Thread..After considerable thought, I’ve decided to remove myself completely from social media. I just want to say a quick thanks to all my followers and the friends (and new colleagues) I’ve met through Twitter before I deactivate my account.

2020 has been particularly difficult for everyone and I hope that I’ve helped to cut through some of the confusion and misinformation around COVID-19. I’m incredibly tired (miserable) and I need to focus on work as we move into what is going to be a difficult winter for the NHS.

I’m chopsy and determined, but I’m also human. Some of the abuse I’ve had on this platform has been a struggle to laugh through. I’ve complained to Twitter about some of the comments I’ve had, and I’ve increasingly used block and mute.

None of this is what I want. Differing opinions are what allows debate and progress. Being challenged on your views is exactly what makes progress in science. But normally you’re challenged with sound argument with some basis in fact.

It’s impossible to challenge conspiracy theories, because the made up worlds they eminate from, are from the imagination. You don’t need fact to dream up dragons. It’s our jobs as scientists to provide the evidence to make the truth irrefutable, so it can’t be a matter for debate

The SARS-CoV-2 virus exists, it has been isolated in cell culture and Koch’s postulates have been proven using mink as an accidental model. PCR and other amplification methods are tools to help us. In the hands of experts, they are powerful and reliable. False results are rare.

The immune response is rapid and involves B cells and T cells. Immune evasion may happen by immunity waning over time. But also by the virus mutating over time as it’s allowed to transmit in the population. ‘Natural herd immunity’ is not a safe strategy to follow.

Because the population is susceptible, you will see the full pyramid of infection presentations. Mild infection always sits at the bottom, but it feeds into the severe infections sitting at the top. The more cases at the bottom the bigger the burden at the top.

It’s a respiratory virus, we don’t know the infectious dose, we know that indoors with poor social distancing and poor ventilation contribute to high risk of transmission. Like MERS and SARS1, super-spreading events (one host, multiple close contacts) cause most outbreaks.

The vaccines are coming, we don’t yet know if they’ll need reviewing annually like influenza or whether a single two dose (prime/boost) course will provide lasting protection.

Mitigation strategies have direct and indirect consequences. Pandemics throughout time have had direct and indirect consequences. The balance between the two is going to remain an ongoing issue as numbers of infections remain high.

In my opinion, we’ve already tipped the balance towards the virus becoming endemic. It’s going to take a lot more concerted effort to get to zero cases globally now. That doesn’t mean we shouldn’t try but at some point we might have to start making even more difficult decisions.

If it becomes endemic, it’ll likely join the other Autumn/winter viruses, coming back possibly annually but maybe biannually? And because I’ve run out of facts..I’m moving increasingly into conjecture..way too dangerous

Stay safe and hopefully for everyone who knows me in person, we’ll all meet on the other side.