Jake Dunning @OutbreakJake Twitter profile | Pikagi

Pikagi

Jake Dunning

@OutbreakJake

11,944

Followers

1,569

Following

309

Media

9,274

Statuses

Personal account/views. Infectious diseases consultant & researcher. Emerging & high consequence infectious diseases. Humanist.

London, England

https://t.co/iLF5msgAVk

Joined March 2012

Don't wanna be here? Send us removal request.

Pinned Tweet

@OutbreakJake

Jake Dunning

7 days

Clinical Management of Hospitalized Patients With High-Consequence Infectious Diseases in England | Health Security We explain how England's HCID Networks provide safe, expert care to people with infections like avian flu, clade I mpox, Ebola & Lassa fever

Tweet card media

Clinical Management of Hospitalized Patients With High-Consequence Infectious Diseases in England |...

Infectious disease physicians in England have been diagnosing and managing occasional cases of viral hemorrhagic fever since 1971, including the United Kingdom’s first case of Ebola virus disease in...

www.liebertpub.com

1

4

15

Last Seen Profiles

@YaleClassicsLib

@eadged

@tyunsehosihosi

@Mbahmaryono77

@jamespaskins

@StalkingVi96051

@bokeplokalmalam

@york_jenni55886

@albedo_mandarin

@MktbAmr

@jandakembangstw

@Debby_Serang

@claretat2

@_alex99good

@TelloBox1

@stw_pdg

@erkantarhantr

@WednesdayPM_84

@paklove77

@StadiumThrills

@DannyOlima

@misterj1995

@Time_Intensive

@AE868655

@keitanaaa

@Jeffry81067857

@thiagomilcent

@Sparkles_favour

@BtownGaels

@xbinazirx

@ThrashWeeaboo

@reyneill_

@Sofi_pl4

@Theeli262370

@BROWNIE_bott

@siapkantisu

@OutbreakJake

Jake Dunning

4 years

No, because it's totally disproportionate to any reasonable estimate of risk. Stop whipping up hysteria and anxieties. Stop singling out outdoor runners for no good scientific reason and instead focus on avoiding the actual high risk, indoor scenarios for transmission.

@GMB

Good Morning Britain

4 years

Should runners wear masks? Professor Trish Greenhalgh tells @piersmorgan and @susannareid100 that it is 'important to be socially responsible' due to the way Covid transmits. Amid the fears that a wet mask can breed germs, she says the mask should be washed straight away.

1K

94

312

47

114

1K

@OutbreakJake

Jake Dunning

3 years

And so it begins, one of the greatest medical screening experiments in the history of medicine in the UK. We all knew Dom's pet project would not simply disappear, despite it going quiet recently. No doubt there will be a veneer of public health pseudoscience coming to support it

Tweet media one

58

267

694

@OutbreakJake

Jake Dunning

4 years

@CMO_England considers the question can't people just be allowed to take their own risk? He said "if I as an individual increase my risk, I increase the risk to everyone around me, and then all of their contacts". Spot on. Societies acting collectively are achieving the most.

14

209

663

@OutbreakJake

Jake Dunning

4 years

Worried about COVID-19 risks outdoors? Ignore the increasingly bizarre musings about outdoor aerosol risks coming from some who should know better, and instead listen to Muge - a real expert on viruses, who also understands risk assessment. No need to panic, or to shame joggers.

@mugecevik

Muge Cevik

4 years

Concerns about outdoor transmission risk seem to be trending again. What is the risk of transmission outdoors and should we be more worried about outdoors with the new more-transmissible variant? 🧵(1/n)

419

6K

14K

23

146

622

@OutbreakJake

Jake Dunning

3 years

Yeah, because that's what everyone in Public Health lives for: more lockdowns. FFS, even for the right wing Libertarian press, this is truly pathetic.

Tweet media one

52

59

482

@OutbreakJake

Jake Dunning

3 years

History will rightly judge rich countries that keep saying "we can boost our own people & provide vaccines to poorer countries". Words, not actions thus far - just 15% of doses promised have been delivered to LICs. I will not accept a booster until vaccine inequity is addressed.

45

71

483

@OutbreakJake

Jake Dunning

4 years

So please, I beg you, as a respiratory IPC expert and someone who still looks after sick patients in hospitals: please stop peddling the idea that we are skimping and knowingly putting colleagues at risk; it's simply not true and is making this whole situation scarier for people.

12

108

446

@OutbreakJake

Jake Dunning

3 years

Just a reminder, while everyone is busy promoting boosters for all in the hope they will reduce Omicron's impact, that a huge proportion of people living in low- and middle-income countries are yet to receive even a first or second dose, thanks to the actions of rich countries.

