A pretty great thread summarising medical/public health interventions which sounded logical and like the obvious thing to do, but RCTs showed they weren't.

Nice @lancet article on screening linked here also.

And a short thread...
1/
https://www.thelancet.com/journals/lanepe/article/PIIS2666-7762(20)30002-8/fulltext

"The history of screening is already replete with examples where at best more good could have been done, & at worst unnecessary harm was caused, because an overenthusiastic belief that more testing is always better led to unwillingness to allow critical appraisal of programmes."

We cannot be sure that mass testing is a net-positive PH intervention.

I believe it can be, but it is hugely complex - even a well-designed RCT would struggle to cover everything.

But, we are in a pandemic, & so acting without near-certain evidence is completely justified.
3/

However, when the evidence is really quite clear on ways the mass testing programme could be so obviously improved to maximise benefit (actual support to isolate, widening symptom list, strategic testing of contacts), I do not believe it is scientifically or ethically sound...

... to support the roll-out in its current format.

Some people seem very certain mass testing either definitely will or definitely won't work - I wish I had their confidence...

The history of screening & medicine in general is full of times when evidence surprises experts..
5/

Given the roll-out is happening whether we 'agree' or not, I think its important that people with relevant expertise, networks, & a platform do all that they can to communicate how we can maximise the benefit and reduce harms/costs of this huge and uncertain PH intervention.

6/

Hence...

https://twitter.com/ScienceShared/status/1379036219242332160?s=20

and

https://www.bmj.com/content/372/bmj.n208.full

Just realised it didnt link the thread at the top - apologies.

Worth a read. https://twitter.com/mgtmccartney/status/1253423493162491905?s=20

(obviously I wasn't referring to my own thread when I said 'pretty great thread on PH interventions...' lol).

Also I ofc realise that some of those tagged here only advise, & do not make policy on things such as support to isolate, but I am an optimist..
I am positive there is always one more lever to pull, way of phrasing things, or media briefing which can change policy-makers minds.