritized in the same sentence as age + gender.

I grew accustomed to reading/hearing: a 70-year-old Black man w/ history of x, a 50-year-old Hispanic woman presented w/ y.

3/

However, when it came time for me to use race/ethnicity, there was always tension. Race/ethnicity are self/socially-ascribed identities that in clinical practice are almost always assumed by providers based on appearance. I was also concerned about the potential for bias

4/

I wondered how my own care would be impacted or not impacted by my ethnicity (Hispanic) – I have light skin so I’m not sure if my doctors would even identify me as such – but how would my care be different if I was presented as a 30-year-old Hispanic male?

5/
HEALTH
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matthew remski
matthew remski
@matthewremski
A staple of anti-lockdown conspiracism in yoga/wellness is that public health measures are oppressive, authoritarian, and stifling what it means to be human. Masks suppress identity and speech. Vaccines assault the sovereign body. Influencers must rise up against tyranny! /1

Ironically, pandemic management in economies where yoga/wellness is lucrative has been a neoliberal, choose-your-own-adventure mess in which centre-right governments barter with public health to enact a patchwork of half-measures that punish the poor and marginalized. /2

The goal is not universal health rights, or protecting medical systems, or saving as many lives as possible. The goal is to return to business-as-usual, using public health as a pit stop on a productivity race off a cliff. The ice caps aren’t melting fast enough, I guess. /3

Right-leaning governments, like influencers, have assessed the COVID threat with the magical bias of limitless optimism. Then they work to normalize COVID casualties as a new cost of doing business. *This* is what alt-healthers and Qamoms call “socialist”, or “communist”. /4

Centre-right governments and wellness influencers share a goal: get back to the optimism of making productivity heroic and consumption virtuous, without any reflection on structural issues of injustice, or what universal health care funding and standards would look like. /5
HEALTH
\u2744\ufe0f Mac n\u2019 Chise \u2744\ufe0f
❄️ Mac n’ Chise ❄️...
@sailorrooscout
The importance of T-cell immunity!
A recent study has found that after one dose of Pfizer’s vaccine, patients had a strong T-cell response, and a boosted antibody response after their second dose. This is good news for many reasons so let’s read up.

This study found that people’s antibodies were moderately effective against the original strain after their first dose of Pfizer’s vaccine, less effective against the B.1.1.7 variant, and were unable to neutralize the B.1.351 variant. Read what I said, that’s only after ONE dose.

However, they had strong T-cell responses against ALL known variants after the first dose. So why is this important? To recap, T-cells stimulate B-cells to make antibodies. Antibodies are just your first line of defense which is what is initiated when you get a vaccine.

It’s our T-cells that are responsible for long-term immunity. When antibodies diminish after your initial inoculation, your T-cells-will tell your B-cells it’s time to produce more antibodies. As long as your T-cells still recognize this virus and inform your B-cells they need

to produce antibodies, the vaccine is still doing its job. Your antibodies will get built up over and over again. Just FYI your TCRs and your BCRs target different parts of the Coronavirus’ spike protein. Antibodies can prevent infection, your T cell-responses ensure that those
HEALTH
Yohannes #Tigray First
Yohannes #Tigray First
@Yohannes_T_M
@MSF was allowed to enter #Mekelle on 16 Dec & here is their account 👇

"no basic supplies. The local hospital was running at 30 to 40 %, with very little medication"

This is why one of the reason why we demand unfetters #HumanitarianCorridor
#TigrayGenocide

#Adigrat "The situation was very tense & its hospital was in a terrible condition. Most of the health staff had left, there were hardly any medicines &there was no food, no water and no money"
#StopWarOnTigray
#TigrayGenocide
#HumanitarianCorridor
#EritreaOutOfTigray

After 1 month since @AbiyAhmedAli declared victory

"#Adwa & #Axum. There we found a similar situation: no electricity & no water. All the medicines had been stolen from #Adwa general hospital & the hospital furniture & equipment were broken"

