Gabriel Leung @gmleunghku Twitter profile

Last Seen Profiles

@tekitoh_chan

@Coach_Hes

@NCLU_ORG

@WeaverBask

@Ahmed_3_sultan

@paleofuture

@ChrisUnits

@Swenstar5

@fromkdwithluv

@AMT_Auto

@EcoEnClave

@AikoUsui

@MatznerJon

@glusjy

@LionSportsCHS

@ErisInTexas

@meowspaw

@SNYGiants

@LineaCalienteEd

@powers1av3

@deraojv

@tamilcinestars

@zumbipacas1

@hijabjilbab1

@glusjy

@celltinels

@FrcsMentor

@michi426ANS

@CWRBLX

@benglishhh

@GarciadeSaura

@yennywahid

@jakerawr

@travly

@NeBanovich

@Hunter191309

Gabriel Leung

@gmleunghku

4 years

Absolutely! Of every 1,000 infecteds who show symptoms, 14 will die. Highly age dependent where the risk of getting infected is 3x and then risk of dying is another 3x in 70+year-olds compared to those in their 30s. This is NOT seasonal flu nor even 2009 pandemic flu!

Marc Lipsitch

@mlipsitch

4 years

Show me a seasonal flu that leads to triage of whom to let die in icus despite intense social distancing & I’ll stop worrying. Or an exponentially growing uncontrolled pathogen that infects 1% then “dissipates”. This is wishful fantasy not contrarianism. True we need more data.

50

625

2K

24

241

586

Gabriel Leung

@gmleunghku

4 years

In solidarity with our Singaporean friends. Our collective experience may be relevant to other large cities elsewhere.

9

167

370

Gabriel Leung

@gmleunghku

4 years

Absolutely agree with @CT_Bergstrom Case of poor risk comms and incomplete reading of the science. and clearly show 35-44% of all infections were caused by presymptomatic shedding of index cases.

Temporal dynamics in viral shedding and transmissibility of COVID-19

Nature Medicine - Presymptomatic transmission of SARS-CoV-2 is estimated to account for a substantial proportion of COVID-19 cases.

www.nature.com

12

159

330

Gabriel Leung

@gmleunghku

4 years

UK pandemic response will be all that much poorer without direct input of @neil_ferguson . He is one of the best infectious disease modellers in the world, whom UK should treasure not flog. Prurient and puritanical headlines are a malicious distraction.

14

58

306

Gabriel Leung

@gmleunghku

4 years

The best exposition of the nuances of COVID-19 immunology so far

Eric Topol

@EricTopol

4 years

An especially astute and succinct essay on #COVID19 protective immunity @TheLancet today highlights unknowns on duration, role of T lymphocytes, what constitutes real protection, and herd immunity features

34

884

1K

4

174

292

Gabriel Leung

@gmleunghku

4 years

Finally my mum may understand what I do for a living!

United Nations Geneva

@UNGeneva

4 years

Epidemiologists study health & disease conditions within populations of people. They can play a major part in establishing access to proper sanitation & hygiene services for all. ➡️ More inspiring jobs with a purpose: #170Jobs #HealthForAll

1

40

73

8

38

285

Gabriel Leung

@gmleunghku

4 years

Well done Canada! Now the “dance” around 1 begins

David Fisman

@DFisman

4 years

By the way: take some time out of the day to pat yourself on the back, Canada. We did this together. We’re not finished, but we have achieved a lot.

45

478

2K

5

78

274

Gabriel Leung

@gmleunghku

4 years

One of the clearest explanations of the role of models in COVID-19 control from @sarahcobey

13

148

254

Gabriel Leung

@gmleunghku

3 years

This is why social science research is so important. We have yet learned the lesson from the 2015 West African Ebola outbreak

Robert Reich

@RBReich

3 years

This is depraved.

2K

1K

8K

18

50

236

Gabriel Leung

@gmleunghku

4 years

‘Unknown pneumonia’ deadlier than coronavirus sweeping Kazakhstan, Chinese embassy warns

Deadlier than Covid-19? China warns of unknown pneumonia in Kazakhstan

Statement from embassy warns that death rate is ‘much higher’ than coronavirus and says local authorities have yet to identify cause.

www.scmp.com

69

181

213

Gabriel Leung

@gmleunghku

3 years

Since last Dec, , HK has adopted sewage surveillance to make statutory testing orders in potentially infected apartment blocks, having netted 50+ otherwise undiscovered transmission chains so far

‘Sustained’ evidence of Covid-19 found in Hong Kong housing block’s sewage

Residents of 731 flats at Fung Chak House in Choi Wan (II) Estate – as well as recent visitors – must be screened after the disease was detected in sewage samples.

www.scmp.com

Eric Topol

@EricTopol

3 years

What a waste the we are not using wastewater surveillance, capable of forecasting covid cases 3 weeks in advance "High-throughput surveillance could greatly ameliorate comprehensive community prevalence assessments by providing robust, rapid estimates"

36

222

738

8

77

226

Gabriel Leung

@gmleunghku

4 years

This is why we need to learn much more about “correlates of protection” against SARS-CoV-2 beyond serology, quickly

Eric Topol

@EricTopol

4 years

When we don't measure important stuff. A thread about the immune response to #SARSCoV2 1. Since serology/IgG can be readily measured, this is what is conventionally used to assess an individual's response That's a very incomplete picture

34

670

1K

3

75

219

Gabriel Leung

@gmleunghku

4 years

This is hugely encouraging BUT it’d be important to understand whether vax prevents INFECTION (therefore transmission) or just SYMPTOMATIC DISEASE. Cold chain storage and distribution will also be a major challenge.

