There is also increasing concern with now hundreds of seemingly #COVID19 associated Pims-TS syndrome cases confirmed in several countries. Pims-TS (whole system inflammatory toxic shock syndrome similar to #Kawasaki symptoms) has resulted in...

And a retrospective cohort study based on 1286 close contacts of 319 #COVID19 cases in Shenzen showed that children (and younger people generally) were as likely as adults to be infected (but also much less likely to have mild or severe symptoms).

Additionally, work by @ONS, who have been doing some excellent research on the impact of #COVID19 in the UK, showed there is currently no evidence that age affects the likelihood of being infected with #COVID19 in the UK.

The man leading the coronavirus response in Germany, @c_drosten, heeds caution, showing evidence there is no sig difference in viral loads between children & adults. This highlights how much we have to learn & that all steps should be taken w/ caution.

It seems clear that, unlike with influenza, children aren't key drivers of transmission & most will suffer no symptoms. But not being 'the key driver' doesn't mean they can't still drive transmission, & there is increasing concern over a related inflammatory syndrome... 18/

These @nytimes & @guardian articles summarise Denmarks approach.

And in Denmark, re-opening of schools (w/ effective social distancing measures), led to an increase in R from 0.7 to 0.9 shortly after (although now returned to 0.7). This seems to be the main 'case study' the UK is basing it being safe for schools to re-open. 16/

Still, Prof @GrahamMedley, UK chief modeller, says children not the 'key drivers' of #coronavirus transmission... And @WHO says in countries where schools have remained open, outbreaks in schools have been rare & are normally associated with contacts with adults. 15/

However, in regards to contact tracing studies suggesting children are less infectious, there needs to be more rigorous data to draw conclusions from this data alone, as need to take into account the potential for #superspreaders. 14/

There is also a fair bit of contact tracing data suggesting that children are less infectious, such as this in a French chalet cluster, where an infected child did not transmit the disease despite close interactions within schools.

There are also many studies showing lower incidence in children, such as a population-based study in Iceland in which 9199 were tested, of the 564 children <10y, 38 (6.7%) tested positive, vs 1183/8635 (13.7%) adolescents & adults, suggesting lower incidence in children.

And this @ScienceMagazine paper shows risk of infection upon exposure in children may be about 1/3 (sorry for the simplification) that of adults, although also suggests proactive school closures can reduce peak incidence by 40-60% & delay the epidemic.

...on the spread of the virus. Should be noted that this models school closures and effect on peak rather than the re-opening of schools.

So let's dig a little into the evidence for & against re-opening schools. A @ucl review published in @LancetChildAdol concluded that the evidence to support the closure of schools to combat Covid-19 is “very weak” & school closures are likely to have a minimal impact... 9/

It should first be made clear that there is no scientific consensus on this, w/ many contrasting views & little strong evidence on the issue. This uncertainty means there is inherently significant risk involved & increases the need for evidence to be discussed #transparently. 8/

But what is the evidence, and when will UK schools really be able to open safely? This @guardianscience article summarises the contrasting views between experts, with some experts saying it's low risk & a difficult but necessary decision.

However, teaching unions & parents have raised legitimate concerns over whether it will really be safe, and @TheBMA announced that "Until we have got case numbers much lower we should not consider re-opening schools. The NEU is right to urge caution."

Whilst @michaelgove said he can 'guarantee teachers and children will be safe.' More reasonably, @WHO chief scientist @doctorsoumya has said children are "less capable of spreading the virus, and are low risk."

The increasing educational disadvantage means it is urgent to find a SAFE way to resume education. Dismissing concerns from teaching unions as 'scaremongering,' the Education Sec @GavinWilliamson announced that R being below 1 is the ‘green light’ for schools to re-open... 4/

School closures have presented a huge challenge to children, parents & policymakers. A study by @TheIFS showed that better-off children now spend 30% more time on education than poorer children & school closures will increase educational inequalities.

On 20 March 2020, UK schools closed their gates to all but the children of essential workers and those deemed most vulnerable. This remains the case; although the gvmnt has now said that more children will return to school at the start of June. 2/

When should #Schools #Reopen in the UK? This thread summarises the key points & evidence on the issue & finishes with some things the government must do before allowing schools to re-open.

