BC SOCIETY
Saved by @jay_millerjay

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 this.

https://t.co/NiNHZV6TDO
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%).
Concerningly, the REACT-1 study data released today show that prevalence of infection across England is now highest in primary school children & young adults, with the drops being less steep in primary school children compared to other age groups.
These data are consistent with outbreak data from PHE surveillance, showing that outbreaks in primary schools & pre-school settings continue to occur (albeit at a lower rate than before in primaries), but much more than in secondary schools- in line with higher attendance.
This evidence also feeds into the second myth we hear about - that primary school children don't contribute substantively to transmission. This simply doesn't hold up to scrutiny. The plot from the PHE shows that the number of clusters of cases has been very similar in both.
We also see from the ONS data that primary and secondary school children had the highest prevalence of infection in the community compared to all age groups in December, prior to school closures -prevalence was 2% among primary school children and 3% in 2ndary school children.
All this evidence strongly suggests that infection among children is not simply 'a reflection of infection in the community'. It makes no sense to think that children are getting infected in their households and not within schools.
It's clear that infection in children closely tracks school openings, closure, & the level of attendance. We've seen this in England time and time again. And it's not just secondary schools. It's clear that primary schools play an important role. What about global evidence?
This comprehensive study in Nature Human Behaviour that looked at thousands of interventions implemented at different time points in >200 countries showed that closure of educational institutions was one of the most effective interventions in reducing R.
https://t.co/ANWt3OiiZv
But what about the impact of closure of preschool vs primary vs secondary schools. There was no difference- all of them were similarly effective in reducing R- and closure of any setting had a substantial impact on reducing R.
We also have evidence from the UK from our last lockdown in November, when schools were open, and regions where the new variant was dominant (as it is across the UK now) were showing increases in cases (R>1). R in these regions dropped to below 1 only after schools were closed.
This real-world evidence is reflected in recent modelling by LSHTM that also suggests that in almost all scenarios opening primary or secondary schools would lead to rises of R above 1 in England.
https://t.co/opkso4Nx2S
It's astonishing that despite all this evidence, the need for mitigatory measures in schools in England has been ignored, and we still promote the myth that primary school settings don't contribute significantly to transmission, and that transmission doesn't happen within schools
We don't have to even look to the 8th of March when the govt is planning to reopen schools. We're having outbreaks in schools now - in preschool & primary school settings. Primary school children have the highest prevalence of infection along with young adults. When will we act?
Want to end on the ONS data on school transmission from last year that showed that primary school children were 2x more likely than adults to be the first case in the household, and once infected, 2x more likely to infect contacts than adults.

https://t.co/suNOYlSYgy
This is some of the least biased evidence we have - as it's based on random surveys of children so not dependent on them being symptomatic, and tested. Why are we ignoring this breadth of evidence to the detriment of children, teachers, and communities?

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Deepti Gurdasani
Deepti Gurdasani
@dgurdasani1
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. 🧵


data shows *both* primary & secondary school teachers are at double the risk of confirmed infection relative to comparable positivity in the general population. ONS household infection data also clearly show that children are important sources of transmission.

Yet, in the parliamentary select meeting today, witnesses like Jenny Harries repeated the same claims- that have been debunked by the ONS data, and the data released by the @educationgovuk today. How many lives have been lost to these lies? How many more people have long COVID?

has repeatedly pointed out errors & gaps in the ONS reporting of evidence around risk of infection among teachers- and it's taken *months* to get clarity on this. The released data are a result of months of campaigning by her, the @NEU and others.

Rather than being transparent about the risk of transmission in school settings & mitigating this, the govt (& many of its advisors) has engaged in dismissing & denying evidence that's been clear for a while. Evidence from the govt's own surveys. And global evidence.

Why?
EDUCATION
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
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Deepti Gurdasani
Deepti Gurdasani
@dgurdasani1
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.
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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.
GOVERNMENT
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

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Summarizing:

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1/ The “I Have a Dream" speech is one of the most extraordinary speeches in American history. You should read it again. First, a few thoughts about the common American heritage Dr. King relied upon in calling Americans to rededicate themselves to the unfinished work of freedom.