CEPI

@CEPIvaccines

4 years

We welcome today's announcement from @Pfizer / @BioNTech_Group with interim data from their Phase III clinical trial indicating 90% effectiveness of their #COVID19 vaccine candidate. Full statement from our CEO, Dr Richard Hatchett, on our website:

5

48

133

5

61

216

Gabriel Leung

@gmleunghku

4 years

Opinion | Lockdown Can’t Last Forever. Here’s How to Lift It. - The New York Times

Opinion | Lockdown Can’t Last Forever. Here’s How to Lift It. (Published 2020)

We need to hit and release the brakes on physical distancing, again and again, until we safely get to immunity.

www.nytimes.com

25

114

210

Gabriel Leung

@gmleunghku

4 years

Work led by @bencowling88 sharing the HK experience using flu surveillance as parallel proxy to show likely effectiveness of interventions against COVID-19. If HKers can do it against our background of social unrest during the past 9 months, so can the world! In solidarity.

Andy Biotech

@AndyBiotech

4 years

Very important new study on impact of non-pharmaceutical interventions against #COVID19 and influenza in Hong Kong by @gmleunghku team More evidence that #coronavirus can be mitigated by social distancing and behavioral changes short of draconian measures

8

141

232

7

103

191

Gabriel Leung

@gmleunghku

4 years

Just out: COVID-19 vaccine trials primarily assess prevention of virologically confirmed disease; NOT infection or transmission. An “effective” vax confers protection from disease but might not reduce spread...1/5

The Lancet

@TheLancet

4 years

NEW—What can we expect from first-generation #COVID19 vaccines? Comment from Malik Peiris & Gabriel M Leung ( @gmleunghku )

0

56

89

7

104

170

Gabriel Leung

@gmleunghku

4 years

Using entirely different methods we found similar clustering dynamics 8000km away

Clustering and superspreading potential of severe acute respiratory syndrome coronavirus 2 (SARS-...

Superspreading events have characterised previous epidemics of severe acute respiratory syndrome coronavirus (SARS-CoV) and Middle East respiratory syndrome coronavirus (MERS-CoV) infections. Using...

www.researchsquare.com

Kai Kupferschmidt

@kakape

4 years

Haven’t had a chance to look closely at this preprint about #covid19 in Israel, but interesting to see that their model "indicates that #SARSCoV2 transmission dynamics were driven by an extremely high level of viral superspreading”. Looks like evidence is accumulating.

2

74

156

5

55

166

Gabriel Leung

@gmleunghku

4 years

Of every 1,000 infecteds who show symptoms, 14 will die. Highly age dependent where the risk of getting infected is 3x and then risk of dying is another 3x in 70+year-olds compared to those in their 30s. Protect older adults!

Marc Lipsitch

@mlipsitch

4 years

We in @CCDD_HSPH were proud to support the @hkumed team led by Joe Wu, Kathy Leung, and @gmleunghku on the work reported in this new preprint on severity and transmission of #COVID ー19 in Wuhan

3

43

92

8

107

158

Gabriel Leung

@gmleunghku

3 years

Absolutely delighted to be joining @wellcometrust board to help further its mission and recently announced strategy on mental health, infectious diseases and global heating

Aidan Warner

@aidanwarner

3 years

Really pleased to announce two new appointments to Wellcome's board -- Gabriel Leung of @HKUniversity and Arup Chakraborty of @MIT .

1

5

27

13

20

162

Gabriel Leung

@gmleunghku

2 years

Quick nowcast and forecast on situation awareness of HK Covid 5th wave…1/n

6

65

141

Gabriel Leung

@gmleunghku

4 years

When we have serosurveys results that can clarify whether children are sufficiently infective to warrant school closures - that’s why they’re so so important

Rainbow Wong

@rainbegeria

4 years

‘When Can We Go to School?’ Nearly 300 Million Children Are Missing Class.

2

8

11

8

36

126

Gabriel Leung

@gmleunghku

2 years

Thanks @EricTopol for shoutout…I’ve put together a thread here to explain in a little more detail about this and another recent preprint on inpatients...

Eric Topol

@EricTopol

2 years

1st report of real-world effectiveness of Paxlovid in the outpatient setting, BA.2 wave, Hong Kong 75% reduced death, 31% reduced hospitalization, 53% reduced adverse outcomes No impact of vaccination on outcomes; superior to Molnupiravar impact @hkumed

14

186

560

1

31

120

Gabriel Leung

@gmleunghku

4 years

Our original results are NO LONGER VALID given that the reported no of exported cases have essentially doubled from 24 hrs ago when the model was completed. Reconfiguring model but expect multiples of the first estimates in a nonlinear way.

