Thread by @EricTopol

Our informative and refreshing podcast w/ @nataliexdean, a guiding light in the pandemic
medscape.com/viewarticle/93… @Medscape w/ @cuttingforstone
A🧵summary
1. "We're struggling right now in the United States....there's a lot of uncertainty"

2. We need a coordinated response of "all these public health things that people don't always appreciate, they add up." Some places in the US are doing it well.
Explains forward and backward contact tracing.

3. On herd immunity confusion, a term that is usually in the context of vaccines. See below.
We need to focus on "proactive strategies to protect people"

4. What about Sweden's strategy?
Nice explanation here; not a simple herd immunity model as many have characterized

5. What should be the criteria for efficacy of a #SARSCoV2 vaccine?
WHO and FDA have agreed on 50%, but that is a point estimate with 95% lower confidence intervals that can't/shouldn't be too low (like only 15 or 20% effective)

6. There's a prodigious challenge here vaccinating billions of people, mostly healthy, and remarkably diverse--the aged, children, different ancestries. The vaccine trials are not adequately representative and subgroups so not provide adequate power, uncertainties in dosing, etc

7. Getting acceptance of the vaccine relies on public trust. Key thoughts on what is needed here

8. Efficacy is not a simple yes/no.
"It's possible that a vaccine to make people less symptomatic but they could still be infectious to others"
(which means using masks for awhile)
and many other nuances.
It will take time to get to 80% coverage

9. Excited about the prospects of rapid testing

10. What about vaccine safety?
Short term
"We need at least 1-2 months of follow-upon enough people after they receive their second dose"
Then there's the long term safety issues for which there are less concerns but needs to be defined (the dengue vaccine took 2-3 years)

11. Other uncertainties include the duration of protection from the various vaccines which will require extended follow-up and the issue that some trials have very low seropositive (1%) participants but currently ~15% of Americans are estimated to be seropositive

12. Would you take the vaccine right now?

13. We discussed the WHO, the COVAX efforts that the US pulled out from (beyond the WHO, as well), their efforts on #LongCovid, daily press conferences and the @COVID19Tracking project that both Dr. Dean and I are advisors

14. We wrapped up with her experience using social media. If you don't already, follow @nataliexdean. You'll learn a lot .