#StopWarOnTigray
#TigrayGenocide


"Beyond the hospitals, around 80 or 90 per cent of the health centres that we visited between Mekele and Axum were not functional, either due to a lack of staff or because they had suffered robberies"

#StopWarOnTigray
#TigrayGenocide
#EritreaOutOfTigray
@UN @POTUS @StateDept


"1 woman had been in labour for 7 days without being able to give birth. Her life was saved because we were able to transport her to #Mekele"

It is really heartbreaking to imagine how many of our mothers & sister have lost their lives.

#StopWarOnTigray
#TigrayGenocide
@UN
HEALTH

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My top 10 tweets of the year

A thread 👇

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Kate Julian
Kate Julian
@katejulian
1/ Something strange is happening with people’s sex lives. 20-somethings are having sex later and less frequently than previous generations. I spent several months digging into this for @theatlantic. https://t.co/5ehzmWY9wi


2/ This phenomenon—I’m calling it a Sex Recession—really surprised me. It seemed improbable in the age of Tinder, digital porn, and attitudes that are generally permissive and sex-positive.

3/ What’s happening isn’t exclusively American: Similar trends are being observed in other countries, including Japan, Australia, the U.K., Finland, and the Netherlands.


4/ One cause is obvious: Adults under 35 are less likely to be living with a partner than in recent decades, and more likely to be living with their parents—which, it’s safe to say, isn’t great for one’s sex life.

5/ But I also found other explanations, each with profound implications. The first, unsurprisingly, has to do with internet enticements. Netflix and other online entertainment may be substituting for sex.
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@HiteshAwasthi89
Sri Maha Bhairavar Rudhra alayam, Chengalpet, Tamilnadu

This temple is being constructed merely on the instructions from Bhairava by his devotee Shri Bhairava Siddhantham Swamy. The Temple is fully enshrinedin a transparent glass enclosure..1/n


with Rudrakshas on both the sides of the entrance This temple has a circular Sanctum Sanctorum which has twelve stepseach representing a sign of zodiac and after that twelve steps we find the supreme deity of this temple Sri Kshetra Paata Bhairava. 2/n


Beneath the Bhairava, in the lower level are installed the Ashta Bhairavas, SapthaRishis in the form of stones, and Saptha Kannis in the form of brass lamps. Thereare a number of little blue and white lights in the ceiling that is shaped like a dome.. 3/n


which give an ethereal atmosphere when switched on. The steps representthe twelve signs of the zodiac and when one steps over them to reach thesanctum sanctorum all the doshas pertaining to the horoscope are cleared onceand for all..4/n


The Sthala Vriksham ”Peepal Tree” which is grown on a pedestal, a trident which is considered as Bhairavi, Pancha Mukha Anjaneya, Prathyankara Devi, Subramanya, Rudra Vinayaga, Vaishnavi Devi, Naga Rudra, Eswara, Vana Durga etc. 5/5

#IncredibleBharat
#DekhoApnaDesh
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foone
foone
@Foone
An interesting set of games that I've been vaguely interested in since I was a kid, after seeing one at a friend's house and never being able to find it again, was the BATTLES IN A DISTANT DESERT/BATTLES ON DISTANT PLANETS series.


These are turn-based wargames for windows 3.x, sharing the same engine.
Battles in a Distant Desert is from 1992, and is based on the first Iraq war (Desert Storm)


and Battles on Distant Planets is from 1991, and takes place in SPACE!
I'm pretty sure this is the one I played as a kid.


They've got 3 options to play with:
* Player vs. Player
* Player vs. Computer
* Computer vs. Computer

So it's a 0-2 player game!


They also did a DOS strategy game called "STARDATE 2140.2: GALACTIC CONQUEST" in 1990, but it seems to be lost.
All the games share an experimental AI system based on neural networks.
FUN