there are many things I would not have believed about the pandemic pre 2020, but top of them is the fact that Western nations would completely ignore 24 months worth of *actually implemented* policies that were vastly more successful

I've had people mention rising case numbers in Japan and South Korea. But let's really put that rise into perspective. Nations that have early accepted that #COVIDisAirborne simply fair better

Yes, Neoliberal John Snow wins the Internet today H/T @gregggonsalves Reminds me of this….

Update: Switzerland now reports deaths by booster status. Compared to unvaccinated people, the COVID mortality rate is: • 9x lower after full vaccination • 48x lower after a booster [From our post with @maxcroser on death rates by vaccination status: http://ourworldindata.org/covid-deaths-by-vaccination…]

Update on Omicron by Dr @mvankerkhove from @WHO's Q&A

The rise of Omicron Translated from @numeroteca

Impact of social distancing OVER a month. 15 vs 406 infections. See below and avoid gatherings

It was always likely that immunity to COVID-19 would wane, and we now know the median time to waning is around 1.5-2 years post infection for most people, sometimes less

And the ones who did die? Well we don't hear so much from them.

That whole opening up going well for Australian inbound tourism then. https://wwwnc.cdc.gov/travel/notices/covid-4/coronavirus-australia

where is the longer term plan for actually making our environments safer to enable us to mix more safely? e.g. cleaner indoor air? better building design for all new builds? We need to take *positive steps* to enable return to normal - not just pretend that Covid has gone away.

This makes it so clear that the release of *all* measures right now (esp masks, esp schools) is only to protect himself & his job. Boris has zero interest in protecting others from getting sick, needing hospital or dying. Or protecting businesses, schools, NHS from disruption.

Hope springs eternal.

I took a look at all these NY sequences. I don't think these point mutations S:681H are real. Why? Because they appear all over the Omicron diversity. Some sequences have S:346K, some S:701V, most miss S679K, a few have it. That's the signature of contamination/co-infection.

Kids account for <0.2% of cancer deaths in US Kids account for <0.2% of heart disease deaths in US Kids account for <0.3% of all deaths in the US

This would be an astonishing percentage if @trvrb is right that only 1 in 4 or so cases detected in US.

No RCTs necessary to slay all you myocarditis downplayers

75 years of research on human diseases in 1 minute

Pretty big difference US vs UK in this wave. Vaccination differences likely a big part of it.

Version with fewer ages and the CIs plotted:

I hate it when I have to keep increasing the y-axis... #Omicron is #NotMild #LongCovidKids #SpotCovid

Just under a million boosters given. 4 confirmed myocarditis cases, 9 under review. All 4 have recovered.

Booster coverage by deprivation and age in England @IndependentSage

Great thread by @flodebarre on latest genotyping results in France: shows a small increase in potential B.1.640.2 during December in southern France thats now on the decline as Omicron is growing

For those interested first upload of B.1.640.2 onto GISAID was on 4th Nov 2021 from Paris by Roquebert et al, first uploaded Omi was almost 3 weeks later on 22nd Nov 2021 from HK by Alan et al

and as @shay_fleishon pointed out there havent been any new sequences uploaded since before Christmas... this virus has had a decent chance to cause trouble but never really materialised (as far as we can tell at least...)

Lots of chat about B.1.640.2 in the last few days - just a few points to keep in mind: - B.1.640.2 actually predates Omicron - in all that time there are exactly... 20 sequences (compared to the >120k Omis in less time) Def not one worth worrying about too much at the mo...

And for age 0-5...

NL is slightly behind the UK re #omicron and based lockdown on a.o. this model (source @MarionKoopmans). Despite uncertainty the ‘continue as is’ effect on ICU beds occupied (red) is chilling. Green model is with lockdown after and blue is before Christmas. Decisiveness matters!