Laurie Garrett

@Laurie_Garrett

4 years

4/ #nCoV2019 "...Shanghai, Chongqing, Guangzhou & Shenzhen during this period. If SSEs were observed in the nosocomial or community settings, our statistical tool can accurately predict the final outbreak size w/in 2-5 days after 3 or more cases of the cluster has been observed."

0

14

31

3

86

107

Gabriel Leung

@gmleunghku

4 years

What if the first generation of vaccines reduce disease severity but do not block transmission? The concept of herd immunity may then be inapplicable

Michael Mina

@michaelmina_lab

4 years

This is one of the most succinct and best written short pieces on herd immunity, what it is and where we are heading with #COVID19 . If not comfortable with math, just get through the first sentences and it’s worth continuing the read.

99

696

1K

9

24

106

Gabriel Leung

@gmleunghku

3 years

Cautionary tale of eminence-based medicine, ironically concerning one who has preached so much about the evidence-based variety

Eric Topol

@EricTopol

3 years

The John Ioannidis story. The consummate physician-researcher who "wrote that the virus might claim only 10,000 lives in the United States" by @PeteJamison

43

127

352

4

28

106

Gabriel Leung

@gmleunghku

4 years

COVID-19 will turn out to be the grossest and gravest health related inequity in the last century

Carlos del Rio

@CarlosdelRio7

4 years

A superb special issue of Annals of Epidemiology on #COVID19 edited by @pssinatl with "must read" articles on the racial/ethnic disparities in COVID19

2

29

56

2

28

102

Gabriel Leung

@gmleunghku

4 years

Simple function of an R0=2-2.5 with mass action homogeneous mixing dynamics. The attack rate of 70-80% is meaningless per se because one needs to understand 1) over what time period this could happen and 2) severity of infection. Then we can make informed decisions to mitigate.

HKU Medicine

@hkumed

4 years

Prof @gmleunghku , Dean of @hkumed , and the chair of public health medicine at @HKUniversity , said the overriding question was to figure out the size and shape of the iceberg. #COVID19 #coronavirus #nCoV2019

0

20

45

6

48

99

Gabriel Leung

@gmleunghku

4 years

Well done Singapore! If only all health protection agencies could emulate your professional competence and transparency from the first imported cases, until there becomes too many cases to count

Marc Lipsitch

@mlipsitch

4 years

An example of the kind of detailed epidemiology needed to guide control measures in #ncov outbreaks

6

95

219

6

30

95

Gabriel Leung

@gmleunghku

4 years

Stay strong and keep smiling Neil. Feel better soonest - we need you back for the science. In solidarity!

neil_ferguson

@neil_ferguson

4 years

Again, many many thanks for everyone’s very kind support. I was tested given my recent proximity to people leading the UK response. Positive. Which is a strange experience - to be infected by the virus one is modelling 🙄. Still feeling rough, but not awful.

370

557

3K

2

19

97

Gabriel Leung

@gmleunghku

4 years

Brilliant risk comms!

The Guardian

@guardian

4 years

Watch Will Smith explain the importance of social distancing

41

478

1K

4

27

96

Gabriel Leung

@gmleunghku

4 years

Brilliant tour de force by ⁦ @mlipsitch ⁩ - infectious disease epidemiology defined as true consilience for the public’s health

Good Science Is Good Science - Boston Review

For the sake of both science and action in the COVID-19 pandemic, we need collaboration among specialists, not sects.

www.bostonreview.net

1

36

96

Gabriel Leung

@gmleunghku

4 years

It’s a good problem not having enough cases to reliable estimate Rt...long may that last!

KK Cheng

@KKCheng4

4 years

Poor Hong Kong. When the magic number R has entered everyday parlance in Europe and N America, our friends in HK are deprived of the daily pleasure of checking what the prevailing R is. @gmleunghku @bencowling88 😂

0

10

24

3

18

95

Gabriel Leung

@gmleunghku

4 years

Better late than never...well done Richard et al for pushing to make this happen for the public’s health 👍

richard horton

@richardhorton1

4 years

The morning after the dramatic change in strategy to COVID-19 by this govt, I can’t help but feel angry that it has taken almost two months for politicians and even “experts” to understand the scale of the danger from SARS-CoV-2. Those dangers were clear from the very beginning.

254

2K

7K

5

23

92

Gabriel Leung

@gmleunghku

4 years

Absolutely...HK observed a similarly attenuated/interrupted flu season back in January, likely as a result of anti-COVID measures

Dr. Tom Frieden

@DrTomFrieden

4 years

The threat of a severe flu season during the Covid pandemic is not a given. In fact, the Southern Hemisphere has seen dramatically lower incidences of flu this season, likely a result of public health measures such as mask-wearing and hand-washing.

20

141

378

5

25

90

Gabriel Leung

@gmleunghku

4 years

Need 2 more tests: 1) viral culture to determine viability of the RNA detected by PCR 2) IgG serology If 1 is negative and 2 shows protective titre, then the patient could be safely discharged.

