This is hardly a model of clarity—SARS-CoV-2 antibodies are potent and vanishing? Vaccines have boosted prospects and reduced hopes?—so let's look at the studies themselves.

Short story: generally good news for a vaccine, generally bad news for herd immunity. /1 ImageImage
Do we usually retain immunity to coronaviruses? Researchers who have collected blood samples since 1985 took a look at 10 subjects and concluded immunity lasts likely just 6 to 12 months. Perhaps this is why there's no herd immunity for common colds. /2 medrxiv.org/content/10.110… ImageImageImage
That said, when it came to the original SARS-CoV (2002–2004), the antibodies persisted much longer—84% still had neutralizing antibodies 36 months later. But, like the authors ominously warned in 2007, we don't know what that means. /3 nejm.org/doi/full/10.10… ImageImageImage
So is SARS-CoV-2 like seasonal coronaviruses or SARS-CoV? A bit of both. Asymptomatic patients lose antibodies rapidly (40% are IgG negative after 8 weeks). Symptomatic patients also lose them, but not as quickly. /4 nature.com/articles/s4159… ImageImage
Patients with severe symptoms have a larger antibody response than those with moderate symptoms, but they still generally lose the antibodies, like with seasonal coronaviruses. /5 medrxiv.org/content/10.110… ImageImageImage
To be clear, this data is messy, with huge variability among patients. And nobody will say "if you don't have this many IgG or this much neutralizing titer, you're not immune!" But this data is not going the way we'd want to assure us that infection creates lasting immunity. /6 ImageImageImageImage
In other words, Rand Paul, who said on March 22 he had tested positive and who was apparently asymptomatic, might have already fallen to an undetectable level of neutralizing antibodies by the time he was berating Dr. Fauci 101 days later. Not good for herd immunity. /7 ImageImageImage
But there is good news. As background, here's how SARS-CoV-2 uses your cells to replicate. The antibodies made most quickly by your immune system attack the virus's nucleocapsid protein, but the most potent ones attack the spike protein or its receptor binding domain. /8 ImageImageImage
Those S & RBD antibody levels also generally decline, but some are both potent and made by everybody. If that's right, a vaccine can focus on building up more of those particular antibodies, rather provoking a generalized response and hoping it works. /9 nature.com/articles/s4158… ImageImageImageImage
Anywho, immunology is a wee bit more complicated than 10 tweets by a fool like me. And I haven't mentioned T cells, partly because that's still a big unknown. I'd just rather not see a pile of conflicting headlines about antibodies saying we're both saved and/or doomed.
/end
This Moderna study is promising, but it's still just a proof-of-concept (phase 1) for mRNA vaccines, not robust data. Tiny sample sizes. The PsVNA neutralization drop-off around 6-7 weeks or so is disconcerting, and I'm not keen on the partial PRNT data. nejm.org/doi/full/10.10… ImageImage

• • •

Missing some Tweet in this thread? You can try to force a refresh
 

Keep Current with Max Kennerly

Max Kennerly Profile picture

Stay in touch and get notified when new unrolls are available from this author!

Read all threads

This Thread may be Removed Anytime!

PDF

Twitter may remove this content at anytime! Save it as PDF for later use!

Try unrolling a thread yourself!

how to unroll video
  1. Follow @ThreadReaderApp to mention us!

  2. From a Twitter thread mention us with a keyword "unroll"
@threadreaderapp unroll

Practice here first or read more on our help page!

More from @MaxKennerly

29 Oct
This decision is ludicrous, as the dissent explains. The ballot receipt extension arose by consent decree on August 3, 2020. The plaintiffs, two Republicans who will be electors if Trump wins, dithered until September 22, when they filed this lawsuit. /1
Neither of the plaintiffs have standing. The lawsuit was filed too late, so laches apply. The 8th circuit decision is too late, so Purcell applies. The 8th circuit decision ignored Minnesota law, which specifically authorizes the Secretary of State to abide by court orders. /2
And the majority's interpretation of "legislature" in the Constitution's electors clause (1st pic) is wackadoodle nonsense, as explained by the 2nd, 3rd, and 4th pics, from the dissent.

The federal courts need to be completely overhauled.

/end ImageImageImageImage
Read 4 tweets
20 Oct
Let's talk for a minute about the Pennsylvania election case.