Some useful tips from me

This is much better. #COVIDisAirborne https://who.int/news-room/questions-and-answers/item/coronavirus-disease-covid-19-how-is-it-transmitted

What you guys keep saying for coronavirus immunity versus what keeps happening

Interesting. From this afternoon in @nytimes: https://nytimes.com/2022/01/01/us/omicron-covid-holidays-surge-testing.html

Much less loss of smell and taste with Omicron, but more sore throat than with Delta https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/1046623/Technical-Briefing-34-14January2022.pdf… @UKHSA symptom data from ~175,000 Omicron and ~88,000 Delta cases

Maryland - just awful to watch what's unfolding. Now at *1714* hospitalizations 130 in 24 hrs. 16.5% test positivity. Some counties have acted but no statewide policy! No measures to slow the spread. https://coronavirus.maryland.gov

BREAKING: U.S. reports 400,000 new coronavirus cases, the biggest one-day increase on record, with some states yet to report

544 children with #COVID19 were admitted to U.S. hospitals yesterday— this shattered the previous single-day record that was set 2 days ago (421) source: HHS (https://healthdata.gov/Hospital/COVID-19-Reported-Patient-Impact-and-Hospital-Capa/g62h-syeh…)

#COVID Update: -339,853 Test Results Reported -76,555 Positives -22.53% Positive -7,919 Hospitalizations (+546) -80 new deaths reported by healthcare facilities through HERDS

meet @michaelmina_lab for detailed info on what LFTs are for... https://twitter.com/michaelmina_lab/status/1477831287482241032?s=20

There are sone issues with data from Wales and Northern Ireland covering the holiday weekend, but still, wow. U.K. breaches the 200k daily cases mark for the first time.

I can tell you for a fact that it isn’t ‘mild’ for everyone.

How many more days until Rhode Island's cases line exceeds the word "exceeds" in the text header?

Our 6 year old is fully vaccinated He has been in in-person daycare & then elementary school since June 2020 Both daycare & school have required a mask; he wears a well-fitting, comfy 2 layer mask with a KN95 filter as a middle layer—he has had no problem wearing one

Thank you @j_g_allen for continuing to advocate for childhood vaccination & for sharing evidence on masks Yesterday, the U.S. saw a record number of COVID-19 pediatric hospital admissions, almost 1,000 Unvaxxed kids are 10 X more likely to be hospitalized than vaxxed kids 1/2

In medicine this is what we call a conflict of interest.

Good news: admissions for flu not quite as tiny as last year, but close. https://gov.uk/government/statistics/national-flu-and-covid-19-surveillance-reports-2021-to-2022-season…

3. The geographic breakdown shows some variation, but not tons. The middle of the country has more Delta than anywhere else. The @CDCgov Nowcast can be found here: https://covid.cdc.gov/covid-data-tracker/#variant-proportions…

2. The @CDCgov Nowcast suggest that 98% of what's out there right now is #Omicron. Less than 2% is Delta. Nothing else currently being spotted.

1. #Omicron's takeover was stunningly rapid and is now nearly complete, at least in the U.S. The latest "Nowcast" from @CDCgov (which uses recent data to model what's happen now) suggests most of what is circulating here now is omicron.

5/ PS. As indicated in the chart, even with a booster, vaccines are less effective against Omicron than against Delta. This makes N95 or KN95 masks that much more important.

4/ Notably, staff seem to be okay. They were required to wear N95s (but students could ware any ole mask). It will be interesting to see if this holds.

3/ The takeaway should be to get your booster if you qualify (eg, based on when you got your last shot). Also, wear N95s or KN95s. I wish my kids’ middle & high schools had required at least KN95s. Rumor is that a third of the high school is out w/ positive Covid.

2/ This chart speaks to infection, not hospitalization. Thus, those who were double vaxxed early on (but are not yet boosted) may still have some protection against hospitalization—just not against infection, & it’s unclear how much that protection against hospitalization is.

This chart says it all. If u got double vaccinated early on & are not yet boosted, ur effectively unvaccinated against Omicron infection. Thus, many adults & teens are effectively unvaccinated against infection. Kids got vaccinated recently & thus may be in a safer position. 1/Quote Tweet

Simple as pie.

A week later and NY State data still showing an extremely high hospitalization VE in the face of Omicron.