13

101

462

@OutbreakJake

Jake Dunning

3 years

Out of interest, is any comparable country evaluating its pandemic response through a series of personal recollections and anecdotes that may lack objectivity or impartiality, whilst still responding to a pandemic? Or is this another "world-beating" achievement for the UK?

15

59

405

@OutbreakJake

Jake Dunning

4 years

Please read Adam's thread. No one is trying to induce immunity in a lot of people deliberately; antibody responses will follow naturally, in a lot of people all over the world, because this is a pandemic & so many people will be infected. The key goal is to avoid a sharp peak.

@adamjkucharski

Adam Kucharski

@adamjkucharski

4 years

I am deeply uncomfortable with the message that UK is actively pursuing ‘herd immunity’ as the main COVID-19 strategy. Our group’s scenario modelling has focused on reducing two main things: peak healthcare demand and deaths... 1/

528

5K

13K

29

191

405

@OutbreakJake

Jake Dunning

5 years

We have updated the #COVID19 infection prevention and control guidance for hospitals in England. Note the changes made to PPE recommendations for different clinical scenarios; this applies to all departments, including ICU - just follow the table.

Tweet card media

[Withdrawn] COVID-19: infection prevention and control (IPC)

Guidance on infection prevention and control for seasonal respiratory infections including SARS-CoV-2.

20

358

409

@OutbreakJake

Jake Dunning

4 years

Everyone just needs to follow the table. Right tool for the job, risk-assessment approach. I stress again, safety is not being compromised. However, we all still need to take care. Whatever the PPE, use it carefully and remove it safely. We are all in this together. Thanks.

Tweet media one

13

168

397

@OutbreakJake

Jake Dunning

3 years

My one top tip on pandemics, which I've been repeating since 2010: never make confident predictions in public about pandemic waves or their likely impact. There's a good chance you'll be wrong, or only partially correct; either way, it will probably come back to haunt you.

13

44

400

@OutbreakJake

Jake Dunning

4 years

Sigh, deep breath... Infectious virus particles can "stick around" for 3 hours in air in a sealed device that is designed to keep particles suspended (for 3h). THAT IS NOT THE SAME AS REAL LIFE. Please report science responsibly; if you do not understand a study, ask an expert.

@TheEconomist

The Economist

4 years

The virus can stick around for at least three hours in the air

1K

9K

11K

8

147

379

@OutbreakJake

Jake Dunning

4 years

This is why we do clinical trials. The comments below the post are a real eye-opener. If RECOVERY does confirm HCQ does not work as a treatment for COVID-19, I suspect there will still be people who refuse to believe it, for a multitude of reasons unrelated to science.

@BBCPolitics

BBC Politics

4 years

"There’s no reliable evidence" that hydroxychloroquine works says Professor Peter Horby The Chair of NERVTAG tells #Marr it’s "reckless" to advertise it as a treatment for #Covid_19

38

69

127

25

135

377

@OutbreakJake

Jake Dunning

5 years

Sad to hear on @BBCr4today a person infected with #nCoV2019 being referred to as a "super-spreader". This is inaccurate and inappropriate language that is potentially stigmatising and harmful. Please be more responsible and accurate with your language.

20

89

381

@OutbreakJake

Jake Dunning

4 years

Not sure everyone seeing patients is aware of the request to report cases of #COVID19 where the person had been vaccinated. This surveillance applies to patients & infected HCWs, unless HCW is in SIREN study (it has a separate mechanism). Criteria below.

Tweet card media

[Withdrawn] [Withdrawn] Reporting to the enhanced surveillance of COVID-19 cases in vaccinated...

32

407

372

@OutbreakJake

Jake Dunning

3 years

@DrNeilStone Most people in UK will not have travelled to places requiring yellow fever certificates, so why would one expect them to be aware of a travel-associated vaccine requirement? And there's a big difference between certification to enter another country & to enter a venue in the UK.

8

16

345

@OutbreakJake

Jake Dunning

4 years

So I'm officially off duty, trying to have a few rest days before things get even worse. I am, inevitably, doing some work. But I've not been out of the house for 3 days. Why? Simple, because I have no need to. The number of selfish people doing the exact opposite is appalling.

15

33

335

@OutbreakJake

Jake Dunning

4 years

PS: the full guidance is available here: It's a bit of a long read, but it contains lots of detail and explains the transmission risks and associated precautions in more detail.

20

90

305

@OutbreakJake

Jake Dunning

4 years

I needed to read this myself today. It's good to pause, reflect, and keep one's own mental well-being in check, whoever you are. BBC News - Coronavirus: How to protect your mental health

4

177

308

@OutbreakJake

Jake Dunning

3 years

It's a shame that you have to get all the way to the end before seeing any mention of the difference between effectiveness of vaccines against infection and effectiveness against the important consequences of infection (e.g severe disease).