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

@MarionKoopmans

4 years

This shows how important it is to know kinetics of shedding. That requires studies, difficult to do. See the globally agreed protocol , tier 2. Difficult to do but invaluable information @gail_carson @PREPARE_EUROPE @WHO @JeremyFarrar @Chikwe_I @MackayIM

3

47

71

4

30

82

Gabriel Leung

@gmleunghku

3 years

Elimination or near elimination has been the de facto and increasingly openly espoused goal in East Asia and ANZ for months now. It can be done!

Martin McKee 🇺🇦

@martinmckee

3 years

Really important comments on potential for #ZeroCovid from @c_drosten

6

53

111

4

26

89

Gabriel Leung

@gmleunghku

2 years

These findings are for hospitalised inpatients. A separate set of analyses for ambulatory infected individuals forthcoming soon.

Eric Topol

@EricTopol

2 years

First real world effectiveness study of Paxlovid and Molnupiravir: significant reduction in disease progression & all-cause mortality vs matched controls, more for Paxlovid, during Hong Kong BA.2 wave. Fast viral load reduction @CarlosWongHKU @gmleunghku

36

331

998

3

20

88

Gabriel Leung

@gmleunghku

3 years

Fatal validity threats:- 1) no IRB 2) 1 month follow up only 3) severely underpowered by assuming 50% efficacy when in fact prior evidence suggests 10-20% 4) loose serostatus ascertainment diluting magnitude of efficacy

Eric Topol

@EricTopol

3 years

The underpowered Danish randomized mask trial, w/ only 46% of those in the intervention group adherence, and only focused on the mask wearer (no insight about transmission) is published @AnnalsofIM ✓ commentary by @DrTomFrieden and editors (why publish?)

117

166

538

5

31

82

Gabriel Leung

@gmleunghku

2 years

The only surprise is how predictable the surge has been. We are nowhere near the peak; still v much in the accelerated exponential growth phase:

Laurie Garrett

@Laurie_Garrett

2 years

Hong Kong is overwhelmed by #COVID19 . - 2,071 cases confirmed yesterday - 4,500 more suspected - no more room in hospitals - huge waiting lists for care & treatment

25

77

143

10

23

80

Gabriel Leung

@gmleunghku

4 years

One possible intermediate host, but the puzzle is not nearly solved...much remains to be done through the “One Health” approach to identify the zoonosis in patient(s) zero

Nature Portfolio

@NaturePortfolio

4 years

Coronaviruses detected in a small number of pangolins smuggled into China are related to SARS-CoV-2, a Nature paper reports. The degree of similarity isn’t enough to suggest they are the intermediate hosts that are directly involved in the outbreak.

26

515

894

5

37

77

Gabriel Leung

@gmleunghku

4 years

Spread love, not germs or rumours on Chinese Valentine’s today

HKU Medicine

@hkumed

4 years

. @hkumed wishes everyone a Happy Chinese Valentine’s - Keep calm and stay healthy. #yearoftherat2020

0

9

23

1

20

78

Gabriel Leung

@gmleunghku

2 years

Therefore, if compulsory universal PCR testing were to be implemented under “dynamic zero-covid policy”, it should be deployed mid- to late-April when case numbers will already be at very low levels in order to truly achieve elimination, or “zero covid”…7/n

9

41

76

Gabriel Leung

@gmleunghku

2 years

@EricTopol @OurWorldInData This is the fundamental driver of our fatality risk (2-dose coverage by age) - and what is not shown is that the equivalent amongst older folks in nursing homes is <20%

10

21

75

Gabriel Leung

@gmleunghku

2 years

Another update on HK’s Omicron BA.2 (“5th”) wave nowcast and forecast (we’ve made some important methodological improvements - see for full details)…1/n

Thread Reader App

@threadreaderapp

2 years

@EIDGeek Hola, you can read it here: Enjoy :) 🤖

0

1

2

9

29

73

Gabriel Leung

@gmleunghku

4 years

Kudos to the South Koreans for making available such an invaluable dataset!

Adam Kucharski

@adamjkucharski

4 years

Contact tracing data from almost 60,000 contacts in South Korea.

8

81

197

2

17

73

Gabriel Leung

@gmleunghku

4 years

How Data Became One of the Most Powerful Tools to Fight an Epidemic - The New York Times

How Data Became One of the Most Powerful Tools to Fight an Epidemic (Published 2020)

As public-health experts have known since the 19th century, information can be the best medicine. What new data streams could help quell future outbreaks?

www.nytimes.com

1

33

73

Gabriel Leung

@gmleunghku

4 years

A fine fine balance between expediency and robustness. Lest we forget the fundamental motivation for rigorous peer review. All the more important for COVID-19 when potentially hundreds of millions of lives are at stake.

Peter Daszak

@PeterDaszak

4 years

Fascinating speed that papers have been posted and published on #COVID19 (150+ in 7 wks) vs SARS (150 in 1 yr)!!

5

74

119

4

14

66

Gabriel Leung

@gmleunghku

2 years

@bencowling88 @kjoules We desperately need an unbiased way to keep track of case count; as well as real time estimates of case fatality, all stratified by vaccination status. Time for HK to replicate REACT and/or the ONS surveys in the UK.