Following evidence is that peak infectivity with Omicron comes 3-6 days after symptoms emerge (https://niid.go.jp/niid/en/2019-ncov-e/10884-covid19-66-en.html…), the isolation period is cut to 5 days. How is this 'following the science'

Given ~680k cases per day, this would in turn suggest 0.8% or 1% of the US being infected with SARS-CoV-2 every day. This would translate to perhaps 5% or 10% of individuals currently infected with SARS-CoV-2 in the US. 15/15

I don't have a good sense of how well testing infrastructure held up in London and how this compares to the US, but in general, this would suggest to me to be using something closer to 1 in 4 or 1 in 5 for reporting rate in the US rather than the 1 in 10 I've seen floated. 14/15

This fits with case reports suggesting a large fraction of symptomatic infections for Omicron (https://eurosurveillance.org/content/10.2807/1560-7917.ES.2021.26.50.2101147…, https://medrxiv.org/content/10.1101/2021.12.22.21268021v2…). 13/15

This suggests to me that despite severe outcomes being more rare with Omicron and despite a huge surge in cases that reporting rate for Omicron in London remained fairly stable and did not differ hugely from Delta. 12/15

Importantly if we look at this ratio in Dec during which time Omicron became predominant and case loads increased dramatically, we see that both prevalence and cases increased in tandem and the ~35X ratio was largely maintained. 11/15

If we assume the average infection tests positive for ~10-days (based on @stephenkissler et al https://nejm.org/doi/full/10.1056/NEJMc2102507…), we get an estimated reporting rate of 10/35 = ~29% or very roughly detecting 1 in 3.5 infections as a case. 10/15

We can plot the ratio of prevalence to cases with this 0-day lag to arrive at the following picture through time, where there's some variation, but a ~35X ratio of daily prevalence to daily cases is decently consistent. 9/15

We can compare timeseries of prevalence to cases since Oct 2020. Here we observe a 0-day compatible lag between specimen collection date for cases and prevalence. 8/15

In late December, London had ~26k daily confirmed cases, or 0.3% of the population being recorded as confirmed cases every day. 7/15

Recent data from late Dec from London had ~9% of individuals positive by PCR for SARS-CoV-2. So roughly 1 in 11 people with infections with detectable virus in London. 6/15

Here, I'll be comparing @ONS survey data to @UKHSA case counts in a dataset compiled by @seedragons and available at https://github.com/seedragons/london_covid… (and supplemented with data through Dec 31 via https://ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/conditionsanddiseases/datasets/covid19infectionsurveytechnicaldata…). 5/15

However, the single best study I'm aware of for estimating reporting rate is the ongoing @ONS study in the UK that mails swabs to a fraction of households regardless of symptom status (https://ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/conditionsanddiseases/methodologies/covid19infectionsurveypilotmethodsandfurtherinformation…). 4/15

Historically, I have assumed that around 30% of infections in the US are reported as cases. This number was derived from seroprevalence and modeling estimates from sites like (no longer updated) https://covid19-projections.com. 3/15

However, a large fraction of infections, symptomatic and otherwise, don't end up reported as cases due to lack of testing (either the individual doesn't seek testing or testing is desired but not readily found). 2/15

With Omicron, case counts in the US and many other countries have skyrocketed. The US 7-day average is now ~680k cases per day, or 0.2% of the population recorded as confirmed cases each day. 1/15

astonishing

Omicron was dominant everywhere in England by Christmas

#COVIDCO2 Quick reference table of rebreathed fraction of air from CO2 measurements, assuming office work levels of oxygen consumption

Here’s the rebreathed fraction of air table from the all-knowing @DavidElfstrom

https://ventilation-mainz.de More than 300 such systems now installed in German schools...if you find this too complicated a simple #corsirosenthalbox filter system will help and can be built in a matter of minutes...https://youtu.be/PtelygpNJQw... failing that windows open + wear masks!

Today at 4! "COVID-19 Vaccines: Science versus Anti-Science" with @PeterHotez. Presented by @huckinstitutes

Our new study: heterogeneous vaccination strategy with inactivated vaccine + mRNA booster elicits strong B and T cell response against the WT and VOC including Omicron @VirusesImmunity

Join the discussion by posting your ideas on problems and solutions in volunteer retention and voluntary sector interactions here: https://padlet.com/groupsandcovid19/b87lztp889ivp9np

Sustaining mutual aid and community support groups: Covid-19 and beyond Free online event, 12.30pm November 3rd

“I want my life back” is a hell of a thing to say much less publish when 5.5 million people have actually lost their actual lives.