If anything prepared me for life in lockdown during COVID-19, it was researching my book Convent Autobiography: Early Modern English Nuns in Exile. I knew from this work that people can live satisfying and complex lives within restricted circumstances, that routines and a sense of shared purpose are important – and that there’s room to develop a deeper understanding of ourselves as individuals and as members of society, once we’ve stripped away so much of what once occupied and shaped our former lives.The women who established or joined the English convents on the Continent and in America between the 1530s and 1800s took huge personal risks. Leaving home to join a convent was illegal and could result in fines or imprisonment, yet nearly 4,000 women did so in order to take vows of poverty, chastity and perpetuity, meaning they promised to stay in their convents for the rest of their lives.Most convents required new nuns to ceremonially ‘die to the world’, meaning they would radically reduce the amount of contact they had with friends and family outside their cloister to focus on their relationship with God and their new spiritual community. Winefrid Thimelby, who served as Prioress of St Monica’s Augustinian Convent in Louvain from 1668-1690, beautifully articulates what separation and absence from loved ones meant to her in a letter to her sister Katherine back in England:

Lessons for lockdown from Early Modern convents

10.1016/S1473-3099(20)30402-3

Clinical manifestations of coronavirus disease 2019 (COVID-19) are rare or absent in children and adolescents;1Lee P-I Hu Y-L Chen P-Y Huang Y-C Hsueh P-R Are children less susceptible to COVID-19?.J Microbiol Immunol Infect. 2020; (published online Jan 1.)DOI:10.1016/j.jmii.2020.02.011Crossref Scopus (14) Google Scholar,  2Pavone P Giallongo A La Rocca G Ceccarelli M Nunnari G Recent COVID-19 outbreak—effect in childhood.Infectious Diseases & Tropical Medicine. 2020; 6: e594Google Scholar hence, early clinical detection is fundamental to prevent further spreading. We report three young patients presenting with chilblain-like lesions who were diagnosed with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Two of them were asymptomatic and potentially contagious. Skin lesions, such as erythematous rashes, urticaria, and chicken pox-like vesicles, were reported in 18 (20·4%) of 88 patients with COVID-19 in a previous study.3Recalcati S Cutaneous manifestations in COVID-19: a first perspective.J Eur Acad Dermatol Venereol. 2020; (published online March 26.)DOI:10.1111/jdv.16387Crossref Scopus (11) Google Scholar These symptoms developed at the onset of SARS-CoV-2 infection or during hospital stay and did not correlate with disease severity.3Recalcati S Cutaneous manifestations in COVID-19: a first perspective.J Eur Acad Dermatol Venereol. 2020; (published online March 26.)DOI:10.1111/jdv.16387Crossref Scopus (11) Google Scholar In our cases, lesions involved the acral sites, especially the dorsum of the digits of the feet, beginning as erythematous-violaceous patches that slowly evolved to purpuric lesions and then to blisters and ulceronecrotic lesions, with final complete return to normal. Burning and itching were also present with some of the lesions. Informed consent was obtained from the parents of patients 1 and 2 and from patient 3 himself.

Silent COVID-19: what your skin can reveal

In top journals, more papers fail than pass replication tests and papers failing replications spread as widely as replicating papers. This dynamic raises research costs by over 20bn annually, jeopardizes the literature, and exposes the need for new methods for predicting replicability. Using 96 studies that underwent rigorous manual replication, we developed an artificial intelligence (AI) model that predicts a paper’s replicability. We then tested the model on 317 diverse out-of-sample studies that span disciplines, methods, and topics. We find that AI predicts replicability better than statistics and individual reviewers and as accurately as prediction markets, the gold standard of replicability methods. Further, AI generalizes to out-of-sample data at AUC levels up to 0.78. Finally, tests indicate that the AI model does not show biases common to human reviewers. We discuss how AI can address replication problems at scale in ways that current methods cannot and can advance research by combining human and machine intelligence.

The Replicability of Scientific Findings Using Human and Machine Intelligence

10.1073/pnas.1909046117

Replicability tests of scientific papers show that the majority of papers fail replication. Moreover, failed papers circulate through the literature as quickly as replicating papers. This dynamic weakens the literature, raises research costs, and demonstrates the need for new approaches for estimating a study’s replicability. Here, we trained an artificial intelligence model to estimate a paper’s replicability using ground truth data on studies that had passed or failed manual replication tests, and then tested the model’s generalizability on an extensive set of out-of-sample studies. The model predicts replicability better than the base rate of reviewers and comparably as well as prediction markets, the best present-day method for predicting replicability. In out-of-sample tests on manually replicated papers from diverse disciplines and methods, the model had strong accuracy levels of 0.65 to 0.78. Exploring the reasons behind the model’s predictions, we found no evidence for bias based on topics, journals, disciplines, base rates of failure, persuasion words, or novelty words like “remarkable” or “unexpected.” We did find that the model’s accuracy is higher when trained on a paper’s text rather than its reported statistics and that n-grams, higher order word combinations that humans have difficulty processing, correlate with replication. We discuss how combining human and machine intelligence can raise confidence in research, provide research self-assessment techniques, and create methods that are scalable and efficient enough to review the ever-growing numbers of publications—a task that entails extensive human resources to accomplish with prediction markets and manual replication alone.