Covid infection protection waning in double jabbed

Experts say it is to be expected and boosters may be needed, at least for some people, ahead of winter.

22

57

298

@OutbreakJake

Jake Dunning

3 years

On the 'ignoring a bleeping smoking alarm' analogy for the COVID App, it's not a good one. People tend not to tolerate smoke alarms that go off every time they make some toast. Devices that do not work as intended, or are too sensitive, can be counterproductive & can cause harms.

21

32

284

@OutbreakJake

Jake Dunning

5 years

Calling UK hospital staff - we have added #COVID -19 PPE videos to the @PHE_uk YouTube channel. Donning PPE: Doffing PPE: Links are being added to the IPC guidance on . With thanks to @GSTTnhs . @NHSEngland

Tweet card media

COVID-19: Donning of Personal Protective Equipment (PPE)

This video shows how to safely don (put on) the Personal Protective Equipment (PPE) for Aerosol Generating Procedures (AGPs) specific to COVID-19. This guida...

www.youtube.com

9

250

278

@OutbreakJake

Jake Dunning

3 years

One of the most important papers to emerge during the pandemic, in my opinion. Well worth a read. A good reminder to address our preconceptions, biases & polarised viewpoints, and not take all we are told at face value. Embrace the shades of grey!

13

85

275

@OutbreakJake

Jake Dunning

2 years

Calling UK clinicians & public health practitioners. UKHSA has provided/updated guidance on case defs, vaccination and contact tracing/management this weekend. Links now added to monkeypox guidance page, but easy to miss, so here is the link to the section

Tweet card media

Mpox: background information

The epidemiology, symptoms, diagnosis and management of monkeypox virus infections.

14

190

272

@OutbreakJake

Jake Dunning

3 years

On the bright side, at least all those poor sensitivity LFD tests that the UK government bought prematurely will not go to landfill unused. And I guess those who are involved in lucrative LFD and consultancy contracts will continue to benefit. Great stuff - backdoor Moonshot.

12

58

261

@OutbreakJake

Jake Dunning

3 years

It's immoral to boost many to 'optimise immunity', without evidence that's it's needed, while at the same time knowing the clear benefits of two doses and that millions globally are being denied two doses through the selfish actions of the richest nations.

We shouldn’t be giving Covid boosters while millions wait for a first dose | Andrew Pollard and...

There’s no evidence yet that top-up shots are needed, so let’s help those around the world who urgently need the vaccine, say Andrew Pollard and Seth Berkley

www.theguardian.com

17

75

258

@OutbreakJake

Jake Dunning

4 years

I finally found the guy who comes up in all of my publication searches (and puts me to shame in terms of academic outputs). Even better, he appears to be a wonderful human being and a #COVID19 #NHS hero!

@joeldunning

Thoracic Surgeon - Joel Dunning

4 years

I have changed from being a consultant thoracic surgeon to an ICU Nurse to help with the intense pressures on our ICU now. If like me you are in the NHS but working less to free up space for COVID patients, can I encourage you to #put -in-a-shift in your ICU to help them out !

885

6K

26K

5

34

248

@OutbreakJake

Jake Dunning

1 year

Sadly, this Tweet is misleading. The reality: if you manage to get into medical school at 18, study for 6 years (which costs £9k per year), do 8 years of junior doctor service, exams & training, & then 19 years as a consultant, you will eventually earn £106k pa, 33 years later 🎉

Tweet media one

@DHSCgovuk

Department of Health and Social Care

1 year

The BMA has demanded a 35% pay rise for junior doctors. Junior doctors can undertake career advancement to long term careers, with the starting salary for consultants being £88,364.

Tweet media one

305

28

73

11

59

242

@OutbreakJake

Jake Dunning

3 years

It appears we're being asked to participate, with minimal info, in a mass screening experiment driven by political expediency, seemingly to speed up the exit from lockdown. A security blanket of false reassurance to encourage mixing, and an arrogant refusal to consider harms.

4

69

238

@OutbreakJake

Jake Dunning

3 years

Is SARS-CoV-2 infection less of a risk when you get it for a second time? Important research [pre-Omicron] from @UKHSA colleagues: Evaluation of disease severity during SARS-COV-2 reinfection, January 2020 to April 2021, England: an observational study

Tweet media one

Tweet media two

Tweet media three

12

85

223

@OutbreakJake

Jake Dunning

4 years

The roads in London and my Tube journey were noticabley busier this morning. Why? Nothing has changed and this outbreak is far from over. This is no time for selfishness that may sicken and kill (let's call it out for what it is). Stay at home. Protect the NHS. **SAVE LIVES**.