Coronavirus variants: Where do they come from? How do we spot them? What do they mean for COVID vaccines, and future of the pandemic?

https://travellingtabby.com/uk-coronavirus-tracker/… The 263 new deaths reported today is the most in a day for almost 8 months. From the 208 new deaths in England, 9 were in individuals below the age of 50, and 1 was a teenager in the 15-19 age range. #Covid19UK #coronavirusuk #DailyCovidUpdate

99.995% of people who drank from that pump didn't die. We need to learn to live with the dirty water. Dirty water is fine to drink if you don't have underlying health conditions. It's not necessary to clean the water unless it's *wholly* waterborne.

Russia at 1.04 MILLION excess deaths since March 2020, which is about 240% higher than their reported COVID-19 deaths. This is 1st place worldwide (for countries with data) in absolute excess mortality, 2nd place on per capita terms and 9th on p-score. #poptwitter #epitwitter

Wow. 17 years of T cell immunity guys. Looks like it works as advertised.

Sign of the covid times - front page Scotland edition contrasting with front page London edition

Huge honor to be back @inthebubblepod with @ASlavitt We talked about engaging people with whom we disagree Why disdain for unvaccinated folks is counter-productive And why kindness and understanding (with a side of mandates) will keep our nation in good stead for the long run

.@ASlavitt and @ashishkjha discuss the danger of covering COVID like a political horse race, why he appears on Newsmax so frequently, and how he deals with #COVID skeptics in his own extended family. Listen at http://ow.ly/8jcL50GmwLh

I agree with pretty much all of this @FT article https://ft.com/content/e200156f-2e5a-4165-8aa2-28c24fe3c036

We must protect people with comorbidities from cholera in this 1854 epidemic. I went into medicine – consumption specifically – and public health to protect our most at-risk. Did this tweet alone do enough to protect those most at-risk? Because that's all I'm going to do.

this might be my favourite one so far...

CNN emailed to let me know they are “fact checking” this Tweet & writing an article about it. So I want to be clear, the CDC’s own data says those dying with covid have four or more comorbities & instead of 75% of deaths it’s around 95%. See for yourself. https://cdc.gov/nchs/nvss/vsrr/covid_weekly/index.htm

Here is @ClayTravis showing that he didn't read the article.

Suddenly the CDC admits that 75% of virus deaths were people with 4 or more comorbidities. Seems the “science” now sees the looming 2022 midterm election consequences for lockdown Dems…

Here is @CortesSteve showing that he did not read the article.

BREAKING: CDC Director admits that over 75% of COVID deaths are in people with ‘at least 4 comorbidities.’

here is @jennybethm showing that she did not read the article.

You stupid idiots. You stand in the way of public health. You peabrains do not understand there is no virtue in Omicron-based immunity and mutagenesis. One mutation from Histidine could spell natural disaster you stupid frauds. You are brainless.

T cell immunologist getting very upset at people arguing that high levels of transmission are a good thing

https://travellingtabby.com/scotland-coronavirus-tracker/… Today is the first time in almost three weeks that the positivity rate has been under 20%! Although it is also the first time in about 11 months that we've had over 1,500 people in hospital with the virus. #covid19scotland #DailyCovidUpdate

The US reported 1.4 million COVID cases yesterday and hospitalizations are the highest ever. We’re sailing into this hurricane with virtually no effort to change course because fancy people believe they have a god-given right to their normal lives, no matter how bad things get.

While U.K. daily reported cases fall, COVID deaths (379) up to 28 days after a positive test have sadly hit the highest level since February last year.

The ’with’ or ‘because of’ Covid hospitalization argument is intentionally politicizing data.

Curious if this what @Twitter meant when they talked about their commitment to combat covid disinformation.

Increases in hospitalizations routinely lag behind cases by a week (sometimes more). Deaths have an even longer lag. On 12/30, we had seen a 56% increase in 7-day hospitalization counts, and today we are seeing an 81% increase week-to-week. We have already passed the Sept peak.

