I've been wanting to write this thread for a while. It has been inspired by hearing a common thought: why can't people just "listen"? If people just followed the rules, we wouldn't be in this mess. I think this is oversimplification of the problem with COVID: 1/

It is true, there are people who haven't been following guidelines (by definition that happened a LOT at Christmas/NYE in my region), but even before, we know transmission in private gatherings happens. 2/
These private gatherings are pictured to be big raucous parties, but in reality, even before lockdown, this is just people having dinner, watching TV, doing things we did before on a daily basis. These little ripples when added across the country make a big wave.. 3/
...and little can be done about this apart from positive messaging. You can't very well have police patrolling neighbourhoods across the country. 4/
Next thing is we keep hearing over and over and over, stay home. There are diminishing returns with this advice, but also, most people who can stay home ARE. So what's the issue? There are a HUGE # of people who can't stay home because they work in essential jobs 5/
These are jobs in factories, warehouses, transport companies, etc. What's worse is that many people who work in these sectors have large households so it can amplify to many people all at once. Neither of these are prevented by lockdown or curfew. 6/
Many workers here go to work feeling unwell (when quite contagious) because the alternative is being off for several days and potentially not having money to pay for essentials. 7/
When compared to the message "Stay home!" we don't hear about the (huge) issue in tweet #6&7, though we are starting to: paid sick leave, community testing blitzes, isolation centres. 8/
Another factor is winter. SARS-COV2 is a resp virus, and like other resp viruses, its spread happens best indoors with prolonged, close contact (enhanced by poor ventilation). This is why historically we see flu or common cold outbreaks especially in winter. 9/
A common thing I hear is that what's happening to us right now is because we "just didn't do enough" or we were "reckless". Sure, some of the problem could be ways we handled outbreak, but there is a lot that was not in our control. 10/
A resp virus which spreads best at and just before the onset of symps (often very mild) means that it's not something we could ever contain in most circumstances. Yep, some countries were successful, but it's complex and goes beyond just, "everyone followed the rules" 11/
Now on to the lockdown: there is a lot of criticism that we "just haven't locked down enough". That may be the case, but going beyond the restrictions we already have, apart from closing essential services, there are few options left. 12/
The curfew in Quebec seems like it would work if your impression of the situation was that spread is happening because people are not staying home. But as I mentioned above, it is much more complex, and this does not address some of the major drivers... 13/
...some that we could act on (occupational safety, paid sick leave, isolation centres etc) and others we can't do much more about without getting heavy-handed (indoor transmission in private gatherings) 14/
Ironically, a curfew could potentially worsen things if more people on average are gathering inside. Unintended consequences are important to consider. A large intervention is often like squeezing a balloon. 15/
Oh and by the way, though no one likes restrictions and lockdowns, it should be said that at some point it definitely becomes necessary to attempt to slow spread and reduce eventual strain on hospitals. 16/
Summary:
1. Pandemic is complex and much more than just people not listening.
2. We should think about things lockdowns/curfews don't address like occupational exposure
3. Advice to reduce contacts currently is important, but is not the only focus of public health response 17/
4. There are many factors we can't control (e.g. weather) that play a big role, so to blame current situation squarely on failure on something we did or didn't do, is not accurate. 18/
This past year I've learned so much about public health and infectious diseases (i'm a specialist in latter, and work closely with former), and I'm still riddled with uncertainty! Ecstatic that vaccination is here and we can see that light at the end of the tunnel! 19/19

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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%).

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🌺श्री गरुड़ पुराण - संक्षिप्त वर्णन🌺

हिन्दु धर्म के 18 पुराणों में से एक गरुड़ पुराण का हिन्दु धर्म में बड़ा महत्व है। गरुड़ पुराण में मृत्यु के बाद सद्गती की व्याख्या मिलती है। इस पुराण के अधिष्ठातृ देव भगवान विष्णु हैं, इसलिए ये वैष्णव पुराण है।


गरुड़ पुराण के अनुसार हमारे कर्मों का फल हमें हमारे जीवन-काल में तो मिलता ही है परंतु मृत्यु के बाद भी अच्छे बुरे कार्यों का उनके अनुसार फल मिलता है। इस कारण इस पुराण में निहित ज्ञान को प्राप्त करने के लिए घर के किसी सदस्य की मृत्यु के बाद का समय निर्धारित किया गया है...

..ताकि उस समय हम जीवन-मरण से जुड़े सभी सत्य जान सकें और मृत्यु के कारण बिछडने वाले सदस्य का दुख कम हो सके।
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तदुपरांत सुर्य व चंद्र ग्रहों के मंत्र, शिव-पार्वती मंत्र,इन्द्र सम्बंधित मंत्र,सरस्वती मंत्र और नौ शक्तियों के बारे में विस्तार से बताया गया है।
इस पुराण में उन्नीस हज़ार श्लोक बताए जाते हैं और इसे दो भागों में कहा जाता है।
प्रथम भाग में विष्णुभक्ति और पूजा विधियों का उल्लेख है।

मृत्यु के उपरांत गरुड़ पुराण के श्रवण का प्रावधान है ।
पुराण के द्वितीय भाग में 'प्रेतकल्प' का विस्तार से वर्णन और नरकों में जीव के पड़ने का वृत्तांत मिलता है। मरने के बाद मनुष्य की क्या गति होती है, उसका किस प्रकार की योनियों में जन्म होता है, प्रेत योनि से मुक्ति के उपाय...