5

12

67

Gabriel Leung

@gmleunghku

4 years

Brilliant!

Mark Humphries

@markhumphries

4 years

The Armchair Epidemiologist

173

3K

8K

5

12

64

Gabriel Leung

@gmleunghku

2 years

I was 1/510 respondents. Bottom line: don’t shoot the messengers who stay true to science!

Jon Cohen

@sciencecohen

2 years

Important @cathleenogrady story about abuse of COVID-19 scientists:

10

54

117

12

9

66

Gabriel Leung

@gmleunghku

2 years

Doing so earlier, especially when case numbers will still be too high to properly and appropriately isolate and care for, paying particular attention to population mental and emotional wellbeing in HK’s unique context, would not be recommended…8/n

5

12

63

Gabriel Leung

@gmleunghku

2 years

Vaccines protect against serious complications and death, but do not work nearly as well against infection. It would have been irresponsible for a medical school sharing staff and students with a major tertiary hospital not to have issued a warning

Leo Poon

@world_epidemic

2 years

Why there is so much concern about the positive sewage samples at Kenndey Town? This is a study from @zhangt1968 and @HKU_SPH Use of Sewage Surveillance for COVID-19: A Large-Scale Evidence-Based Program in Hong Kong

5

13

46

19

14

63

Gabriel Leung

@gmleunghku

2 years

New real-world evidence on covid antivirals. Sample: all initially ambulatory covid infectees in HK during BA.2.2 surge in spring 2022. Design: 1:10 propensity-score matched retrospective cohort as primary analysis; case-control for sensitivity…1/n

2

18

63

Gabriel Leung

@gmleunghku

2 years

V disappointing especially given HK’s early and sustained privileged access to vaccines and a full year of lead time to shield the most vulnerable groups by vaccination

Gabriel Leung

@gmleunghku

2 years

@EricTopol @OurWorldInData This is the fundamental driver of our fatality risk (2-dose coverage by age) - and what is not shown is that the equivalent amongst older folks in nursing homes is <20%

10

21

75

13

21

62

Gabriel Leung

@gmleunghku

3 years

What an auspicious day for #InternationalDayOfWomenInScience - day of the Lunar New Year of the Ox, and a perfect palindromic day 12.02.2021! Support women scientists by creating and maintaining a safe and happy place for them to thrive!

1

14

62

Gabriel Leung

@gmleunghku

2 years

Full report and deck 1/6

HKU Medicine

@hkumed

2 years

LIVE: Press Conference on Modelling the #Omicron Fifth Wave in Hong Kong

4

28

39

8

25

62

Gabriel Leung

@gmleunghku

3 years

An eminently sensible idea that could tide over the interim before mass vaccination coverage. Time for action (or at least large scale feasibility trials) and not more endless debate. Caveat: should not be used as “passport”.

Marc Lipsitch

@mlipsitch

3 years

Really important statement of the proposal for massive rapid antigen testing from @michaelmina_lab -- with compelling replies to many different grounds for skepticism. How We Can Stop the Spread of Coronavirus by Christmas

44

232

619

2

14

60

Gabriel Leung

@gmleunghku

4 years

Thanks for the brilliant video summary...couldn’t have done it better ourselves!

Medmastery

@medmastery

4 years

Video review of a recent study by @gmleunghku and colleagues. Key take-aways: patients start shedding virus ∼2 d before symptom onset, are most infectious on the day before symptom onset and stop being infectious ∼7 days after symptom onset. #COVID19

2

95

159

1

18

57

Gabriel Leung

@gmleunghku

2 years

As always, we do not hang on to data and most certainly never during the exigency of an evolving pandemic. We released this particular set of findings within 24 hours of finalising them, and posted the full preprint within the subsequent 24 hours.

Joel Chan

@kjoules

2 years

@Amine19O @Jason42146758 @gmleunghku The media and the scientific community have been chomping at the bit for Hong Kong’s BNT vs SV data. No way could HKU keep the data private for so long; any interim data would be of tremendous interest to the scientific community

1

0

7

3

9

57

Gabriel Leung

@gmleunghku

2 years

Thank you @kjoules for summarising and spreading the key messages

Joel Chan

@kjoules

2 years

LIVE Gabriel Leung is speaking at HKU

3

19

77

3

5

56

Gabriel Leung

@gmleunghku

4 years

Hats off to the heroic effort by colleagues at China CDC under Geoege Gao, Feng Zhejian and Li Jun’s leadership, as well as their provincial and municipal counterparts, to provide these first epi estimates

HKU Medicine

@hkumed

4 years

The study published in @NEJM says " there is evidence that human-to-human transmission has occurred among close contacts since the middle of December 2019". The authors of the study include Prof @gmleunghku , Prof @bencowling88 , & others. #WuhanCoronavirus

3

34

43

3

16

54

Gabriel Leung

@gmleunghku

2 years

Not at all. Our message was for staff and students who can be vectors of infection for the highly vulnerable patients in our teaching hospitals. We have an extra responsibility towards those we look after, as opposed to our own risk. First do no harm.