If schools are not a source of transmission for COVID-19, why were school board per capita rates of infection 1.77x HIGHER than their surrounding community? SOURCE: Ministry of Education data; Compiled on December 17th, 2021; Calculations are mine.

Glad I never minimized covid for kids or fear mongered about the vaccine.

As the world turns.....vertical the Omicron signature (|) @OurWorldInData

Good lord! The percent positivity rate in #Ottawa LTC's PCR tests was 83.72% yesterday (while Ottawa large was 50%)!

Teachers on these islands will get FFP2(rightly so).Healthcare workers on other parts of these islands..nah!..Surgical masks/spit guards/not PPE,for working with COVID-positive patients risking other patient’s, our own & our family’s health.”Protect the NHS”⁦@CMO_England

London peak IN PATIENT in Jan 2021 was 7917. So currently about one doubling from that peak.

A few tweets on masks for kids (thanks @dgurdasani1). US schools were 3.5 x more likely to have COVID-19 outbreaks if they did not have a mask requirement at the start of school compared with schools that required universal masking on day one. 92/

"Importantly, higher study quality was associated with lower prevalence of all symptoms, except loss of smell & cognitive symptoms" ....as someone who studies cognition I didn't find that as reassuring as possibly intended...

masking is not an "unevidenced intervention" and, at this point, it is outright disinformation to claim so. Sad coming from an academic at a respectable institution

Seasonality, huh?

Misinformation on social media is a key challenge to effective and timely public health responses. Existing mitigation measures include flagging misinformation or providing links to correct information but have not yet targeted social processes. Here, we examine whether providing balanced social reference cues in addition to flagging misinformation leads to reductions in sharing behavior. In 3 field experiments (N=817, N=322, and N=278) on Twitter, we show that highlighting which content others within the personal network share and, more importantly, not share combined with misinformation flags significantly and meaningfully reduces the amount of misinformation shared (Study 1-3). We show that this reduction is driven by change in injunctive social norms (Study 2) but not social identity (Study 3). Social reference cues, combined with misinformation flags, are feasible and scalable means to effectively curb sharing misinformation on social media.

Having an incidence of >4000/100.000/14 days (Geneva) is scary & just unbelievable - every day I learn of several friends & colleagues that are positive or were exposed. I wonder how long our household will manage to stay #COVID19 #SARSCoV2 free...

But But But Sweden......... @afneil maybe Tegnall was wrong eh mate

But looking at the wider UK context, Derry is currently looking at 4.5% of everyone *in the entire county* testing positive for COVID in the past week, which is absolutely bonkers. South Wales, the Scottish Central Belt and NW England not too far behind.

The West: "We think you're doing covid pandemic strategy all wrong." Asia: "We don't think of you at all."

Fantastic reassurance for parents. Australian kids it’s time for your jab!!!!Quote TweetEric Topol@EricTopol · 5 JanRemarkably low rate of myocarditis among children mRNA (Pfizer) vaccinated age 5-11 Total of 12 cases among 8.7 million doses given https://cdc.gov/vaccines/acip/meetings/downloads/slides-2022-01-05/02-COVID-Su-508.pdf… Rate of 4/million in boys is <1/10th the rate in teens

BREAKING: U.S. reports 716,714 new coronavirus cases, setting world record for cases in one day

The COVID data coming out of NYC jails is...beyond staggering. Today's report shows a 7-day avg positivity rate of 37%, w/502 ACTIVE INFECTIONS. With a ~5K census, that means that nearly one in ten people in DOC has an ACTIVE infection. Crisis on crisis. https://hhinternet.blob.core.windows.net/uploads/2022/01/CHS-COVID-19-data-snapshot-2020103.pdf

"Eminent" Professor Sunetra Gupta retweets pub landlord. The advancement of "science" 2020-2022...

Warning on death data on https://coronavirus.data.gov.uk NHS England has not reported hospital deaths since 1 January. The backlog will be reported Wednesday. Data are incomplete yesterday, today and tomorrow. Expect a bigger number reported on Wednesday.

NHS Chiefs: 'Hospitals in Crisis' Head Teachers: 'Schools in Crisis' Prime Minister: 'Crisis? What Crisis?' (i.e. you will have to sort it out without any support from us)

Your 2022 reminder that Arnold Schwarzenegger is an absolute gem

"Uncoupled"

A lot of people wear disposable masks.