20

83

212

@OutbreakJake

Jake Dunning

4 years

As seen and smelled when walking home from work the other day: the bluebell meadow next to @RoyalFreeNHS . Moments of joy like this really make a difference. It's very much a privilege currently, I know, and I am truly grateful.

Tweet media one

8

16

204

@OutbreakJake

Jake Dunning

4 years

The UK ranks sixth globally in net national wealth & now we're having to fight for free school meals & rely on charitable food banks to stop families going hungry. We live in a country that prides itself on charity, charity that should not be needed. It's perverse and a disgrace.

11

46

202

@OutbreakJake

Jake Dunning

3 years

@sdbaral Apparently, those of us who say this, including people who spend their lives studying emerging and established respiratory viruses and the infections they cause, and how to reduce their impact, do not understand what 'zero covid' means. Personally, I'd rather not deceive people.

7

7

195

@OutbreakJake

Jake Dunning

3 years

@devisridhar I suspect in the future we may be able to describe similarities between SARS-CoV-2 infection (at that point in time) & seasonal respiratory virus infections, but we're not there yet. Brave & misleading for ministers to say/imply that we know they're behaving similarly right now.

13

19

203

@OutbreakJake

Jake Dunning

3 years

While we in the UK celebrate the extension of vaccination to groups at relatively low risk of severe/complicated COVID & start planning boosters for others, countries with inadequate supplies of vaccines continue to suffer. We must do more to help others.

@wesselsjohn1

John Wessels

3 years

Senegal’s third wave - cemeteries are saying that they are burying as many people in 2 days as they usually would in a week - Dakar, 2021. #afp #afpphoto #photojournalism #senegal #dakar #reportage #covid

Tweet media one

Tweet media two

2

70

85

12

69

188

@OutbreakJake

Jake Dunning

3 years

Don't get too hung up about which vaccine you've received or are being offered - both are doing their stuff well, despite variants. The most important thing is that we all take up the offer of vaccination and turn up for both doses. Safe, effective vaccines - nothing more to say.

@MAbsoud

Michael Absoud

3 years

Delta variant in UK Significant reduction in Hospitalisations after 1 dose (57-85%) And particularly after 2nd dose (85-98%)

Tweet media one

6

77

170

13

54

187

@OutbreakJake

Jake Dunning

4 years

Thanks for sharing these important data. To minimise future deaths and suffering, we must continue to call out all those who spread misinformation, whether it's a deliberate propaganda tactic or simply due to ignorance or a failure to learn facts about #COVID19 (and flu).

@laoneill111

Luke O'Neill

4 years

These data indicated how much more severe COVID19 is for those over 35 when compared to flu.

Tweet media one

0

984

2K

8

99

179

@OutbreakJake

Jake Dunning

5 years

Important new guidance for everyone to be aware of in the UK. If you have the most common symptoms of #COVID19 infection (cough; fever) AND have a mild illness, follow the new stay at home guidance: Testing of people with mild illness has now stopped.

9

171

183

@OutbreakJake

Jake Dunning

3 years

I'm as desperate as anyone for life to return to normal, but this is ill-considered medical screening. It may also signify abandonment of the principles of medical screening in England; perhaps a taste of things to come with UKHSA - political ideas dictating public health policy?

4

42

178

@OutbreakJake

Jake Dunning

3 years

Nice example of a scientist who is not afraid to say what they think should happen, but who also acknowledges complexities, weaknesses & uncertainties, & respects different scientific opinions & models, & does it without slagging off others or using passive-aggressive sub-tweets.

@JamesWard73

James Ward

3 years

So it’s time for me to come off the fence re 19th July. I’m in favour of: a) Opening up on 19/7, but with stronger mitigating baseline measures than the govt is proposing b) Opening up vaccinations to 12-17s as supply permits, starting with the vulnerable. Long🧵follows...

210

403

2K

6

15

180

@OutbreakJake

Jake Dunning

2 years

Feigl-Ding only has one purpose - to get noticed (and earn money by being recognised). He has zero expertise in anything to do with infectious diseases.

@benryanwriter

Benjamin Ryan

2 years

Here is one of Eric Feigl-Ding's most egregious posts about monkeypox, in which he falsely jumped to the conclusion that airborne transmission was a substantial threat. In fact, the overwhelming driver of the outbreak was intercourse between men.

10

70

434

5

23

173

@OutbreakJake

Jake Dunning

4 years

Noticeable difference tonight on my way home from work (Saturday night). Streets deserted now. Tube was like a personal taxi, and super-fast too. Well done, London! And thanks to @TfL for getting me and other key workers home safely. #StayAtHome #ProtectOurNHS #SaveLives

4

17

168

@OutbreakJake

Jake Dunning

3 years

@bealelab I suspect this mistake left you shaken, but not stirred?

