Thread by @VincentRK

Important insights from the Antarctica cruise ship story. @ThoraxBMJ. #COVID

217 on cruise
All asymptomatic before cruise, & for first 7 days

128 developed COVID (59%) despite precautions after 1 case

81% asymptomatic
19% symptomatic
3.1% Intubated
1 death (0.8%)

1/

Fascinating: There were 10 rooms shared by 2 people in which 1 developed COVID, & 1 didn’t despite sleeping & staying in same room for >30 days! @ASlavitt @Rfonsi1 @vmontori

- Is everyone susceptible?
- Will negatives be positive later?
- Will negatives get antibodies or not?
2/

In this study, everyone in the ship was tested & no external contact.

Many other insights.

-Screening for fever and symptoms not enough.
- First symptoms on Day 8 means long presymptomatic phase
-60% got infected despite good precautions; it’s a highly contagious virus.

3/

What’s really important is even if only 3% of people who get COVID get very ill and need intubation, that is still a huge number for the health care system of any country to handle.

1% mortality rate is more than any of us can bear. It’s a huge loss of life.

4/

Here is a link to the full paper. thorax.bmj.com/content/early/…

I couldn’t tag the authors. But I’m hoping for an update. On all the persons who tested negative. Especially what the serology showed.

To get clean unbiased estimates, the inception cohort has to be good, and the testing has to be complete. This is as good as a cohort study I’ve seen on COVID. Probably closer to the truth than most others which have biases. One thing we need is more follow up and repeat testing.

@Rfonsi1 - you may want to reach our to authors and offer the full cellular and humoral immunity profiling we discussed. @vmontori

This thread won’t be complete without some pics from our own Antarctica cruise from 2017. Unforgettable. I hope despite all the problems, the passengers still took home enduring memories of the peace and beauty of the place. @PSampathkumarMD

Linking related thread which also raises questions about susceptibility.

https://twitter.com/vincentrk/status/1276159410264576000