It's a year since I first tweeted about an unusual pneumonia spreading in Wuhan, China. I lost my mother to Covid-19 on 27th December. My research on the disease, summarised in this thread, is dedicated to her.
https://twitter.com/trishgreenhalgh/status/1343510752691425281?s=20
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Thanks to the funders of my research: @wellcometrust, @esrc, @nihrresearch, @healthfdn, @scotgov, @The_MRC, and to collaborators formal and informal. Thanks also to my wonderful Twitter followers for your contributions and interest.
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The virus that causes Covid-19 (SARS-CoV-2) is airborne. This means it is transmitted by *shared air* at both close range (< 2m) and more distant (>2m). It *is* important to physically distance but there’s nothing magical about 2m.
https://www.bmj.com/content/370/bmj.m3223
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Two metres or one: what is the evidence for physical distancing in covid-19?

Rigid safe distancing rules are an oversimplification based on outdated science and experiences of past viruses, argue Nicholas R Jones and colleagues Physical distancing is an important part of...

https://www.bmj.com/content/370/bmj.m3223
That paper, led by @drnrjones with @DrZeshanQureshi and others not on Twitter, argued that we need to shift from “what is the effect size of intervention X and is it statistically significant?” to a complex system model in which multiple factors all contribute and interact.
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The @drnrjones paper included a #CovidRiskChart showing (in broad terms) the influence of crowding, ventilation, masking and activity (e.g. speaking) on transmission rates. Chart and many translations of it are in this thread.
https://twitter.com/trishgreenhalgh/status/1300086990709362693?s=20
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Masks work. Even imperfect masks worn by most people reduce transmission – and this gets *magnified* with each person not infected. Masks aren’t harmful but they do interfere with communication. With @CzypionkaThomas and others.
https://twitter.com/trishgreenhalgh/status/1343804157342453760?s=20
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My PhD student @HeleneMarivdW led on a paper about masking as a social practice – something that has cultural meaning and moral worth (or, in some societies, has negative connotations).
https://www.bmj.com/content/370/bmj.m3021
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Face coverings for covid-19: from medical intervention to social practice

Helene-Mari van der Westhuizen and colleagues argue that face coverings should be considered not as medical equipment but as a social practice informed by norms and expectations ### Key messages...

https://www.bmj.com/content/370/bmj.m3021
Another of my PhD students, sports medicine physician @DrPaulDijkstra, @drnrjones and student Jonny Bowley worked with me on this paper summarising the evidence on masks and exercise.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7494435/
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Exercising and face masks: An important hypothesis buried in a selective review

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7494435/
Masks are a controversial and emotive subject. I summarised my response to the counter-arguments (“masks don’t work and are harmful”) in this graphic.
https://twitter.com/trishgreenhalgh/status/1318078587455606784?s=20
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I also wrote a piece for @spectator on why the Danish randomised controlled trial of masks wasn’t good science.
https://twitter.com/trishgreenhalgh/status/1331186825038340097?s=20
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With colleagues from Singapore and drawing on rapidly published guidance from China, I wrote an early guide to assessing patients with suspected Covid-19 remotely.
https://www.bmj.com/content/368/bmj.m1182.abstract
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Covid-19: a remote assessment in primary care

### What you need to know A 37 year-old healthcare assistant develops a cough. Next day, she wakes with a fever (which she measures at 37.4°C) and shortness of breath. She manages her condition at...

https://www.bmj.com/content/368/bmj.m1182.abstract
With @sarashawx2, @ChrysanthiP and others (led by Joe Wherton), I wrote a summary of the qualitative evidence base for video consulting.
https://bmjleader.bmj.com/content/4/3/120?utm_term=consumer&utm_content=012020&utm_campaign=usage&utm_medium=cpc&utm_source=trendmd
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Guidance on the introduction and use of video consultations during COVID-19: important lessons from...

Background Following several years of qualitative research, we have developed evidence-based guidance on setting up and conducting remote video consultations. Drawing on emerging evidence, we have...

https://bmjleader.bmj.com/content/4/3/120?utm_term=consumer&amp;utm_content=012020&amp;utm_campaign=usage&amp;utm_medium=cpc&amp;utm_source=trendmd
With colleagues from Oxford and Imperial (including @lusignan_s and @bcdelaney1), I did (and continue to do) research to develop a scale for assessing patients with acute Covid-19 remotely (by video or telephone).
https://twitter.com/trishgreenhalgh/status/1327150486320013314?s=20
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Undertaken before the pandemic but relevant to remote consulting during it, I contributed to @LucasSeuren’s micro-analysis of turn-taking in video consultations (those awkward gaps and overlaps):
https://www.sciencedirect.com/science/article/pii/S0378216620302782
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Whose turn is it anyway? Latency and the organization of turn-taking in video-mediated interaction

Latency in video-mediated interaction can frustrate smooth turn-taking: it may cause participants to perceive silence at points where talk should occu


https://www.sciencedirect.com/science/article/pii/S0378216620302782
Currently still at preprint stage, we did a systematic review led by academic fellow Asli Kalin and with @javid_lab, @mjknight0380 and @mattinadakim on the different exertional desaturation tests being considered for Covid-19.
https://assets.researchsquare.com/files/rs-105883/v1/fae6ab19-d5bd-44ee-98df-7b62a2e3e48e.pdf
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With @mjknight0380, @ChristineACourt and others, I did a clinical review of management of long Covid in primary care. This fed (with other work) into NICE guidance, so see also @NICEcomms for updates.
https://www.bmj.com/content/370/bmj.M3026.abstract
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Management of post-acute covid-19 in primary care

### What you need to know Post-acute covid-19 (“long covid”) seems to be a multisystem disease, sometimes occurring after a relatively mild acute illness.1 Clinical management requires a whole-pati...

https://www.bmj.com/content/370/bmj.M3026.abstract
With @laddsemma @rushforthalex and others from #longcovid communities, I did interview and focus group research on the lived experience of long Covid.
https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-020-06001-y
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Persistent symptoms after Covid-19: qualitative study of 114 “long Covid” patients and draft...