Estimating the deep replicability of scientific findings using human and artificial intelligence

Wharton Dean, Geoffrey Garrett, speculates that the pandemic will reverse the trends of globalization and urbanization. He predicts a reduction in international cooperation and the increased likelihood of international conflict. In addition, it could also see a reverse in the trends of cities growing, as people live in more spacious and less crowded places. The economic effects of a less global and urban world may not be positive.

The post-COVID-19 world could be less global and less urban

10.1016/S1473-3099(20)30403-5

There have been increasing calls for universal screening of health-care workers for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).1Black JRM Bailey C Przewrocka J Dijkstra KK Swanton C COVID-19: the case for health-care worker screening to prevent hospital transmission.Lancet. 2020; (published online May 2.)http://dx.doi.org/10.1016/S0140-6736(20)30917-XSummary Full Text Full Text PDF Scopus (0) Google Scholar We have been screening health-care workers at The Portland Hospital for Women and Children (London, UK) since March 17, 2020. By April 16, 2020, we had tested nasopharyngeal swabs taken from 266 staff members (>50% of the workforce) using SARS-CoV-2 RT-PCR, and 47 (18%) were found to be positive. Of these positive cases, 31 (66%) were symptomatic and 16 (34%) were asymptomatic (figure). Overall, 28 (48%) staff members remained positive at 7 days after the initial test was taken, 16 (34%) at 10 days, and four (9%) at 14 days, with one health-care worker remaining positive until 26 days. Of 25 symptomatic staff members who initially tested negative and were retested, only one (4%) became positive after 7 days. Potential factors associated with SARS-CoV-2 positivity are summarised in the figure.

COVID-19 screening of health-care workers in a London maternity hospital

10.1016/S1473-3099(20)30398-4

In response to delays in research for 2009 influenza A/H1N1, in 2012 the National Institute for Health Research (NIHR), a UK funder, funded a portfolio of nine projects.1Simpson CR Beever D Challen K et al.The UK's pandemic influenza research portfolio: a model for future research on emerging infections.Lancet Infect Dis. 2019; 19: 295-300Google Scholar These projects were put on standby in a maintenance-only state awaiting activation in the event of new influenza pandemic. The portfolio covered key pathways of health care, including surveillance, primary prevention, triage, and clinical management. In 2018, a request was made by NIHR to adapt these projects to include new and emerging infectious diseases. All projects were able to be repurposed and eight have now been activated in response to the coronavirus disease 2019 (COVID-19) pandemic.

The UK hibernated pandemic influenza research portfolio: triggered for COVID-19

10.1038/s41562-020-0875-0

The geographic variation of human movement is largely unknown, mainly due to a lack of accurate and scalable data. Here we describe global human mobility patterns, aggregated from over 300 million smartphone users. The data cover nearly all countries and 65% of Earth’s populated surface, including cross-border movements and international migration. This scale and coverage enable us to develop a globally comprehensive human movement typology. We quantify how human movement patterns vary across sociodemographic and environmental contexts and present international movement patterns across national borders. Fitting statistical models, we validate our data and find that human movement laws apply at 10 times shorter distances and movement declines 40% more rapidly in low-income settings. These results and data are made available to further understanding of the role of human movement in response to rapid demographic, economic and environmental changes.

Mapping global variation in human mobility

Last year we published a list of ten psychology findings that reveal the worst of human nature. Research has shown us to be dogmatic and over-confident, we wrote, with a tendency to look down on minorities and assume that the downtrodden deserve their fate. Even young children take pleasure in the suffering of others, we pointed out. But that’s only half of the story. Every day, people around the world fight against injustices, dedicate time and resources to helping those less fortunate than them, or just perform simple acts of kindness that brighten the lives of those around them. And psychology has as much to say about this brighter side of humanity as it does the darker one. So here we explore some of the research that demonstrates just how kind and compassionate we can be.

Good At Heart? 10 Psychology Findings That Reveal The Better Side Of Humanity

10.1101/2020.04.06.20054320

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