Thread by @ASlavitt

COVID Update July 7: I spent the last 24 hours with 3 scientists, all of whom have seen vaccine data, 2 of whom are former regulators, all of whom have opinion.

Will 🧵 soon if interested.

My core question was what the world is going to look like in 3 years but asked other things as well.

(I go into detail on vaccines and trails & everything on upcoming #inthebubble).

2/

Starting with a slew of good news. 3/

The vaccine data from Oxford (being run in Brazil looks strong). No real safety issues so far. Gives people the antibodies.

People are getting it post-COVID & some will in a challenge trial. 4/

What “works” means— how long & for whom is less clear. But probably more like a flu vaccine (40%?) vs MMR (97%).

There will be multiple vaccines after the first expected in the Fall. Each likely progressively better. 5/

The monoclonal antibody therapy is also very exciting. Maybe even more so than a vaccine. If you get infected, it’s another way to confer immunity & prevent it from advancing. 6/

Therapy trials are easier and quicker than vaccine trials.

Frustration that some vaccine trials are moving too slowly & not sharing data other than in press releases. That’s something people can advocate for. 7/

Everyone— and I can’t emphasize this enough— was a huge proponent of masks. Efforts to invalidate masks were considered absurd. 8/

The reason I mention these things is that the principal thing I learned is that the future will be defined by all of these things in combination: vaccines, therapies, masks, and other human interventions. 9/

Mutations yes, but there wasn’t much concern that vaccines could keep up.

Also viruses become less deadly over time and there is cross-immunity and other potential 10/

T-cells more important and less understood than antibodies. 11/

What is the FDAs hurdle for approving an EUA?

Safety and a 50% or greater chance of improvement. 12/

In 6 months or so, so far science is doing as well as our leaders are doing poorly. 13/

The future is always murky but given what I heard I asked: so, optimistic about reducing lethality but not eradication? Basically that’s what it sounded like.

Yes, there will be a new normal. 14/

What’s in this new normal? Will I be able to hug my mother?

The answers landed on “I hope so.” But no promises. 15/

Will people wear masks in the future?

Hope that we are more like Asia where this becomes a norm, particularly when people are sick. 16/

Crowds, arenas?

Take it slowly. Masks and immunity and digital apps will help. But people will be taking risks.

Antibody therapies could make catching CV less deadly & therefore a more acceptable risk. 17/

What will the time before a vaccine look like?

Crappy. Horrible response in the US. Way too many unnecessary deaths. Fall will be awful. 18/

Chance that the early vaccines turn out to be unsafe or don’t pan out? Possible but low. 19/

Will people be able to trust what they hear from the FDA or Trump Administration?
It’s an issue.

Will you?
Likely. Will look at the data.

Would you take a vaccine?
Depends on the data.

Expect there to be data before approval?
Yes.

Will you speak out no matter what?
Yes. 20/

This felt like a realistic glimpse into the future: continuously better. Not one dramatic moment.

No “life before vaccine” or “life after vaccine.” But gradual changes. 21/

The major takeaway. There absolutely is a light at the end of the tunnel even if it’s hard to see sometimes. Even if our leaders have made this harder. Even if it’s very dispiriting. 22/

The hard things will pass if we’re patient (which is hard) & pass more quickly if we make tougher decisions.

I know the marathon is harder to run when you don’t know what mile you’re at. But if you count on & help others, I view it better as a relay race. /end

PS If people have different knowledge, feel free to add it.

In this area, I’m not an expert. Just trying to give the benefit of my network.

Maybe I got the date wrong. Maybe I didn’t and I’m writing this for people in Europe. No need to judge.