KoenRoeyers 🇭🇰

@KoenRoeyers

2 years

@gmleunghku Fear mongering and one of the reasons why HK is falling behind the rest of world. Focus on severe cases/ deaths

2

1

34

16

9

56

Gabriel Leung

@gmleunghku

3 years

Good luck @michaelmina_lab we all have lots to learn from this experiment

Michael Mina

@michaelmina_lab

3 years

THREAD: Today I am announcing a new massive public health research study - with @Citibank - to use and evaluate frequent at-home rapid testing. The study is evaluating how well workplace infections are prevented by frequent home-tests. 1/x

21

139

631

2

6

54

Gabriel Leung

@gmleunghku

4 years

“Medicine is a social science and politics is nothing else but medicine on a large scale. Medicine...has the obligation to point out problems and to attempt their theoretical solution; the politician...must find the means for their actual solution” - Rudolf Virchow 2/2

1

16

52

Gabriel Leung

@gmleunghku

4 years

Sensible summary of lessons learned so far in preparation for the second wave

How the world can avoid screwing up the response to Covid-19 again

With the current drop-off in cases and deaths likely to be followed by local, regional, and possibly national resurgences, the implication is clear: We have to do better next time.

www.statnews.com

2

22

54

Gabriel Leung

@gmleunghku

4 years

Leadership!

Joshua Salomon @jsalomon.bsky.social

@SalomonJA

4 years

Inspiring example, and infuriating contrast. Watch Chancellor Merkel explain the fragile margin of #COVID19 transmission dynamics, and the significance of getting R below 1 vs. allowing it to reach 1.1 or 1.2. “Thin ice.” Crisis leadership from a scientist.

0

21

44

2

10

52

Gabriel Leung

@gmleunghku

2 years

5th wave has peaked on March 4. Estimated no of people infected by March 7 = 1.8M (1.0-2.7M). No of daily infections to fall below 1,000 by end Apr and to below 100 by mid May…2/n

7

27

52

Gabriel Leung

@gmleunghku

4 years

If only more world leaders at least speak likewise, if not actually think and act so

Antonello Guerrera

@antoguerrera

4 years

The most thunderous Easter message of recent times 🇩🇪

184

4K

11K

0

18

51

Gabriel Leung

@gmleunghku

4 years

How Farr off? Lest history not repeat itself surely we can do better than this

Farr's Law Applied to AIDS Projections

Farr's Law of Epidemics, first promulgated in 1840 and resurrected by Brownlee in the early 1900s, states that epidemics tend to rise and fall in a roughly symmetrical pattern that can be approxima...

jamanetwork.com

Marc Lipsitch

@mlipsitch

4 years

This IHME model used to be 1840s technology (Farr’s law). Now seems more like Ptolemaic astronomy with epicycles and deferents. This from an institute whose reputation is based on GBD which is valuable iff (sic) next year is like last year. Not experienced in epidemic models.

5

35

177

3

19

50

Gabriel Leung

@gmleunghku

2 years

Since beginning of 5th wave, there have been about 1.7 (0.32 – 2.86) million people already infected as of February 28, 2022…2/n

6

16

50

Gabriel Leung

@gmleunghku

4 years

Science has affirmed Japan’s “counter-cluster” approach, given overdispersion or clustering/superspreading tendency of SAR-CoV-2 ...1/2

Natalie E. Dean, PhD

@nataliexdean

4 years

Learning more about Japan's counter-cluster response from this recent presentation. H/t @swiftrocky

23

294

648

1

29

48

Gabriel Leung

@gmleunghku

3 years

Vaccinating double the number of people with a single dose as quickly as possible is probably the right call under the circumstances in UK. Highly contextual decision that should not be directly applied to a different setting. We have lots to learn from the UK’s trial.

The Guardian

@guardian

3 years

Why is Britain delaying second doses of Covid vaccines?

21

44

56

3

15

49

Gabriel Leung

@gmleunghku

2 years

About 600 (and counting) nursing homes have so far recorded test positive cases, amongst residents and/or staff.

Gabriel Leung

@gmleunghku

2 years

@EricTopol @OurWorldInData This is the fundamental driver of our fatality risk (2-dose coverage by age) - and what is not shown is that the equivalent amongst older folks in nursing homes is <20%

10

21

75

4

11

43

Gabriel Leung

@gmleunghku

4 years

Thanks @Peter_Ashcroft . We made the Correction () within 24 hrs of receiving your helpful advice. Still awaiting @NatureMedicine to upload - probably inundated with COVID-19 papers like every other journal!

1

14

48

Gabriel Leung

@gmleunghku

4 years

Why Most Published Research Findings Are False by John P. A. Ioannidis

Vinay Prasad MD MPH

@VPrasadMDMPH

4 years

New pre-print by John PA Ioannidis Certain to be provocative, Ioannidis and colleagues estimate the risk of dying <65 vs >80 from COVID-19 If you disagree with the result, try to articulate what you think is wrong, AND what your estimate is.

45

48

173

0

6

48

Gabriel Leung

@gmleunghku

4 years

The most lucid exposition of all the nuances in vaccine efficacy for optimal health protection - a must read!