3

4

171

@OutbreakJake

Jake Dunning

3 years

Seriously, what is it about people misrepresenting published data and making baseless assumptions about others?

@jneill

James Neill  ≠ 𝕏

3 years

Seriously what is it with pediatricians minimising child Covid.

9

6

44

6

7

161

@OutbreakJake

Jake Dunning

3 years

@apsmunro @mugecevik @kallmemeg @chrischirp @martinmckee One of the most pointless exercises throughout the pandemic has been the recurring, real-time comparison of countries 'performance' without proper consideration of how numbers are generated & reported differently.

5

15

165

@OutbreakJake

Jake Dunning

4 years

I am proud to be just one small part of @PHE_uk . My colleagues have worked around the clock since January, and continue to do so, under very difficult circumstances.

@UKHSA

UK Health Security Agency

4 years

Thanks to @MattHancock for recognising the contribution of Public Health England scientists who are working round the clock to keep people safe #COVID19

16

67

329

12

23

164

@OutbreakJake

Jake Dunning

3 years

Brilliant study - congratulations to all involved. Who, like me (repeated exposures, never had COVID, remains anti-N Ab negative), is wondering whether they have some juicy pre-existing PA-specifc T cells knocking around? I'd love to know about my own T cells!

@maini_lab

Maini Lab UCL

3 years

🚨Advance publication out today in @Nature 🚨 Pre-existing polymerase-specific T cells expand in abortive seronegative SARS-CoV-2 Our latest work as part of @UKCICstudy

61

172

482

8

29

160

@OutbreakJake

Jake Dunning

4 years

When #COVID19 started back in January, PHE issued guidance rapidly and recommended FFP3, gown, eye protection and gloves for all scenarios in hospitals. This was in excess of what is needed, but it was early days (in learning mode) & we wanted a single, easy to follow approach.

6

39

149

@OutbreakJake

Jake Dunning

4 years

Thank goodness for sensible opinions from sensible people. Enough with scaring people unnecessarily and encouraging people to extend the use of face coverings to situations with arguably neglible risk. BBC News - Covid-19: Can you catch the virus outside?

Covid: Can you catch the virus outside?

The risks of catching Covid indoors are well-known, but what are the chances of being infected outdoors?

12

58

154

@OutbreakJake

Jake Dunning

4 years

Spending NYE and the next 3 days as part of the national incident response team is no walk in the park (particularly 12 months in), but I really feel for all my NHS hospital colleagues this New Year, especially my own @RoyalFreeNHS family. Stay strong, stay safe, and thank you.

5

2

156

@OutbreakJake

Jake Dunning

2 years

Waking up to monkeypox Spot on, from my friends & colleagues Piero Olliaro & Emmanuel Nakoune. We shouldn't need to wait for emerging infections to occur in rich countries to address the same disease occurring more commonly in low & middle income countries

Tweet card media

Waking up to monkeypox

In the past couple of weeks, the world has discovered monkeypox, an otherwise neglected infection caused by an orthopoxvirus related to the now eradicated smallpox. Monkeypox has been causing regular...

5

57

157

@OutbreakJake

Jake Dunning

4 years

Unsurprisingly, there is a massive global demand for PPE right now. Thanks to advanced pandemic planning, the UK has some reserve stocks of PPE and we are better off than many other countries. But this is not an infinite supply and most PPE is made in... China

8

30

148

@OutbreakJake

Jake Dunning

3 years

12 years ago this week I was lucky enough to be taking this photo of Monte Fitz Roy. I trekked for 14 hours that day, sometimes through waist-deep snow. I met just one person all day, a park ranger. It was truly wonderful, at the end of a great HIV medicine placement in Argentina

Tweet media one

7

8

157

@OutbreakJake

Jake Dunning

2 years

Thank you to patients around the world, from past & current monkeypox outbreaks, who gave permission for photos of their skin lesions to be shared online & in publications, to educate & inform healthcare professionals & members of the public. I'm certain it's helped many people.

0

14

151

@OutbreakJake

Jake Dunning

3 years

COVID-19 vaccination: evidence of waning immunity is overstated From @mugecevik and colleagues.

7

28

150

@OutbreakJake

Jake Dunning

5 years

Disease X Academic Prophecy: 1. Share the genome! 2. Minion +++ 3. Heavily caveated modelling delights newspapers 4. Angry letters about port screening 5. Angry letters about PHEIC/no PHEIC 6. Someone mentions statins 7. Armchair Expert reviews 8. Advise on HBO mini-series Fin

13

31

147

@OutbreakJake

Jake Dunning

3 years

One thing is certain: few people know what it's like to be a member of an advisory committee to government (in addition to normal day jobs) during a major health crisis involving a completely new infectious disease. Good to know there's no shortage of willing, skilled volunteers.

