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It's coming towards the end of the year, and there are still countless people minimizing the pandemic and spreading untruths
So I thought I'd do a bit of a thread of FACTS about COVID-19 1/n
So I thought I'd do a bit of a thread of FACTS about COVID-19 1/n
2/n Fact 1: the death rate of COVID-19 varies substantially by age, but is high even for relatively young people
For example, a 1 in 2,700 risk of death from COVID-19 for a 35 year old, based on our comprehensive paper on the topic https://link.springer.com/article/10.1007%2Fs10654-020-00698-1
For example, a 1 in 2,700 risk of death from COVID-19 for a 35 year old, based on our comprehensive paper on the topic https://link.springer.com/article/10.1007%2Fs10654-020-00698-1
3/n Fact 2: COVID-19 is MUCH more dangerous than influenza
For younger age groups, COVID-19 may be similarly lethal. For anyone over 30, it is much worse. @zorinaq has a nice graphic on this
For younger age groups, COVID-19 may be similarly lethal. For anyone over 30, it is much worse. @zorinaq has a nice graphic on this
4/n Fact 3: RT-PCR testing for COVID-19 has a very low rate of false positives. This is both conceptually demonstrable https://virologydownunder.com/the-false-positive-pcr-problem-is-not-a-problem/
And mathematical fact https://gidmk.medium.com/most-positive-coronavirus-tests-are-true-positives-60c95fe54fec
And mathematical fact https://gidmk.medium.com/most-positive-coronavirus-tests-are-true-positives-60c95fe54fec
5/n Fact 4: most deaths that are counted as COVID-19 (at least in the US and other developed nations) have COVID-19 as the "underlying" or main cause https://jamanetwork.com/journals/jama/fullarticle/2771761 https://gidmk.medium.com/covid-19-deaths-are-mostly-caused-by-coronavirus-2a6d2d43bd09
6/n Fact 5: herd immunity through natural infection is not a way out of the pandemic. It will not bring us "back to normal", and certainly not within the timeframes proposed https://www.researchsquare.com/article/rs-25862/v1
7/n Fact 6: COVID-19 is a real disease caused by the SARS-CoV-2 coronavirus. Somehow people are still questioning this (yes, really)
@MackayIM has a great piece here https://virologydownunder.com/sigh-yes-the-covid-virus-is-real/
@MackayIM has a great piece here https://virologydownunder.com/sigh-yes-the-covid-virus-is-real/
8/n Fact 7: In the published data thus far, there is no large increase in suicide rates associated with lockdowns, although there are increases related to the pandemic itself https://gidmk.medium.com/have-lockdowns-caused-suicides-during-covid-19-dd6b7a741f39
9/n Fact 8: The cost-benefit of government action against COVID-19 is COMPLEX
In some situations, it may be harmful. In others, beneficial https://www.imf.org/en/Publications/WEO/Issues/2020/09/30/world-economic-outlook-october-2020
In some situations, it may be harmful. In others, beneficial https://www.imf.org/en/Publications/WEO/Issues/2020/09/30/world-economic-outlook-october-2020
10/n Fact 9: about 20% of people who catch COVID-19 are fully asymptomatic (i.e. they never experience symptoms at all)
https://jammi.utpjournals.press/doi/abs/10.3138/jammi-2020-0030
https://jammi.utpjournals.press/doi/abs/10.3138/jammi-2020-0030
11/n Fact 10: there is quite a lot of evidence demonstrating that people can spread COVID-19 before becoming symptomatic, with some indication that the most infectious period is right around the onset of symptoms https://theconversation.com/covid-19-when-are-you-most-infectious-150760
12/n Fact 11: there is some t-cell cross reactivity for SARS-CoV-2
Fact 12: this DOES NOT MEAN that we have "pre-existing immunity". From the expert: https://twitter.com/profshanecrotty/status/1293344524731691008?s=20
Fact 12: this DOES NOT MEAN that we have "pre-existing immunity". From the expert: https://twitter.com/profshanecrotty/status/1293344524731691008?s=20
13/n Fact 13: most places in the world are far below "herd immunity" numbers
We need a vaccine for community immunity!
We need a vaccine for community immunity!