Marc Lipsitch

@mlipsitch

4 years

Great experience writing with @nataliexdean for the first time!

3

23

123

1

13

47

Gabriel Leung

@gmleunghku

4 years

Take care Neil. You have (relative) youth and good baseline health on your side, despite the hazardous politics and SARS-CoV-2!

neil_ferguson

@neil_ferguson

4 years

Sigh. Developed a slight dry but persistent cough yesterday and self isolated even though I felt fine. Then developed high fever at 4am today. There is a lot of COVID-19 in Westminster.

2K

14K

1

6

44

Gabriel Leung

@gmleunghku

4 years

Test and ye shall find

Eric Topol

@EricTopol

4 years

US "has registered 159 cases in 14 states but as of March 1st it had, indefensibly, tested just 472 people when South Korea was testing 10,000/d. Now that America is looking, it is sure to find scores of infections—and possibly unearth a runaway epidemic."

4

78

131

2

19

43

Gabriel Leung

@gmleunghku

2 years

Unlike most places with privileged access to vaccines, HK did not manage to persuade our elderly to get jabbed for over a year despite having prioritised them - This has left us in our present v vulnerable situation

Gabriel Leung

@gmleunghku

2 years

The only surprise is how predictable the surge has been. We are nowhere near the peak; still v much in the accelerated exponential growth phase:

10

23

80

9

12

43

Gabriel Leung

@gmleunghku

2 years

Apparent divergence with the UK of the “decoupling” between cases and severe complications/deaths is worrying. Carries massive implications not only for US, but potentially other places that are relatively immunologically naive (low prior infection +/- vax), incl HK where I live

Eric Topol

@EricTopol

2 years

Now adding the United States A much higher baseline of deaths/capita because of relative lack of containment/vaccination during the Delta wave

23

108

365

2

13

43

Gabriel Leung

@gmleunghku

3 years

Well done everybody @hkumed - while research metrics are often fraught with interpretation challenges, you should feel proud of these results that are hard earned by your dedication and inspiration. THANK YOU!

HKU Medicine

@hkumed

3 years

Over 70% of @HKUMed ’s research projects assessed deemed to be “world leading” or “internationally excellent” by 🇭🇰’s University Grants Committee in the Research Assessment Exercise 2020. Thank you to our #academics and #scholars for making this possible!

0

12

33

0

3

43

Gabriel Leung

@gmleunghku

2 years

The 2 conditions are:- 1) >=2 jabs coverage >90% amongst 70+, esp those in nursing homes 2) sufficient supply and liberal use of Paxlovid for all infected 70+, those with serious chronic conditions or immunocompromised, and those who live in homes for the aged or disabled

28

9

39

Gabriel Leung

@gmleunghku

3 years

It has taken several generations of researchers to bring this about: the late Anthony Hedley since the late 1980s, TH Lam since the 1990s to the present, Sarah McGhee, Sophia Chan through the 2000s to her current role as minister, and most recently Kelvin Wang and Michael Ni

HKU Medicine

@hkumed

3 years

We welcome the passing of a bill to ban e-cigarettes and heated tobacco in Hong Kong. “It is especially crucial now that we work in tandem with support from the general public to one day achieve the aspiration of a smoke-free city" said Prof @gmleunghku

3

21

56

3

8

41

Gabriel Leung

@gmleunghku

3 years

Quite! Proud that @DFisman and I went to school in that city three decades ago, but feel sad for those whose health is now supposedly guarded by the author of that thread

David Fisman

@DFisman

3 years

this is quite a thread.

26

71

308

2

5

39

Gabriel Leung

@gmleunghku

4 years

Well done to the new Chief Scientist Office @doctorsoumya for putting this on...so so important and literally lifesaving!

Soumya Swaminathan

@doctorsoumya

4 years

The Urgent Questions Scientists Are Asking About Coronavirus @who research and innovation meeting is exploring these and more. @gmleunghku @jameschau @WHOWPRO @DrTedros @CDCgov @JeremyFarrar @JEPaquetEU @CMO_England @NIH @mpkieny

0

44

78

2

17

39

Gabriel Leung

@gmleunghku

4 years

Important red flag for national authorities and @WHO to quickly facilitate surge capacity for RT-PCR testing in a risk-based manner

Marc Lipsitch

@mlipsitch

4 years

Simple comparison of observed to expected exported cases of #nCoV suggests Indonesia, Thailand and perhaps Cambodia may be missing cases. New preprint @CCDD_HSPH w Pablo Martinez de Salazar @NeneRiehus Aimee Taylor @Caroline_OF_B

8

45

73

0

19

38

Gabriel Leung

@gmleunghku

4 years

1/2 When 2 groups independently come up with almost identical answers, and ...

Marc Lipsitch

@mlipsitch

4 years

Estimating an absolute risk at the start of a pandemic is like estimating the absolute risk of dying within three days after a cancer diagnosis. Not false but not either serious or sensible

13

223

757

0

21

37

Gabriel Leung

@gmleunghku

4 years

In the tug o’war between a completely susceptible population and seasonal forcing, the former usually wins.