9

6

148

@OutbreakJake

Jake Dunning

4 years

I could not have said it better, or any more clearly. #StayAtHome .

5

56

144

@OutbreakJake

Jake Dunning

3 years

A good reminder (including to myself) that COVID knowledge & decision-making is often more grey than black and white. What we think should happen, will happen, or has happened, is not necessarily supported by actual data. Objective appraisal remains important, even in a crisis.

@drraghibali

Dr Raghib Ali OBE MD MPH FRCP

3 years

Seven persistent myths about Covid and lockdowns in the UK / England. I thought I would put one thread together on what I think are 7 myths that continue to be propagated - mainly by those who, although well-intentioned, always assume that more restrictions are the answer.

282

2K

6K

8

42

146

@OutbreakJake

Jake Dunning

4 years

Stability & Viability of SARS-CoV-2, NEJM: correspondence & authors' reply. Take home: keep going with droplet & contact precautions, plus additional airborne precautions if you're around aerosol-generating medical procedures (just like we've been saying).

Tweet card media

Stability and Viability of SARS-CoV-2 | NEJM

To the Editor: The letter by van Doremalen et al. (published March 17 at NEJM.org)1 provides important information on the viability of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, t...

5

70

145

@OutbreakJake

Jake Dunning

4 years

The main transmission risks for coronaviruses are exposure to droplets, inhalation of which is prevented by a surgical mask, & contact-transfer of virus (prevented by gloves, apron, careful doffing, hand hygiene etc.). This is fine & true for most clinical scenarios in hospitals.

5

34

142

@OutbreakJake

Jake Dunning

4 years

More great news in the fight against #COVID19 ! A European adaptive RCT of antiviral treatment is now recruiting & it includes the following arms: standard of care (SoC); SoC + remdesivir; SoC+ Kaletra; SoC + Kaletra + interferon-beta-1a. Well done to the trial team on launching.

@nathanpsmad

Nathan Peiffer-Smadja

4 years

DisCoVeRy c'est parti ! DisCoVeRY clinical trial: first inclusions today. Bravo à tous @IAME_Center @Cedric_Laouenan @yazdanpanah_y @REACTing_fr @Inserm NCT04315948 @GBirgand @Laurie_Garrett @HelenBranswell @ABsteward @LaSF2H @Professeur_geek @e_charani

Tweet media one

Tweet media two

Tweet media three

7

83

130

9

64

141

@OutbreakJake

Jake Dunning

3 years

What is the evidence that red-listing quickly, following initial spread of a new signficant VOC in another country with many travel links, buys useful time (accepting that cannot stop all importations & that some may have already occurred)? Does that time change final outcomes?

35

20

143

@OutbreakJake

Jake Dunning

4 years

By rationalising the PPE recommendations, so that the right tools are used for each job (clinical scenario), according to transmission risks, we will help ensure that we do not run out of PPE, especially the components needed for AGPs.

3

27

133

@OutbreakJake

Jake Dunning

3 years

I fear for those who have false positive tests, given the performance of T&T and the likely slow turnaround of confirmatory tests, just as I fear about consequences of false negatives - the potential 'green light' false reassurance effect, which has not been studied sufficiently.

3

24

140

@OutbreakJake

Jake Dunning

24 days

I've been diagnosing, managing and doing research on mpox outbreaks in the UK & internationally since 2018, and even I find this advice bizarre and a tad fear-mongering. It does not seem like normal human behaviour, but each to their own, I guess? I do worry if all's okay though.

Tweet media one

19

25

139

@OutbreakJake

Jake Dunning

3 years

@skepticalzebra Or, perhaps, fuelled by people who want to create anxiety and drama, to advance a particular agenda? Lying or even failing to fact-check is generally bad for all in the long run, even if the cause is a good one.

5

4

132

@OutbreakJake

Jake Dunning

4 years

Great to see there are so many people who know they will perform better, should they become the next CMO & they have a pandemic to deal with. Based on views expressed, we should also expect them to resign in protest when ministers reject their recommendations. Best of luck.

8

10

136

@OutbreakJake

Jake Dunning

4 years

As #COVID19 patient numbers increase, and continue to increase in coming weeks in the UK, we no longer have the luxury of using the easiest "no need to think" single ensemble approach for every scenario. We should not and cannot use PPE that is not necessary for the task at hand.

