Deepti Gurdasani 10h, 25 tweets, 5 min read
Some thoughts on the PMs briefing today:
-false 'now or never' narrative alert
-no mention of long COVID or CV
-implicit that mass infection of young doesn't matter
-abdication of govt responsibility
-Internal inconsistency and confused messaging🧵 First, the 'now or never' narrative.
The govt says we are in a position to open up because vaccines are working well and keeping hospitalisations down.
The PM says that if we don't open up now, when? He & Whitty claim opening up in winter may make matters worse. Is this true? This is an interesting claim- the suggestion is that we should let it rip now, rather than delaying, because then the surge will coincide with winter leading to a bigger wave.
This claim doesn't even pass basic scrutiny Here's why:
'Internal inconsistency alert': If the govt claims that we are in a position to open up now when 50% of our population is fully vaccinated, then surely vaccinating more people over the summer (PM said all adults will be offered vaccine by Sept) will help hugely & do the opposite
If the claim is that vaccines are good enough to protect us now, why wouldn't they be good enough to prevent hospitalisations/deaths in winter, when *many more* will be vaccinated- lowering transmission & weakening the link between cases & deaths further?
So then the wave in autumn should be much smaller, despite possibly more indoor contact, shouldn't it?
Or is something else going on?
As far as I can see,
the claim is actually derived from this statement in the Imperial model released on the 9th June. 
This suggests that the problem may actually be waning immunity in the population & lack of vaccination of children over winter. So a large wave over the winter (compounded by lack of childhood vaccination + schools open) may impact even those who have been fully vaccinated.
But it suggests this could be offset with booster doses & childhood vaccination, which wasn't examined in the model at all- and doesn't seem to have factored in govt decision making. Why? So the govt is essentially providing us with a false choice between two bad options Tolerate mass infection now when only 50% of the population is fully protected. Or tolerate mass infection over winter when it could be worse due to waning immunity & lack of vaccination among children. We shouldn't need to do either, if govt got its act together. Remember that if we're in a situation where immunity is far more short-lived in the elderly now, it's largely because we imported a variant that has moderate escape against vaccines - which reduces the duration of protective immunity among the elderly. Neutralising antibody activity against SARS-CoV-2 VOCs B.1.617.2 and B.1.351 by BNT162b2 vaccination https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)01290-3/abstract
Suggesting that mass infection now is better than vaccination, when many more people will be vaccinated in the coming wks makes no sense. If we're concerned about waning immunity, we need to deal with this by vaccinating all inc children, & a clear plan for boosters.
Mass infection to boost infection acquired immunity for a better winter really shouldn't be the strategy. Also, vaccinating adolescents could have a fairly large impact on transmission - this could have an important impact on the size of the wave, including an autumn/winter wave.
It would also mean that we're protecting young people and adolescents rather than exposing them to the very real risks of long COVID - that 7-8% of children who get infected will develop for 12 wks or more. For many, this will last for over a year, and be debilitating.
Why are we happy to follow a strategy of protection of vulnerable through vaccination + mass infection and herd immunity in children- when we could vaccinate many of these groups in the coming months!
Imagine having children develop infection and long COVID, knowing they could've been vaccinated. But we're planning to rather exposing millions of children to infection in the coming months - and there is no plan for vaccination for them.
And of course no mention
that this is exactly the strategy that has been shown to provide the best grounds for virus adaptation towards escape- high transmission in the unvaccinated + vaccination of the more vulnerable alone.
Vaccine escape in a heterogeneous population: insights for SARS-CoV-2 from a simple model https://www.medrxiv.org/content/10.1101/2021.03.14.21253544v1
Transmission has consequences- we've already seen them with the emergence of alpha in the UK. If we manage to evolve an escape variant that reduces the effectiveness of vaccines further- this is problematic at global level, given how efficient we are at exporting new variants. If the govt is following a mass infection strategy, because they
-don't have a clear booster strategy to deal with the waning immunity
-no plan to vaccinate children despite most other countries doing this
they should be honest about this. And stop presenting two false options. They should be honest that there were other options like childhood immunisation that could've massively reduced some of these risks, but they've decided not to do that - but rather decided to expose our children to mass infection.
And also that they're hanging the clinically vulnerable out to dry. There's nothing CV children or adults can do to protect themselves in environments where others don't wear masks, where there is no attention to ventilation.
Many (particularly children) will not be eligible for vaccination & some will not respond fully to it -
What should they do in terms of 'personal responsibility' to protect themselves?
What do they do when they go into classrooms/workplaces with no mitigations?
What do they do when their employers tell them they have to come in because the govt has removed 'work from home' guidance? Do they accept losing their jobs, or risk their lives going into workplaces where masks aren't mandated, where there are no ventilation requirements?
'Personal responsibility' is complete abdication of govt responsibility - a govt that has completely failed the public. The impacts of this will of course be amplified for the disadvantaged, the vulnerable, ethnic minorities, and for children.
Please tell me what 'personal responsibility' my child can exercise in a classroom of 32 children where no one is required to wear masks, & there are no basic ventilation requirements & infection rates are sky high. What 'personal responsibility' can i exercise as her parent? The govt should make clear that 'herd immunity' by infection an active choice being made here. One that will lead thousands of our young disabled, with future impacts we don't even fully understand. A choice our govt made when safe & effective vaccines were available. 
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by rumbeando Sun Jul 04, 2021 11:15 am
Bleeding Blitva
