Some say our only options are (1) lockdown until we have a vaccine, or (2) “controlled” infection of the young to eventually achieve herd immunity. I believe this to be a false choice, demonstrating a serious lack of imagination.https://twitter.com/nataliexdean/status/1256329944323387392 …
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Some will say “herd immunity is not the strategy, it is the outcome.” It is the strategy that I think is bad! The idea is to slow but not eliminate transmission in the young, while walling off those at high risk. Transmission slows once enough young people have been infected.
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I believe that those who support “managed” infection strategies are underestimating the true impact on morbidity and mortality (the numbers are staggering!). And they are over-estimating their ability to “manage” a virus that has so quickly gotten out of hand.
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Any strategy that does not aim to protect EVERYONE from infection will put EVERYONE at risk. Young people work at nursing homes, or live with their parents. The world is not neatly separated into high risk and low risk. The virus will not respect these divides.
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So what is the alternative? Lockdown until a vaccine is not tenable, particularly in the developing world. But why are those our only choices? I don’t think New Zealand and South Korea need to be in lockdown for the next 12-18 months. So why do the rest of us?
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In my opinion, “managed infection” is giving up! Giving up on test, trace, isolate. Digital tracing. Universal testing. Pre-exposure prophylaxis. Sustainable changes to our behavior. I’m NOT saying it will be easy, but accepting that so much death is inevitable is insane! END
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Als antwoord op @nataliexdean
RDTs. I'm now convinced they'll be our (first) saving grace. Then drugs. Then vaccine. This can be done.
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Als antwoord op @K_G_Andersen
Exactly! A point-of-care diagnostic test would be a game changer.
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Als antwoord op @nataliexdean
.. and what makes me really optimistic about this is the fact that this will be driven by scientific innovation and uptake by companies. It'd be great to have national leadership on this, but compared to 'standard' test, trace, isolate, it's not necessary. Time? A few months!
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Als antwoord op @K_G_Andersen @nataliexdean
What do we do then without a pill you can take home? Get people who test positive at the doctor's office into hotels? (I would support this)
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I’m a big fan of isolation outside the home, but I doubt it’ll happen. With massive testing I suspect we’ll learn to self isolate. The beauty of RDTs is that doctors offices aren’t involved - we’re talking testing at the workplace, in the restaurant line, etc.
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Als antwoord op @K_G_Andersen @nataliexdean
Oh yea that’d be amazing. I worry about household transmission with in-home isolation. maybe it’s not enough to sustain exponential growth but it’s hard to see a saving grace without quashing it.
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Relatedly, I think you're right that out-of-home isolation won't happen, but I really think people would go for a free hotel room and room service for a couple of weeks to keep their families safe. Huge missed opportunity here imo.
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