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Nov 29, 2021, 15 tweets

[Thread] 1. @ProfAbdoolKarim on the #OmicronVariant globally:

1. Globally #COVID19 case numbers are increasing
2. The WORLD might be entering a 4th #COVID wave

2. Variants have changed the #COVID19 endgame. Each SA #COVID wave = driven by a different variant with different characteristics:

Wave 1: Wuhan variant
Wave 2: Beta variant (more transmissible than Wuhan, immune escape abilities)
Wave 3: Delta (more transmissible than Beta)

3. #COVID19 case surges have been caused by different variants in different countries.
India = #DeltaVariant
Brazil = Gamma variant
SA = #Beta (Wave 2), Delta (Wave 3)

4. SA has seen a rapid rise in #COVID19 cases the past week - from a low transmission rate barely a week or two ago.

5. SA wasn't caught with its pants down:
- In Sept scientists said they expected a new variant for the 4th wave, based on what happened in previous waves (each wave was driven by a new variant)
- But they didn't know exactly when a variant would emerge or what it would look like

6. Because scientists in SA anticipated a new variant, the government invested heavily in the country's genomic surveillance capability so that we're able to pick up new variants as fast as possible. That is why we were able to detect the #OmicronVariant so fast.

7. What characteristics does the #OmicronVariant have?
We don't have clear evidence yet, we can only predict likely scenarios:
- Some mutations = linked to enhanced transmissibility/partial escape of antibodies in other variants
- Some of its mutations we haven't seen before

8. What #OmicronVariant scenarios can we expect?

1. Diagnostics (#COVID19 tests) = work
2. Clinical presentation (who gets sick + how sick): Not enough data yet, but anecdotal patient cases suggest patients = younger (but fewer younger than older people in SA = vaccinated)

9. What #OmicronVariant scenarios can we expect? (continued)?

1. Clinical presentation (who gets sick + how sick): No clear evidence yet, anecdotal cases suggest no big changes in symptoms and disease severity
2. Will antiviral and steroid #COVID19 treatments work? Likely.

10. Will vaccines work @ the #OmicronVariant?
1. Prelim evidence suggest partial immune escape from antibodies (from jabs/natural infection, so slightly less protection)
2. Likely an increased risk of reinfection (if you've had COVID = could be more likely 2 get infected again)

11. Will vaccines work @ the #OmicronVariant (continued)?

1. We don't yet know yet how #JnJ and #Pfizer will respond (the jabs used in SA) - it will take 2-3 weeks to get answers
2. No previous variant has been able to reduce protection by much @ falling seriously ill

12. Will vaccines work @ the #OmicronVariant (continued)?

1. Different vaccines could respond differently, we know that from the past, especially when it pertains to mild infections
2. E.g.:AstraZeneca doesn't protect well @ mild Beta infections, but it protects well @ Delta

13. We have lots of data to show that #COVID jabs = very good to protect us @ falling seriously ill with #COVID. It's hard to reduce the protection of T-cells (the stuff that protect us against serious illness).

14. Why won't #COVID19 travel bans to stop the spread of the #OmicronVariant work?
1. The variant has already been detected in 11+ countries, isolating SA or southern Africa won't help
2. Better measures = screening at border posts, only let the vaccinated travel

15. SA's investment in genomic surveillance (this is what scientists do to pick up new variants) has paid off, because we've identified the #OmicronVariant exceptionally fast. We now need to convert that success to "response success" (what we do to fight the variant).

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