It's a win for now, because a 4-4 tied SCOTUS vote means the lower court (here, PA Supreme) order stays intact.

But it's terrifying that 4 Justices thought otherwise, and might soon be joined by a 5th (Barrett). /1
Two basic, longstanding principles of law:

first, states control their own elections, though Congress can impose conditions;

second, state courts interpret their own state laws, including state constitutions.

That should've ended this case. Excerpt from PA Dems' brief.
/2
5 Republican Justices already blasted a hole in Congress's power to regulate elections in Shelby County v Holder, invalidating Congress's reauthorization of the VRA. Pics 1 & 2 from Ginsburg's dissent.

In the PA case, the Republicans' brief sang a different tune. (Pics 3 & 4) /3
Read 8 tweets
17 Oct
I was wondering if this was one of those "applying precedent leads us to this unfortunately result..." cases but, no, the reality is that Barrett plowed through state law and a jury's factual findings to cheat the plaintiff out of her fair compensation. /1
The plaintiff's appellate brief is available here: scribd.com/document/48048…

The facts are recounted on pages 16-21 of the PDF. They're awful. The guard repeatedly raped her at the prison.

The issue was whether the county had to pay for the $6,700,000 jury verdict. /2
Consistent with Wisconsin law, the jury had already heard ample evidence about whether the rapes were within the guard's "scope of employment," and they had decided the answer was yes. Excerpts from plaintiff's brief. /3
Read 9 tweets
10 Oct
A good article about the openly activist nature of Barrett's "originalism." We've already seen it in practice from her circuit court opinions, where she uses it—like all "originalists"—to produce the result she wants. For example, let's talk about the Second Amendment.
/1
In DC v Heller, the "originalists" faced a problem: during the constitutional convention, there were several proposals (like from NH's delegation and minorities in MD, PA & MA) to protect individual gun ownership. They were all rejected.

Excerpts from Stevens' dissent. /2
Scalia's response, writing for the majority, was that it was stupid to look at rejected constitutional proposals. Further, the *rejected* NH/MD/PA/MA proposals actually somehow represented a prevailing view of an essential legal right the Framers didn't bother to write down.🤷‍♂️ /3
Read 5 tweets
6 Oct
Putting aside the 15-year-old on TikTok, yes, Trump's condition is still quite worrying. COVID's course is slow compared to the flu. Dyspnea often develops 4 to 10 days after symptom onset, and patients can still deteriorate after that. ncbi.nlm.nih.gov/pmc/articles/P…

/1
In the most recent remdesivir trial (which involved early-stage patients with SpO2 >94%, which it seems Trump went below), one-third of patients who took the drug were still hospitalized 11 days later. Around 10% were still there a month later. jamanetwork.com/journals/jama/…

/2
The decision to give dexamethasone is still a big mystery. Either Trump had 'severe' COVID-19, or he has jumped the gun and might suffer for it, including the known effect of immunosuppression. Neither speaks well for his course going forward. /3
Read 5 tweets
29 Sep
I quibble with that, too. Trump's finances from 2008 onward aren't "mundane." He defaulted on the only bank lending him money, then obtained >$500m in credit despite inadequate collateral, then liquidated >99.5% of his stocks & bonds. That's unusual. /1
Litigation is common in business. The surprising part here is how, as of 2008, Deutsche Bank was the only bank that would loan him money (and only with a personal guarantee), but he nonetheless defaulted. Standing alone, it makes little business sense. /2 chicagotribune.com/news/ct-xpm-20…
The 2008 sale of Trump's Palm Beach home to the bad guy from TENET has always been odd, but perhaps Rybolovlev is just bad with money. 🤷‍♂️ Either way, it coincides with a sharp rise in Trump condos being bought through shell companies and/or with cash. /3
buzzfeednews.com/article/thomas…
Read 14 tweets

Did Thread Reader help you today?

Support us! We are indie developers!


This site is made by just two indie developers on a laptop doing marketing, support and development! Read more about the story.

Become a Premium Member ($3/month or $30/year) and get exclusive features!

Become Premium

Too expensive? Make a small donation by buying us coffee ($5) or help with server cost ($10)

Donate via Paypal Become our Patreon

Thank you for your support!

Follow Us on Twitter!