2

27

129

@OutbreakJake

Jake Dunning

2 years

Clinical features and management of human monkeypox: a retrospective observational study in the UK

Tweet card media

Clinical features and management of human monkeypox: a retrospective observational study in the UK

Human monkeypox poses unique challenges, even to well resourced health-care systems with HCID networks. Prolonged upper respiratory tract viral DNA shedding after skin lesion resolution challenged...

www.thelancet.com

11

64

136

@OutbreakJake

Jake Dunning

4 years

The exception is when we do something to a patient that generates an aerosol (tiny droplet nuclei that can penetrate surgical masks and linger in the air). This risk is mitigated by engineering (e.g. negative pressure rooms) and ultra-fine close-fitting masks, plus eye protection

Tweet media one

8

27

132

@OutbreakJake

Jake Dunning

4 years

More people talking about mass testing, essentially saying that a poorly performing test can & should be tolerated, with no discussion of positive & negative consequences, or the change in pre-test probability over time, or what different tests tell you. Still, nice to be on TV..

11

33

133

@OutbreakJake

Jake Dunning

3 years

@devisridhar It is an experiment, but then much of our pandemic response has been a series of experiments or gambles, some better informed than others. I'd prefer less hubris from ministers, & recognition that you cannot simply tell a novel pandemic virus 'we've won, I'm ignoring you now'. 🙉

3

27

132

@OutbreakJake

Jake Dunning

4 years

With the word "airborne" being thrown around willy-nilly, I wonder whether we will soon see "miasma" being used to describe SARS-CoV-2 transmission?

16

23

129

@OutbreakJake

Jake Dunning

3 years

Well said. Perhaps some of the high-profile scientists who criticise & claim to have all the answers, but have no useful experience of Public Health work, processes & accountability during a pandemic, would benefit from some time spent working on the national incident response?

@BallouxFrancois

Prof Francois Balloux

@BallouxFrancois

3 years

I'm extremely impressed by the quality of the UK #COVID19 data. Their near-real time analyses or the PHE reports are unparalleled in their quality. I'm also in awe of the efforts to present those findings in an approachable way on social media for instance by @kallmemeg . 1/

30

166

1K

7

9

129

@OutbreakJake

Jake Dunning

2 years

This is just one reason why I'm not tweeting about MPX, despite managing cases since 2018 & being someone who does MPX research, policy etc. That & the fact that many with zero experience or relevant credentials seem to be offering their considered thoughts & 'expert advice'. 🤐

@MarionKoopmans

Marion Koopmans, publications: https://pure.eur.nl

@MarionKoopmans

2 years

Ok @Twitter crowd: a request, I am just explaining what I know of monkeypox and the situation. If you are not interested, fine, but quit using this to start pushing toxicity around. Thank you.

756

160

4K

6

10

128

@OutbreakJake

Jake Dunning

3 years

@sailorrooscout Here’s hoping! But it’s only really hope at this stage, as much as I value accounts of how things feel on the ground. We have to wait for quantitative data after usual time lags. We should also remember that a small % of a large number can be a big number itself. Fingers crossed.

5

6

122

@OutbreakJake

Jake Dunning

3 years

@EricTopol When headlining with 'what works?', it would seem important to also info people that these are findings from a modelling study only.

6

10

121

@OutbreakJake

Jake Dunning

4 years

Yet more important and meaningful clinical research from Shamez and other hard-working colleagues @PHE_uk - doing precisely what a public health agency is supposed to do, and doing it well and doing it quickly. Nothing 'sluggish' here.

@ShamezLadhani

Shamez Ladhani

4 years

#COVID19 in care homes: we found that older residents are able to mount the same antibody response and neutralizing antibodies against #SARSCoV2 as the younger healthier staff, irrespective of gender or having symptoms 👉

Tweet media one

19

122

289

2

43

118

@OutbreakJake

Jake Dunning

4 years

Now that we've learned more about the disease, #COVID19 is no longer classified as a High Consequence Infectious Disease ( #HCID ) in the UK. This does not change the seriousness of COVID19, or the importance of measures needed to control it. More info here:

Tweet card media

High consequence infectious diseases (HCID)

Guidance and information about high consequence infectious diseases and their management in England.

23

71

116

@OutbreakJake

Jake Dunning

7 years

Always surprised when friends say to me "but flu is only severe in the elderly". On 04 Jan 2011, there were 851 people with flu in critical care in England (=22% of adult & paeds CC beds). Median age of ICU flu cases (mainly H1N1) was 33y. 415 flu deaths in 15-64y in 2010/11.

4

118

114

@OutbreakJake

Jake Dunning

4 years

Wondering why the UK does not just throw everything at it, or simply copy what another country is doing? I was going to try to explain the honest scientific considerations that underpin our #COVID19 response, but @whippletom has done a better job than I could ever do on Twitter.