14/n Fact 14: COVID-19 has been associated with large increases in excess mortality in many countries, including the US and much of Europe https://www.euromomo.eu/graphs-and-maps
15/n Fact 15: COVID-19 is probably less deadly now than it was at the start of 2020
Fact 16: It is INCREDIBLY HARD to put a number on this difference https://gidmk.medium.com/is-covid-19-getting-less-lethal-f2907e06a0d
Fact 16: It is INCREDIBLY HARD to put a number on this difference https://gidmk.medium.com/is-covid-19-getting-less-lethal-f2907e06a0d
16/n Fact 17: The cycle threshold (Ct) of PCR testing is not some magic silver bullet against a growing epidemic. @MackayIM again has an excellent read on this here https://virologydownunder.com/the-false-positive-pcr-problem-is-not-a-problem/
17/n Fact 18: The comparator to government action for COVID-19 is not "business as usual", it's "widespread epidemic", and anyone who pretends otherwise is being very silly
18/n Fact 19: the corollary to Fact 18 is that a lot of the impact of lockdowns is UNCERTAIN
19/n Fact 20: Lockdowns clearly reduce COVID-19 case numbers in the short term. Other government actions can clearly limit case numbers in the long term. There are now numerous examples https://www.devex.com/news/behind-vietnam-s-covid-19-success-story-98257
20/n (Whether this means that lockdowns "work" depends on your definition of "work" and "lockdowns", but in general it seems fair to say that COVID-19 can clearly be controlled through coordinated government responses)
21/n Fact 21: COVID-19 is the third leading cause of death for 2020 in the United States
In the last few months of the year, it may have overtaken other causes of death to become THE LEADING CAUSE OF DEATH FOR >30 year olds https://jamanetwork.com/journals/jama/fullarticle/2774465
In the last few months of the year, it may have overtaken other causes of death to become THE LEADING CAUSE OF DEATH FOR >30 year olds https://jamanetwork.com/journals/jama/fullarticle/2774465
22/n Fact 22: We still do not fully know the long-term chronic impacts of COVID-19, but they are likely to impact a non-trivial portion of the people who get the disease https://www.nature.com/articles/d41586-020-02598-6
23/n Fact 23: This is something of a repetition of Fact 4, but just to clarify that the evidence is clear that most people who are classified as having died of COVID-19 did indeed die of the disease https://twitter.com/GidMK/status/1341175635700457472?s=20
24/n Fact 24: Another corollary, this time to Facts 9 and 10 - since many people are asymptomatic when testing positive (even though the majority will go on to develop symptoms) isolating PCR+ cases is simply good public health policy
25/n Fact 25: opioid-related mortality has been rising in the US for some time, and while it may have been exacerbated due to the pandemic it is inaccurate to ascribe all overdoses to lockdowns/COVID-19 https://www.cdc.gov/media/releases/2020/p1218-overdose-deaths-covid-19.html
26/n Fact 26: While COVID-19 deaths only made up 40% of all excess deaths in young people in the U.S., it is likely that this is due to undercapture of the COVID-19 burden in this population (i.e. much of the remaining 60% is COVID-19 related as well) https://jamanetwork.com/journals/jama/fullarticle/2774445
27/n Fact 27: Much of the economic and social disruption that people have experienced this year is due to THE PANDEMIC ITSELF and not necessarily government action
28/n Fact 28: During lockdown, New Zealand's death excess deaths DROPPED. The NZ total excess deaths for the year are below usual, in contrast to other countries with large epidemics https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)32647-7/fulltext
29n Fact 29: The average life expectancy for an 80-year-old person alive today in the United Kingdom is 9.12 years. The average death rate from COVID-19 for this group is ~8.5%
https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/lifeexpectancies/bulletins/nationallifetablesunitedkingdom/2017to2019#national-life-tables-life-expectancy-in-the-uk-data
https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/lifeexpectancies/bulletins/nationallifetablesunitedkingdom/2017to2019#national-life-tables-life-expectancy-in-the-uk-data
30/n Fact 30: The UK has had a very large increase in excess mortality this year, orders of magnitude higher than in an average bad influenza season
31/n Fact 31: COVID-19 reinfections occur. While we do not know the exact rate as of yet, and it may be very low, as time goes on the rate is likely to rise https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(20)30764-7/fulltext
32/n Fact 32: The WHO estimated that LESS THAN 10% of the world was infected in October, contrary to common myths https://twitter.com/GidMK/status/1315447821814775808?s=19
33/n Fact 33: Many of these facts are about NUANCE and UNCERTAINTY. Often what we DO know is just that we don't know VERY MUCH
