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Michael Mina Profile picture
@michaelmina_lab
Oct 3, 2020 • 4 tweets • 1 min read • Read on X
For those thinking "look proof that frequent tests dont work"... a wrong interpretation

This is the 1st transmitting event despite 100s (1000s?) of ppl crossing paths w president or through the White House. Testing has since March helped keep the WH generally free of virus.

1/
It is far too easy when thinking about public health to see successes. The very nature of public health is that success is largely invisible. Reporting that no cases transmitted day after day is simply not a story. So we focus on where things go awry - its natural to do so.

2/
This is the same issue as vaccines and preventive healthcare, and public health in general. It does not get the funding it needs because its successes go unreported and undocumented... out of sight out of mind. But it is the daily undiscussed actions of public health that matter
I meant to say... to *not* see successes.

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More from @michaelmina_lab

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
Michael Mina Profile picture
Dec 15, 2023
Please note - If you use expired rapid antigen tests - here's how I think about interpreting them

1) If Negative - do not trust it - especially if control line is faint / absent

BUT

2) If Positive - trust it - *very likely* true positive.

(short thread)
1/
An expired test will Not aberrantly turn positive just because it's old

Expiry makes lines not show up. Does make them become dark.

So, if using an expired test:

Do Trust a Positive.
Do Not Trust a Negative.

*And note that many tests have had extended expiry dates...

2/
Here is a thread about the extensions to the expiration dates.

Not all tests are extended but many of them have and that means that the dates on the box may be different from the actual expiration date. I write about it here and how to find out

3/
Read 4 tweets
Michael Mina Profile picture
Nov 28, 2023
Does halving a vax booster dose make a difference to protection?

It shouldn’t

But could lower adverse effects

New @TheLancet paper is a great reminder that the immune system works on exponential scales

Halving the dose has min impact

Compare blue vs orange (half) per group https://www.thelancet.com/journals/lanwpc/article/PIIS2666-6065(23)00271-7/fulltext#secsectitle0010 No impact between a full dose (in blue) compared to a half dose (orange) in various prime boost groupings.
The paper is a great demonstration of the studies to perform in order to enhance vaccine distribution & access globally

If in emergencies we halve doses could we drive costs down and massively increase access??

Immune kinetics suggests so.

thelancet.com/journals/lanwp…
This is a bit like Ct values on a PCR test.

You can perform two swabs. One can be only half as effective as the first - and it only amounts to a single Ct difference.

One could be a full 90% less efficient and it’s still only 3Cts different!

We often gloss over exponential
Read 4 tweets

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