. I'm guessing it's a good idea to wash/replace them regularly.

Most of it appears to be in this thread actually

So how else could we reduce transmission of an airborne virus if you don’t trust people are savvy enough to get even an ounce of benefit from wearing a mask? Lockdowns and school closures?

Masks are to reduce aerosol inhalation. Nothing to do with washing, touching or snot. As I’m certain you well know.

4. If a big, snotty sneeze did land within a mask, change the mask (just like one would throw the snotty tissue out if it caught the sneeze). Sanitise hands before putting the fresh mask on.

1. Wearing a mask will prevent many sneezes as dust and pollens won't get up the nose to cause sneezing. 2. Not all sneezes produce copious snot. 3. If a child is unwell, they should be home, not masked at school.

As you know very effective piblic healtj can be built from very imperfect measures. Masks are one such P.S. if you sneeze, and the mask is dirty, either wipe with a tissue, or swop masks.

CDC has conducted at least 2 large real-life masking studies in public school systems; Yale and partners did an enormous study in Bangladesh. These all support efficacy of masking. Also snot/hand-washing questions are a distraction; disease is predominantly airborne.

German research demonstrates using an FFP2 once a day every week for five weeks works (provided you're not a heavy user). Now that's physics, science, chemistry & using a platform to promote life!

Dear Prof, We’re you aware that this tweet has an anti-mask tone? I hope this was accidental. Would you be able to share proven methods of good face mask hygiene so others can benefit maximally from this potentially highly effective measure against SARS2 inhalation? Thank you

Friday musings - 5 stages of pandemic grief. (I'm sure you'll have ideas too of what to add!)

Just so I have this clear in my own mind...the Govt has relentlessly pushed the narrative of no need for more restrictions and yet the NHS is building makeshift field hospitals in its car parks

Leeds Hospital to host one of the first 'Nightingale hubs' based in a car park at St James's Hospital. NHS wants space for up to 4k extra beds nationally...but who will staff these beds?

#RobertMalone suspended by #twitter today. Reaction: 1) Great news. He has been spreading harmful #misinformation. (He has NOT contributed to meaningful/constructive scientific debate. His views demonstrably wrong & polarizing.) 2) What took so long? #ScienceUpFirst

Heck of a time to relax NPIs.

7/ the virus is almost exactly like the flu so there is no need to panic. except it kills lots more people, causes some kind of poorly understood neurological changes, and sometimes lingers for months. but all that’s neither here nor there. basically the same.

6/ the virus is airborne but it hates perspex. You put a perspex sheet in its path and it self-destructs out of frustration. Doesn’t matter the size of the room or the size of the Perspex.

5/ related to point 4, the virus hates losses in productivity. Just this past week, a negotiation was held with the virus, and it agreed to hurry and and do what it needs to do quickly so people can get back to work.

4/ the virus can only infect people that are having a good time and not a boring time. That’s why it spreads at parties and other social gatherings but not at schools or workplaces.

3/ in restaurants, the virus is temporarily deactivated when patrons are seated at their tables. As soon as they stand to go to the bathroom or bar (for instance) it promptly reactivates.

2/ for people in a queue, the virus weakens and dies if it must travel perpendicular to the direction of the queue. That’s why people must stand 6 feet apart from the people ahead of and behind them, but not the people next to them in a winding queue. It hates right angles.

1/ the virus spreads well in indoor settings without proper ventilation (e.g. restaurants), but not when the indoor space was built on the sidewalk or street in New York between August of 2020 and January of 2021.

As a non-virologist, here are some things I have learned about covid that I would not have guessed before the pandemic. They are super counter-intuitive:

Another record day for cases in the U.K yesterday. One of the worst Christmas presents we could have received. Please look after each other as well as you can this festive season.

Fatalism can be fatal

Picture says a lot

This is nothing short of scandalous. Unless and until those leading the public health response acknowledge the AIRBORNE nature of the virus and give transmission mitigation advice commensurate with how airborne viruses spread, we will be yo-yoing from wave to wave ad infinitum.