@whippletom

Tom Whipple

4 years

The UK government has just published its scientific evidence and it's....amazing

82

2K

4K

7

70

119

@OutbreakJake

Jake Dunning

3 years

Some important findings that add to our understanding of SARS-CoV-2 transmission and strategies to prevent it. See thread below. It's been a pleasure to co-lead the ATACCC study with Ajit Lalvani & work with all involved over the past 12 months, through pre-Alpha, Alpha & Delta!

@thepragmaticape

Ryan O'Hare

@thepragmaticape

3 years

1/ An important paper out today from researchers at @imperialcollege and @UKHSA shows how COVID-19 is being transmitted in the home - including between people who are fully vaccinated...

7

72

144

7

33

118

@OutbreakJake

Jake Dunning

3 years

Superb

@GOVUK

GOV.UK

4 years

@Mick_Bailey Hi Mick, although there are exemptions for work purposes, you must not have a work Christmas lunch or party, where that is a primarily social activity and is not otherwise permitted by the rules in your tier. You can find more information here: Thanks

306

3K

5K

1

27

117

@OutbreakJake

Jake Dunning

2 years

@statsepi Governments paying business consultants (through the nose, I may add) to provide answers they want to hear, including advice in areas in which they have no expertise, e.g. Public Health. Shameful opportunism. Glad that I no longer have to witness it, but angry we still pay for it

2

15

116

@OutbreakJake

Jake Dunning

4 years

New [PHE vaccine effectiveness surveillance] data show [both Pfizer and AZ) vaccines reduce severe COVID-19 in older adults [even after just first of two doses] Pre-print here: Bravo, @PHE_uk Immunisations team!

1

40

115

@OutbreakJake

Jake Dunning

3 years

It may be voluntary, but there we have seen slippery slopes during this pandemic, so we should not be surprised if our 'clean' status has to be demonstrated frequently going forward for routine activities - not just vaccination status, but now possibly our LFD status too.

2

24

113

@OutbreakJake

Jake Dunning

4 years

Obvious change to my work bus journeys last few days. Much more crowded & often way in excess of stated max. 30 pax. Impossible to distance even 1m on Mon & Tues Almost all seats occupied plus lots standing. Many noses & mouths visible. Zero hand hygiene seen. Feels unsafe. @TfL

7

28

111

@OutbreakJake

Jake Dunning

3 years

Transmission of SARS-CoV-2 in the household setting: A prospective cohort study in children and adults in England Nice paper from PHE colleagues, if you have not read it. It's almost all pre-Alpha (& pre-Delta), but interesting findings nonetheless.

5

36

111

@OutbreakJake

Jake Dunning

3 years

Quite right. Too many assumptions are being made about effectiveness of interventions in this pandemic. Too much settling for "we think it works". Let's not abandon evidence; it does matter, not least because it's possible that those £ billions could be better spent elsewhere.

@bmj_latest

The BMJ

3 years

"The most important question about community mass testing is whether it works to reduce transmission. Unfortunately, we do not yet know the answer" @jacdinnes @siantphillips2

6

43

80

7

34

108

@OutbreakJake

Jake Dunning

5 years

Very easy to say with the benefit of hindsight that containment is pointless, but containment may work sometimes, not least is buying time. We may think we are clever and we can model all we want, but the truth is, the course of each big emerging infection remains unpredictable.

6

18

109

@OutbreakJake

Jake Dunning

4 years

Masks should not be pulled down for a chat or a cheeky Haribo/Quality St & then pulled back up. They should not be worn below the nose. They should not be hanging round necks for a break & then pulled back up. Do not put yourselves at risk; please use & remove all PPE safely. 3/3

Tweet media one

4

71

109

@OutbreakJake

Jake Dunning

3 years

To be fair, in terms of inconsistency in coronavirus control measures, the UK is world-beating (by which I mean the UK government).

4

9

105

@OutbreakJake

Jake Dunning

3 years

@sailorrooscout @mugecevik @ashishkjha @EricTopol I think anxieties that have arisen from the pandemic can make us forget that preventing signficant disease is the key goal. Trying to 'beat' SARS-CoV-2 infections per se is likely an unwinnable battle in the long run. Great to see protection against severe disease remains high.

3

17

107

@OutbreakJake

Jake Dunning

3 years

I actually feel sorry for disciples of various COVID Twitter cult leaders. They're kept happy by a constant feed of preaching & put-downs from their fear-inducing gods, unable to consider alternative possibilities or viewpoints, unable to acknowledge uncertainty or complexities.

6

8

101