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apsmunro's profile
Alasdair Munro
Alasdair Munro
Alasdair Munro
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@apsmunro

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Alasdair MunroVerified account

@apsmunro

Paediatric Registrar | Clinical Research Fellow Paediatric Infectious Diseases @southamptonCRF | Lead Fellow @covboost Trial | Husband and dad | No £COI

United Kingdom
dontforgetthebubbles.com/evidence-summa…
Joined April 2013

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    Alasdair Munro‏Verified account @apsmunro 1 Oct 2020

    "If there's one thing we learn from history, it's that we don't learn from history" A new study from India looks at #COVID19 contact tracing And now reported, "[children] transmitted the virus at rates similar to the rest of the population" 🤔 https://www.latimes.com/world-nation/story/2020-09-30/largest-covid-19-transmission-study-highlights-super-spreaders … 1/10

    3:38 AM - 1 Oct 2020
    • 154 Retweets
    • 332 Likes
    • Michael Brown Fanni K WernerTrapmann @EU27k #PECS @NowTheCitizens Peter ailment73 Spire Kirstin K Andrew Jehl Mathewes 🍦 🧦 Silvia de Dios
    21 replies 154 retweets 332 likes
      1. New conversation
      2. Alasdair Munro‏Verified account @apsmunro 1 Oct 2020

        There is SO much to dig in to here because these findings are complex - but we'll stick with the major issues for now Child index cases were found to have a high proportion of positive contact of the same age They must infect them easily, right? https://science.sciencemag.org/content/early/2020/09/29/science.abd7672.full … 2/10pic.twitter.com/SIUK2IUUkM

        4 replies 9 retweets 38 likes
        Show this thread
      3. Alasdair Munro‏Verified account @apsmunro 1 Oct 2020

        The first caveat, is that to be defined as a index case, the child was almost certainly symptomatic Symptomatic people seem to be much more infectious than asymptomatic A large proportion of children seem asymptomatic (~50%) so findings are not generalisable But wait... 3/10

        5 replies 9 retweets 59 likes
        Show this thread
      4. Alasdair Munro‏Verified account @apsmunro 1 Oct 2020

        We've been here before Remember this study from South Korea which was widely reported to show children aged 10 - 19 were just as infectious as adults? https://wwwnc.cdc.gov/eid/article/26/10/20-1315_article … 4/10

        1 reply 6 retweets 39 likes
        Show this thread
      5. Alasdair Munro‏Verified account @apsmunro 1 Oct 2020

        And remember this study ON THE SAME DATA which corrected for shared exposure (the index case and suspected secondary case both exposed to same original infection source) and found extraordinarily low rates of confirmed secondary infections? https://adc.bmj.com/content/early/2020/08/06/archdischild-2020-319910 … 5/10

        2 replies 12 retweets 56 likes
        Show this thread
      6. Alasdair Munro‏Verified account @apsmunro 1 Oct 2020

        This study has the same methodology, and suffers from the same massive source of bias Children (particularly young children) do not travel alone, especially during lock down in a pandemic They are getting exposed at the same time as their close contacts (usually family) 6/10

        4 replies 12 retweets 81 likes
        Show this thread
      7. Alasdair Munro‏Verified account @apsmunro 1 Oct 2020

        The infected close contacts around same age are likely to be siblings who would be going wherever the index case is going, being exposed to the same sources of infection It is impossible to tease out who the index case infected and who got infected at the same time as them 7/10

        1 reply 7 retweets 59 likes
        Show this thread
      8. Alasdair Munro‏Verified account @apsmunro 1 Oct 2020

        We can see from the graph that the older the children (and more mobile/independent) the lower the rate of associated positive close contacts were around the same age Reduced "infectiousness" seems unlikely to be the cause 8/10pic.twitter.com/L6yJVYH1XF

        1 reply 7 retweets 47 likes
        Show this thread
      9. Alasdair Munro‏Verified account @apsmunro 1 Oct 2020

        Now it may be the case that infected children are just as infectious; it has been difficult to determine Indirect evidence from schools/family clusters with known direction of transmission has suggested not, but we can't be certain This study doesn't get us closer 9/10

        3 replies 7 retweets 50 likes
        Show this thread
      10. Alasdair Munro‏Verified account @apsmunro 1 Oct 2020

        What we should have learnt by now is; -These studies have massive bias for children which cannot be overlooked -Single studies (no matter how big) should not influence policy without context of previous evidence -In contact tracing, small and detailed beats big and dirty 10/10

        12 replies 24 retweets 158 likes
        Show this thread
      11. End of conversation
      1. New conversation
      2. Just An Ordinary Bloke‏ @Unusual_Times 1 Oct 2020
        Replying to @apsmunro

        Great piece isn't it - picked up on in in the middle of the night and was furiously remodeling to include super spreaders. I think we have vastly underestimated their effect on transmission.

        1 reply 1 retweet 7 likes
      3. Alasdair Munro‏Verified account @apsmunro 1 Oct 2020
        Replying to @Unusual_Times

        The paper is awesome and has some really interesting findings - it's a feast of data! But people are really quick to very superficially assess these results and looking at tracing on this scale without granular detail is so complicated It has not been well appreciated

        3 replies 0 retweets 30 likes
      4. Show replies

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