The Lancet Global Health

@LancetGH

4 years

New #COVID19 Comment suggests that early comparisons between the number of cases in the worst affected European countries and in west African countries do not support the hypothesis that the virus will spread more slowly in countries with warmer climates

14

336

314

5

20

40

Gabriel Leung

@gmleunghku

2 years

In👇, we ask whether the novel antivirals work in hospitalised inpts (comprising nursing home residents and already hospitalised pts due to nosocomial infection, in addition to the small % of ambulatory infectees who require admission)? - a Q unaddressed in original trials…1/n

Eric Topol

@EricTopol

2 years

First real world effectiveness study of Paxlovid and Molnupiravir: significant reduction in disease progression & all-cause mortality vs matched controls, more for Paxlovid, during Hong Kong BA.2 wave. Fast viral load reduction @CarlosWongHKU @gmleunghku

36

331

998

1

14

39

Gabriel Leung

@gmleunghku

4 years

First generation vaccines very much needed BUT they are only one tool of many in the overall response. Unlikely to be the ultimate silver bullet many are expecting...5/5

2

12

38

Gabriel Leung

@gmleunghku

2 years

A delightful, albeit almost cathartic, chat with @GavinCleaver @JessamyBagenal on HK’s Omicron BA.2 wave

The Lancet

@TheLancet

2 years

What’s behind the recent surge in COVID fatalities in Hong Kong? What does Omicron mean for zero-COVID approaches? @gmleunghku joins @gavincleaver and @jessamybagenal to discuss the last few months of COVID in Hong Kong on a new #LancetVoice

2

19

28

1

11

38

Gabriel Leung

@gmleunghku

4 years

Sage advice that applies to many of the world’s big cities right now, including HK

Commissioner Ashwin Vasan, MD, PhD

@NYCHealthCommr

4 years

NYC: I need you to stay home. It is our civic responsibility to make sure we do all we can to stave off this #COVID19 pandemic, and that means staying home. It doesn't matter if you have a test or not, because what your doctor will ask you to do will be the same: #StayHomeNYC .

456

206

401

5

17

38

Gabriel Leung

@gmleunghku

4 years

In press @NatureMedicine Wu et al - joint work of @hkumed and @CCDD_HSPH

Gabriel Leung

@gmleunghku

4 years

Absolutely! Of every 1,000 infecteds who show symptoms, 14 will die. Highly age dependent where the risk of getting infected is 3x and then risk of dying is another 3x in 70+year-olds compared to those in their 30s. This is NOT seasonal flu nor even 2009 pandemic flu!

24

241

586

6

25

36

Gabriel Leung

@gmleunghku

4 years

The meaning of sacrifice, apropos the season - and the many and myriad ethical questions in dealing with COVID-19

Jeremy Farrar

@JeremyFarrar

4 years

"Would you volunteer to be infected with Coronavirus to potentially save other people?" - Yes

17

22

78

3

16

36

Gabriel Leung

@gmleunghku

4 years

Protect older adults!

Nature Medicine

@NatureMedicine

4 years

A new study estimates that the overall symptomatic case fatality risk - the probability of dying after developing symptoms of #COVID19 in Wuhan - was about 1.4%. Read now at @gmleunghku @mlipsitch @HKUniversity #SARSCoV2

7

167

194

2

26

34

Gabriel Leung

@gmleunghku

3 years

A richly deserved honour for @bencowling88 - well done Ben!

HKU Medicine

@hkumed

3 years

Watch this video by @HKU_SPH to know more about him:

1

10

1

3

37

Gabriel Leung

@gmleunghku

4 years

Contact tracing including pets: evidence from @hkumed of reverse inter species spread from infected humans to dogs. Question about spread back to humans or other mammals remains.

Nature Portfolio

@NaturePortfolio

4 years

A study in Nature reports 2 infected dogs out of 15 households with confirmed cases of #COVID19 . Genetic sequences of the viruses from the dogs were identical to the virus detected in the human cases, suggesting human-to-animal transmission of SARS-CoV-2.

46

532

696

4

15

37

Gabriel Leung

@gmleunghku

4 years

An epidemiology research agenda to inform outbreak control

HKU Medicine

@hkumed

4 years

"Establishing robust estimates of the clinical severity of infections is probably the most pressing," says Prof @bencowling88 & Prof @gmleunghku of @hkumed in @Eurosurveillanc . #coronavirus #COVID19 For more:

0

21

27

0

25

36

Gabriel Leung

@gmleunghku

4 years

Clearest explanation grounded in the best science...well worth a read! Thanks Marc and colleagues @CCDD_HSPH

Marc Lipsitch

@mlipsitch

4 years

Our @CCDD_HSPH #tweetorial on the modeling of new viruses. Many thanks to @rebeccajk13 for putting this together with input from me and @Caroline_OF_B and to @EpiEllie for inspiration

2

39

93

0

18

33

Gabriel Leung

@gmleunghku

3 years

A v sensible policy that HK amongst other places should emulate, albeit further buttressed by a protective antibody titre as it continues to aim for zero covid

Ben Cowling

@bencowling88

3 years

5

9

59

2

8

35