Darren Markland Profile picture
Intensive care doc, nephrologist, bamboo bike frame builder, active transportation advocate, barista bike rider and general humanist. I own my tweets.

Aug 7, 2021, 14 tweets

I am amazed by how much and how quickly we have learned about this perfect parasite. This article gives us insight into the nuts and bolts of how mutational refinements have made delta so infectious. #covid nature.com/articles/d4158…

First: It’s spike proteins are far more dexterous and literally able to probe the surface of our cells for the ACE2 receptor to unlock the door and gain entry.

Second, the virus as perfected a method that literally catapults in into its host cell at high velocity smooshing it into a coalescent hybrid.

Once inside, the virus deactivates cellular alarm systems, which hide it from the immune system. It shuts down all cellular activity and diverts it to viral reproduction only.

Fourth, it reformats cells, reorganizing their production facilities for maximum short term efficiency, literally redlining our cellular engines. Meanwhile merging multiple infected cells into a multinuculated mega cell that withstands brute force immune attacks.

Finally, as it entered a cell, it has perfected a technique not only to rapidly eject itself from its dying cell, but to rearm its spike proteins with greater efficiency than previous variants. Delta has 3 times the number of “keys” to gain entry to your cells.

This is why it’s infectious before testing becomes positive. Instead of a gradual crescendo of virons streaming out of us, delta is more like lightning followed by thunder. It also explains why it is so easy to catch. The virus is efficient. It takes far fewer of them to succeed.

This knowledge gives us insights into therapeutics and allow me to reassure you the vaccines still are incredibly effective at reducing infections and importantly severe disease, but ….

Certain laws of immunity remain.
🔹With a virus this good we need higher vax rates. 85% at least.
🔹Masks remain essential for because of the very high rate of asymptotic transmission, both in newly infected people, and sadly even in the double vaxed.

Yes, you can get and spread delta if you are completely vaccinated. You’re going to avoid the complications and still live your best life, but it can happen. Trust me on this. Being double vaxed is you doing the right thing for everyone.

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