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1/n A rather broad, technical question. There's been a theory going around about BCG being protective of COVID-19 infections
1/2 BCG (the TB vaccine) is known to elicit innate immunity, and people have been discussing whether it is this aspect that is protective.
3/n So what about other vaccines that potently elicit innate immunity. The shingles vaccine (Shingrix) has a very strong adjuvant that it is thought to elicit an innate as well as an adaptive response
4/n So, Big Data folks, how hard would it be to determine whether Shingrix recipients had a lower infection rate from SARS-Cov2 ?
5/n BTW, the BCG protective immunity has only been shown in children. By adulthood, one would think that that immunity would have long dissipated. But Shingrix is given to adults.
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Siddhartha Mukherjee
@DrSidMukherjee
1/n Listen up: I am no huge fan of Remdesivir (full disclosure, I own GILD stock) but if its going to work, it has to be given early
2/n But that means LOTS MORE TESTING AND EARLY INTERVENTION particularly in high risk people (that we know). So, the FDA approval can only work if a LOT more testing was available.
3/n That, in turn, means the number needed to treat to save a life will go up...and that's a decision that we need to take as a society. Right now, it's the ONLY drug that's been shown to work (leave aside the late stages of severe disease).
Read 9 tweets
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Siddhartha Mukherjee
@DrSidMukherjee
1/n Listen: this is getting into irritating territory. If you want to re-open business, scientists have offered a plan.
2/n Vastly increase testing. Expensive, but the cost is minimal compared to the losses. Mandatory masking indoors. Mandatory masking on subways and buses.
3/n Wait for drugs and antibodies. Vaccines are 12 months away. Offer subsidies to 1099 workers. Restaurants. Entertainment.
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Siddhartha Mukherjee
@DrSidMukherjee
1/n So, the rate of seropositivity in NYC is 20-25%. Not far from what we had guessed. Open the city, and it will be 50%. But that means countenancing another several 1000 deaths.
2/n So..masks, social distancing and school closures must still be in place. New data suggests that subways and closed spaces are sites of infection.
3/n No simple way out of this one. Low tech solutions are probably better. Mask, hand hygeine, distance, isolate the vulnerable. But a 0.7% -1% IFR is what we are looking at.
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