Thread by @DrEricDing

⚠️New #COVID19 recommendations amid spike in #DeltaVariant ➡️All Mississippi residents ages 65+ & anyone with chronic conditions, should avoid all indoor mass gatherings **regardless of vaccination status**. Good. Delta is ~4x more severe than old strain🧵 mississippitoday.org/2021/07/09/msd…

2) The rapid rise of Delta variant cases and virus outbreaks combined with the state’s low vaccination rate led the Mississippi Department of Health to release a slew of new COVID-related guidelines on Friday.

3) The new recommendations, which will stay in place through July 26, also include:

📍All unvaccinated Mississippians wear a mask when indoors in public settings.

📍All Mississippians 12 years of age and older get vaccinated.

4) State Health Officer, Dr. Thomas Dobbs, said that these were decided on because Mississippians collectively have not done what it takes to protect us all, and wants to give the most vulnerable individuals the best guidance so they can survive Delta surge the state is facing.

5) “At this pace, and given the sort of external dynamics that are in play here, we’re going to remain vulnerable for a long time,” Dobbs said.

6) “I don’t think that we’re going to have some miraculous increase in our vaccination rate over the next few weeks, so people are going to die needlessly.” ⚠️

7) “And so when we look at who our most vulnerable people are, it’s going to be the people 65 and older, or who have chronic medical issues.”

8) Where is the evidence that #Delta is ~4x or more severe than old strain? There’s actually 3 studies. One key study from Singapore Ministry of Health actually found #DeltaVariant to have 4.9x higher odds of oxygen, hospital admission, or death!

europepmc.org/article/ppr/pp…

9) In this same study, the Singapore researchers found #DeltaVariant to have much higher viral load than other major strains. Thus, the higher severity is indeed very likely. Both lab and epidemiology supports it. This is also likely one reason why Delta is so transmissible too

10) Before i add more studies on #DeltaVariant in this thread 🧵, I want you all to consider that all these countries are more vaccinated than Mississippi and other Southern conservative state. Yet they are still seeing rapid surges. And accompanied by hospitalization ⬆️ in 🏴󠁧󠁢󠁥󠁮󠁧󠁿

11) “2 dozen” countries with **near vertical rise** in #COVID19 cases. Let that sink in. #DeltaVariant is damn serious.

12) We honestly need to mask regardless of vaccination status too. Here is direct proof, again from detailed analysis from Singapore. Lots of transmission events from vaccinated to unvaccinated.

13) Also notice the large number of asymptomatic transmission (many among vaccinated) in the Singapore outbreak analyses. This is why we need to mask - and do more testing in hotspots even when no symptoms. Masking vaccinated is key to stop chains of transmission to unvaxxed.

14) before I hear one more nonsense comment about “vaccines don’t work”, I want to share this ⬇️. Umbrella ☔️ example is best — it does protect you from rain, but not all water. Doesn’t mean umbrella is useless. You should wear a raincoat (mask) and water resistant clothes too.

15) and in this case with surging #DeltaVariant (equal to a violent thunderstorm ⛈ coming in), you need to do all protective measures: vaccinate, wear mask, ventilate, air disinfection, mass test, contact trace, avoid indoor gathering, and shield elderly. #Delta going vertical.

16) And indeed, sick frail older folks who are vaccinated are possibly much more prone to #COVID19 infection after vaccination. A preprint. Though note, it doesn’t mean young people don’t get breakthroughs (just not due to these factors). medrxiv.org/content/10.110…

17) But but but… do these elderly vaccination breakthroughs cases lead to hospitalizations??? …unfortunately—YES. The authors note: “Post-vaccination infection in frail older adults was not entirely benign, with 30 out of 120 (25%) in this group presenting to hospital.” Wow. ⚠️

18) Okay, more good news & bad news from the same study:

📌Good news—vaccines prevent infections & hospitalizations overall

📌Semi-good / Semi bad news—vaccines increase the likelihood asymptomatic infections. Good it’s mild, but bad for testing pickup & stopping silent spread!

19) Why is asymptomatic infections so bad even if it’s mild? Because the properties of a silent #COVID19 infection means it’s less likely to be testing identified & less likely to be isolated to stop it. This is why vaccinated people (many asymptomatic) must mask! CDC is wrong!

20) this is why I staunchly stand by my comments in May…

📍Doctor says CDC "made a grave mistake" with relaxed mask guidelines.

21) Both WHO and Los Angeles and California Capital all recommend that vaccinated people should mask while #DeltaVariant surging. CDC does not. While I love CDC, the @CDCDirectoris wrong here. CDC much change directions while #DeltaVariant is surging.

22) Even if your country is vaccinated heavily, you’re not immune from #DeltaVariant causing hospitalization and deaths. As reminder, all critical indexes of hospitalizations, ICU ventilation beds, & deaths all rising in England 🏴󠁧󠁢󠁥󠁮󠁧󠁿! Elderly & vulnerable are at high risk.

23) Sobering— “I’m hearing from my ER colleagues what they are facing now is worse than the surge they faced during the winter,” @meganranney said. #DeltaVariant summer winter is coming. wpri.com/health/coronav…

24) Sporting events are also very risky for high risk elderly folks, and those immunocompromised or have chronic diseases. Don’t risk it. Tell your family it’s too risky amid #DeltaVariant surge.

25) #DeltaVariant is more severe damnit! Forgot to add the other two severity studies— UK data from England and Scotland found 2.4x and 2.6x higher risk of hospitalization than #alphavariant, which is already 64% more severe than older. Thus 1.64*2.5x = Delta is 4x more severe!⚠️

26) Don’t believe me? Just read the exact report from UK govt scientists on #DeltaVariant severity…. The ~2.5x more severe than Alpha / ergo 4x more severe than older strains, is on par with Singapore data of ~4.9x more severe (see post #8 above).

27) we need to shield unvaccinated kids too… 7 kids in the ICU in one small state like Mississippi means countless at risk nationwide while #DeltaVariant surges.