Approximately 10% of patients with Covid-19 experience symptoms beyond 3–4 weeks. Patients call this “long Covid”. We sought to document such patients’ lived experience, including accessing and...

https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-020-06001-y
I got involved in several rapid systematic reviews – for example this one led by @elainetoomey1 on when it’s safe for HCWs to re-use, or extend the use of, facemasks and respirators.
https://www.cambridge.org/core/journals/infection-control-and-hospital-epidemiology/article/extended-use-or-reuse-of-singleuse-surgical-masks-and-filtering-facepiece-respirators-during-covid19-a-rapid-systematic-review/A5DACFDC66C8D3001F4A2E67C6A7AEF6
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Extended use or reuse of single-use surgical masks and filtering face-piece respirators during the...

Extended use or reuse of single-use surgical masks and filtering face-piece respirators during the coronavirus disease 2019 (COVID-19) pandemic: A rapid systematic review - Volume 42 Issue 1

https://www.cambridge.org/core/journals/infection-control-and-hospital-epidemiology/article/extended-use-or-reuse-of-singleuse-surgical-masks-and-filtering-facepiece-respirators-during-covid19-a-rapid-systematic-review/A5DACFDC66C8D3001F4A2E67C6A7AEF6
I had a walk-on part in an important study by @lusignan_s and his team to sort out the nomenclature and coding of Covid-19 (building the ship while sailing it etc).
https://eprints.gla.ac.uk/220558/ 
19/
With @kamleshkhunti and others, I wrote about how the ‘Covidisation’ of health services threatens the care of long term conditions. https://www.bmj.com/content/371/bmj.m3793
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Pandemic threatens primary care for long term conditions

Change is required to ensure effective care during and after covid-19 During the height of the covid-19 pandemic, attention was diverted away from primary care’s key roles in early detection of...

https://www.bmj.com/content/371/bmj.m3793
I joined a group led by @thewrittenro arguing for effective and proactive community engagement in the vaccine rollout.
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)32642-8/fulltext?dgcid=hubspot_email_newsletter_tlcoronavirus20&utm_campaign=tlcoronavirus20&utm_medium=email&_hsmi=102667025&_hsenc=p2ANqtz-9p-l7TpN7CXp_1rEABOL6xdSriG353pCHVokE9ZEbbZhOBxk6kgysZL0JdXKsUNnagWtrhBrQnr8uU-7u_Y5jnrjCaSw&utm_content=102668959&utm_source=hs_email
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The COVID-19 vaccines rush: participatory community engagement matters more than ever

The announcement of effective and safe vaccines for COVID-19 has been greeted with enthusiasm. Discussions continue about the ethical challenges of ensuring fair access to COVID-19 vaccines within...

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)32642-8/fulltext?dgcid=hubspot_email_newsletter_tlcoronavirus20&amp;utm_campaign=tlcoronavirus20&amp;utm_medium=email&amp;_hsmi=102667025&amp;_hsenc=p2ANqtz-9p-l7TpN7CXp_1rEABOL6xdSriG353pCHVokE9ZEbbZhOBxk6kgysZL0JdXKsUNnagWtrhBrQnr8uU-7u_Y5jnrjCaSw&amp;utm_content=102668959&amp;utm_source=hs_email
Pandemics are uncertain. I wrote about managing uncertainty in Covid-19 with @harryrutter and @mirandarwolpert
https://www.bmj.com/content/370/bmj.m3349
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Managing uncertainty in the covid-19 era

Uncertainty is inevitable in pandemics, but some simple rules help decision making The covid-19 pandemic is maturing, but uncertainties continue to multiply for individuals and for policy makers....

https://www.bmj.com/content/370/bmj.m3349
I worried that evidence-based medicine (EBM), so often a force for good, had become too tied up in its own methodological red tape to be able to deal with complexity and uncertainty in the pandemic.
https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1003266
22/
Will COVID-19 be evidence-based medicine’s nemesis?

https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1003266
Intern Gilly Mroz along with @rushforthalex, @ChrysanthiP and me, analysed media depictions of remote consulting in the first wave of the pandemic.
https://bjgp.org/content/71/702/e1.short
24/
Changing media depictions of remote consulting in COVID-19: analysis of UK newspapers

Background Remote consulting was introduced quickly into UK general practice in March 2020 as an emergency response to COVID-19. In July 2020, ‘remote-first’ became long-term government policy. Aim...

https://bjgp.org/content/71/702/e1.short
In December 2020, I gave a lecture about the stormy relationship between scientists, the media and the public, called “Give me back my fact”. You can watch it here (from about 9 min for half an hour):
https://twitter.com/CfSocialScience/status/1337430965749166080?s=20

25/
In 2021 I'll be focusing on some ongoing and new research, especially the continuing impact of remote health services (and how to reduce inequalities as services go more digital), and validation of the RECAP score.

/end
You can follow @trishgreenhalgh.
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