James Todaro, MD Profile picture
Sep 17, 2020 10 tweets 4 min read Read on X
1/ Growing research demonstrating importance of protective T-cells against SARS-CoV-2 combined w/ prior research on influenza viruses suggest that nasal mucosa T-cells may explain the rising number of "positive" PCR tests while deaths & hospitalizations remain low.

Here's why.👇
2/ We know a large percentage of the uninfected population already possess T-cells in the blood that recognize SARS-CoV-2.

It seems likely our nasal mucosa also possess these protective T-cells considering airborne spread of common cold coronaviruses.

3/ Substantial research on influenza viruses shows conditioned T-cells in the nasal mucosa is associated with rapid viral clearance and decreased transmission to the lungs upon reinfection.

jimmunol.org/content/167/6/…

pnas.org/content/114/20…

immunology.sciencemag.org/content/2/12/e…
4/ In a study from 2018, mice intranasally infected with a general coronavirus resulted in significantly decreased mortality upon subsequent exposure to SARS-CoV-1 (from 100% to 0%).

The authors attribute this to a protective T-cell response.

ncbi.nlm.nih.gov/pmc/articles/P…
5/ Similarly, for SARS-CoV-2, our nasal mucosa may have protective T-cells from prior exposure to common cold coronaviruses.

These protective T-cells may not stop you from testing "positive", but may protect against symptoms and disease transmission.

I'll explain.
6/ We now know that up to 90% of people with a "positive" PCR test may not actually be infectious.

The PCR test commonly used during this pandemic is too sensitive...meaning it is detecting a tiny amount of viral particles/fragments.

nytimes.com/2020/08/29/hea…
7/ Protective nasal mucosa T-cells in these individuals may be the key to keeping viral loads very low.

That is, while T-cells are killing infected cells, there's enough virus present for a positive PCR test, but not enough present to result in symptoms or disease transmission.
8/ This has obvious implications on herd immunity.

If a substantial percent of the population already has protective T-cells, then the number of people vulnerable to COVID-19 drops dramatically.

This could explain why we see rising "cases", but few deaths and hospitalizations.
9/ Furthermore, Sweden has been in a steady state of about 200 new positive COVID-19 cases a day since July despite reopening without masks.

Perhaps, through a swift spread of COVID-19, the vast majority of Sweden now have protective T-cells limiting viral spread and morbidity.
10/ This area of research certainly needs to be explored further.

It is important, however, to not limit the scope of this research in terms of vaccine development, but to also assess in the context of natural herd immunity—which may already be present in many parts of the world

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More from @JamesTodaroMD

May 18, 2021
1/ Here are the most common crypto investors I’ve observed over the past years.

A) “Get rich quick”
- Basically looking for a lottery ticket
- Makes very small investment because of low conviction
- Often shaken out in dips or suffers a 90-99% loss in a coin that never recovers
2/ Onto the next type:

B) “The Nocoiner”
- Judges the entire space based off the worst players
- Doesn’t take the deep dive to realize the transformative implications specific crypto protocols will have on finance
- Often becomes very bitter every 3-4 years
3) The last crypto investor:

C) “The Fundamental Investor”
- Looks beyond the hype
- Gets hands dirty testing projects
- Forms a thesis, then makes a material investment
- May suffer losses in the first cycle, but has conviction to become an early investor by the next cycle.
Read 4 tweets
Feb 3, 2021
MicroStrategy World 2021 live now...

“Cash is a liability. No longer an asset.” Ross Stevens, CEO Stoneridge and NYDIG
“I now think in bitcoin...It is very freeing. Bitcoin is not volatile. Fiat is volatile...It keeps getting cheaper.”
- Ross Stevens
Property of gold that makes it weak compared to bitcoin:

"Bitcoin is the first store of value ever in which its supply is totally unaffected by its demand. Bitcoin is better at being gold than gold.”

Gold supply can be increased with demand.

Bitcoin will only have 21M coins.
Read 8 tweets
Feb 2, 2021
1/ Primer on the value proposition of bitcoin & decentralized finance (aka ‘DeFi’).

In my opinion, this will continue to be one of the most exciting growth sectors over the next decade...resulting in a complete paradigm shift toward sound money, new financial products & web 3.0.
2/ First, let us dismiss the popular myth that bitcoin is transient like the speculative bubbles of tulip mania and south sea company.

Those bubbles were very illiquid and lasted a short 3-4 yrs.

Bitcoin has been growing for over a decade with billions of dollars traded daily.
3/ Bitcoin is an incredibly unique asset...

An asset resistant to inflation, capped at 21 million coins.

An asset resistant to censorship/seizure that can be privately secured with a seed phrase.

An asset that can be transferred anywhere in the world almost instantly.
Read 17 tweets
Dec 11, 2020
1/ Vaccine mandates are quickly moving from "conspiracy theory" to reality.

In a recent interview, Dr. Fauci asserted that the only return to "normal" is vaccination in 75-80% of the US.

Let's assess if that is really true.
2/ The Pfizer and Moderna COVID-19 vaccines aim to serve two purposes:

a) Protect individuals from symptomatic infection. Trials estimate ~95% efficacy for both vaccines.

b) Decrease the transmission of SARS-CoV-2. This benefit is still unconfirmed.

nejm.org/doi/full/10.10…
3/ In regards to strictly the personal benefit of protection, most Americans would agree that the decision to get the COVID-19 vaccine should be a personal choice.

The debate becomes murkier though when assessing the risk of the unvaccinated infecting those who are vaccinated.
Read 11 tweets
Nov 9, 2020
1/ There's an unusual pattern for voter turnout in Red, Blue & Swing states.

Changes in voter turnout from 2016 to 2020 has been largely attributed to increases in mail-in votes this election.

Interestingly though, Red & Swing states had the greatest increases in voter turnout. Image
2/ This is odd because Democrats had a much greater preference for mail-in voting compared to Republicans.

One would expect that the Blue states (more Democrats) would see the greatest increases in voter turnout due to increased mail-in voting--their preferred method after all.
3/ Instead, Blue states actually have the smallest increase (4.8%) in voter turnout this election.

On the other hand, Red States had a 6.6% increase in voter turnout and Swing states had the largest increase at 8.1%. Image
Read 4 tweets
Sep 18, 2020
1/ An unknown side effect of lengthy lockdowns may be decreased crossover immunity to COVID-19.

Research on SARS-CoV-1 suggests that lack of exposure to the common cold coronaviruses could actually worsen morbidity and mortality in those who do eventually get COVID-19.
2/ Researchers infected mice with a general mouse coronavirus and then 2 days later infected those same mice w/ SARS-CoV-1.

They compared the mortality of these mice vs those infected with SARS-CoV-1 who were not first "primed" w/ a general coronavirus.

ncbi.nlm.nih.gov/pmc/articles/P…
3/ The difference in mortality was astounding.

100% of the mice infected with the general coronavirus first, then with SARS-CoV-1 survived (black circles at top).

Whereas 0% of the mice infected w/ only SARS-CoV-1 survived (black boxes).

(Significant difference with P<0.0001)
Read 5 tweets

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