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Since a lot of my fellow Texans are going to apply for aid through @FEMA let’s talk about the agency and some of the barriers disaster survivors encounter and persisting program flaws.

First things first, @FEMA is part of the Department of Homeland Security. Here’s a blog I wrote about its history and shortcomings in how the agency is funded:

Many people will be applying for Individual Assistance (IA), but past disasters have shown us that help isn’t evenly distributed and frequently struggles to reach those in deepest need. This unpacks some of the class bias in accepted/rejected apps:

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Patriotism is an interesting concept in that it’s excepted to mean something positive to all of us and certainly seen as a morally marketable trait that can fit into any definition you want for it.+


Tolstoy, found it both stupid and immoral. It is stupid because every patriot holds his own country to be the best, which obviously negates all other countries.+

It is immoral because it enjoins us to promote our country’s interests at the expense of all other countries, employing any means, including war. It is thus at odds with the most basic rule of morality, which tells us not to do to others what we would not want them to do to us+

My sincere belief is that patriotism of a personal nature, which does not impede on personal and physical liberties of any other, is not only welcome but perhaps somewhat needed.

But isn’t adherence to a more humane code of life much better than nationalistic patriotism?+

Göring said, “people can always be brought to the bidding of the leaders. That is easy. All you have to do is tell them they are being attacked, and denounce the peacemakers for lack of patriotism and exposing the country to danger. It works the same in any country.”+
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அஸ்தினாபுரத்து அரசி👸...
@SivaRoobini555
#தினம்_ஒரு_திருவாசகம்
தொல்லை இரும்பிறவிச் சூழும் தளை நீக்கி
அல்லல் அறுத்து ஆனந்தம் ஆக்கியதே – எல்லை
மருவா நெறியளிக்கும் வாதவூர் எங்கோன்
திருவாசகம் என்னும் தேன்

பொருள்:
1.எப்போது ஆரம்பித்தது என அறியப்படமுடியாத தொலை காலமாக (தொல்லை)

2. இருந்து வரும் (இரும்)


3.பிறவிப் பயணத்திலே ஆழ்த்துகின்ற (பிறவி சூழும்)

4.அறியாமையாகிய இடரை (தளை)

5.அகற்றி (நீக்கி),

6.அதன் விளைவால் சுகதுக்கமெனும் துயரங்கள் விலக (அல்லல் அறுத்து),

7.முழுநிறைவாய்த் தன்னுளே இறைவனை உணர்த்துவதே (ஆனந்த மாக்கியதே),

8.பிறந்து இறக்கும் காலவெளிகளில் (எல்லை)

9.பிணைக்காமல் (மருவா)

10.காக்கும் மெய்யறிவினைத் தருகின்ற (நெறியளிக்கும்),

11.என் தலைவனான மாணிக்க வாசகரின் (வாதவூரெங்கோன்)

12.திருவாசகம் எனும் தேன் (திருவா சகமென்னுந் தேன்)

முதல்வரி: பிறவி என்பது முன்வினை விதையால் முளைப்பதோர் பெருமரம். அந்த ‘முன்வினை’ எங்கு ஆரம்பித்தது எனச் சொல்ல இயலாது. ஆனால் ‘அறியாமை’ ஒன்றே ஆசைக்கும்,, அச்சத்துக்கும் காரணம் என்பதால், அவையே வினைகளை விளைவிப்பன என்பதால், தொடர்ந்து வரும் பிறவிகளுக்கு, ‘அறியாமையே’ காரணம்

அறியாமைக்கு ஆரம்பம் கிடையாது. நமக்கு ஒரு பொருளைப் பற்றிய அறிவு எப்போதிருந்து இல்லை? அதைச் சொல்ல முடியாது. அதனாலேதான் முதலடியில், ஆரம்பமில்லாத அஞ்ஞானத்தை பிறவிகளுக்குக் காரணமாகச் சொல்லியது. ஆனால் அறியாமை, அறிவின் எழுச்சியால், அப்போதே முடிந்து விடும்.
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