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Michael Mina Profile picture
@michaelmina_lab
Sep 28, 2020 • 8 tweets • 2 min read • Read on X
BREAKING (not so surprising) NEWS:

The Trump Admin is touting rapid antigen paper tests. The @AbbottNews BinaxNOW assay is terrific and is a great start.

But don’t be fooled - the number of tests being distributed by the WH is simply not sufficient...

1/
They are saying there are sufficient tests to be used daily or weekly by many many Americans in the coming weeks, but the actual number of tests they are distributing is no where near what is needed....

2/
Distribution of 30 million rapid tests per month may sound like a lot, but across the US, it is 1 test per person per year!

This is not near the type of rapid test volume that is needed to make a major impact...

3/
Instead the federal government CAN take responsibility and take ownership of testing, instead of simply purchasing what’s available.

The WH need to take a leadership role and actually oversee these tests at a volume that can in fact live up to Trump’s (false) hype...

4/
Pence just said we are doing 3M tests per day. This is false. Not even close.

He is saying the new deployment of these tests will open up America’s schools. Clearly he hasn’t done the basic math. How far can 1M rapid tests per day go to actually keep schools safe?...

5/
Don’t get me wrong, these rapid tests can and will likely be crucial to control this virus. But the math here just doesn’t add up. They need to appropriate not $750M but $20B to produce them with defense production act or other in much greater quantities... 10-20x
If $20B sounds like a lot... it isn’t. Its a small fraction of the losses and COVID stimulus bills that have and will continue to be put in place. A very small fraction.

There’s no reason the WH and congress are not being more proactive with testing and scale up of these tests
One clarification... while frustrated with lack of initiative by WH (understatement), this is progress.

It’s slow, but better than him getting to podium and saying nothing new with testing is happening.

So, a positive announcement, but couched in hyperbole and half truths.

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More from @michaelmina_lab

Michael Mina Profile picture
May 3
Such a bad interpretation that stands to harm patient care

Let's not throw the baby out w the bathwater for COVID-19 (and flu etc)!

Suggesting to only run PCR & not rapid means most (50%-80%) of patients get WORSE care & at higher costs

Here's why:

A 🧵

1/
When I see publications & docs say “don’t use a rapid test, only use a PCR”

it assumes this is an OR only situation

Ridiculous!

A rapid test is… RAPID… and highly affordable

You lose ~nothing by it and give your patient the opportunity to GAIN tremendously

2/
If the test is positive, then for that 80%+ of culture positive ppl … your job is done immediately

You’ve spent $5 and 5 minutes and they can get on treatment right away

If you didn’t do it, it will be be 1-2 days and ~$150 before they can get started on treatment

3/
Read 10 tweets
Michael Mina Profile picture
Apr 20
Here we go again with this asinine cautious approach to testing for H5N1

CDC is NOT recommending that people with no symptoms - but who have had contact w infected animals - be tested at all… and certainly are not recommending a swab w any frequency.

Though we should have learned it in 2020, Here’s why this doesnt make sense:

1/Image
Firstly, tests are our eyes for viruses. It’s literally how we see where viruses are

If we wait until people are getting sick, we may have missed a major opportunity to find viruses jumping into humans before they learn to become so efficient in us that they cause disease

2/
So waiting until we actually have highly pathogenic strains harming humans - when we have a pretty discreet population at the moment to survey - is short sighted

3/
Read 11 tweets
Michael Mina Profile picture
Jan 16
A lot of questions still on:

How long should I isolate?

Do I need to isolate?

When can I go back to work?

Is 5 days enough?

What if I’m still positive?

Why am I not positive when I first get symptoms?

This thread below (and the embedded thread) goes through many of these questions
Now that symptoms start earlier w COVID (bc immunity activates symptoms fast after exposure)

A frequent ? that comes up is what this means for Paxlovid

Often ppl think it means you have to start Paxlovid earlier

Nope - Opposite! You have more time

2/
Bc symptoms start faster but the growth of the virus still takes about the same time as it used to…

Symptom onset today is ~2d post exposure where before it was ~5d

So, as far as virus growth is concerned, day 5 post symptoms (when the trials took place) is day ~8 today

3/
Read 6 tweets
Michael Mina Profile picture
Jan 8
A heartbreaking consequence of lapses in vaccination!

A measles outbreak is spreadinf in Philadelphia.

MEASLES! It sends kids to the hospital, erases existing immune memory (creating long term risks) and kills 1 in 1000

It was eliminated in the US, but we seem hell bent on reversing that

inquirer.com/health/measles…
A particularly deadly consequence of measles is its erasure of previously acquired immune memory - setting kids and adults up for infections that they shouldn’t be at risk from!

We found for example that measles can eliminate as much as 80% of someone’s previously acquired immunity to other pathogens!
science.org/doi/full/10.11…
Image
Read 6 tweets
Michael Mina Profile picture
Jan 3
This paper from Kaiser on new XBB1.5 vax formulation is misleading

NO, it does NOT say that prior vaccination w non updated XBB1.5 vaccines offer no protection

No, it doesn’t even say the XBB1.5 updates to the vaccine formulation are important

🧵
1/
 medrxiv.org/content/10.110…
Here are the key conclusions.
They are WAY misleading

The major issue is w the timing

The comparison is

A) a VERY recent XBB1.5 vaccine given in last 30 days,

Vs…

B) A vaccine received ~1 year or more ago!

Any effect is first and foremost owing to recency of vax

2/ Image
Given everything we know about major short term (weeks - few months) immune responses after vax or infections

The comparison is NOT able to say anything about the importance of updating the vaccine formulation for variants

It simply says what any Immunology 101
Text says..

3/
Read 15 tweets
Michael Mina Profile picture
Dec 24, 2023
Tip on pooling home tests

I’m gathering w family. Had one @Pfizer Lucira multiplex COVID-Flu home molecular test

Had 6 people and 6 swabs

Everyone used one swab. Dunked all 6 into one Pfizer Lucira test

Neg.

Tested everyone for price of one!

Pooling at home works!
Pooling can work w home tests including rapid antigen and rapid molecular tests

However for antigen id be a bit more cautious and not put more than 3 swabs in the buffer

With molecular, particularly Pfizer Lucira bc it has a large volume buffer, 6 is no problem.
Here’s a nasal swab that would work. Don’t use it as a nasopharyngeal swab at home - just use it like any home self swab and swab the anterior nares

a.co/d/iCO1nsI
Read 4 tweets

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