Re-exposures are essential to build our immune system. This is not in question. They are like training.
But like anything, when enough people get a re-exposure, there are going to be rare cases here and there that go awry and someone gets more sick the second time.
2/
But this is rare and should NOT be interpreted as people will not build protective immunity and that vaccines will not work.
The take away from this piece should be “In a rare event, a person in the US gets a severe second infection with SARS-CoV-2”
One other point
3/
Scientists publish information on rare events in academic journals bc we learn a lot from these. But media has a different role than academic journals and should be responsible about reporting on important issues to the every day person. The two are not the same.
Also, I dont think it’s wrong at all for the media to report on rare and interesting events - they are interesting to scientists and physicians and likewise, interesting to others too - BUT - the context should be front and center when it is something this crucial.
I’ve seen a lot of ppl respond and say “people aren’t scared enough”
There is a difference between being informed and being scared about rare events happening. Do we want an extremely rare adverse event from a vaccine to cause everyone to be scared of being vaccinated?
Can we create a brand new metric to know if #COVID19 is increasing/decreasing without staring at case counts & fractions positive - both greatly obscured by test practices.
In this incredible Tweet thread 👆 @jameshay218 describes the new work - we hope will lay new groundwork for public health authorities to track this/future viruses & if control strategies are working
One piece that is so cool about this method is we do NOT need a time series of case data to create a trajectory (those little bars on @nytimes website or google that we’ve all stared at for the past 9 months to see trend up vs down in cases). We can do it from a single day!
3/
The most important point of deployable rapid tests are that they can be used by many people, frequently!
But should not be used as confirmatory testing of -ve PCRs. This doesn’t make sense and WH use for this confuses how these tests are most appropriately used.
2/
These tests should be to screen ppl (frequently) for +ve results to identify people likely needing to be isolated
In this case @POTUS has had numerous PCR tests and is the president! He can get a viral culture test if he wants to go out w confidence he is not contagious
3/
It's said to be poor w very low sensitivity - the news, @US_FDA and many others say so
But this is a mistake. It's a very good rapid test
I explain here at ~3:30
(Just found link from an old talk)
The short story is the main study from NYU that led to the low sensitivity claims used an extremely skewed sample set
If you remove from the paper just the +ve samples with a Ct value >40 (incredibly miniscule RNA loads), the sensitivity of the test jumps from 60% --> 90%!
If you take only samples with Ct values <38 (still on par w almost any other PCR test), then sensitivity jumps from 60% --> 95%!!
So the problem wasn't the test, it was the samples evaluated. 30% of them were at the very limit of detection of a SLIGHTLY better test
Despite high sensitivity when someone is likely contagious, and high specificity relatively speaking - 98%,
When deployed widely, a 2% false positive rate (1 per 50) is too high.
2/x
If deployed alone, a pop screening tests with a 1 in 50 false positive rate will immediately create a lack in confidence of the assay. This is already happening!
I’ve said it before - directly to FDA/CDC and here - we MUST have a clear goal and plan for these tests.
3/x
If we do not get this virus under control now, we are in for a perfect and terrible storm
We are not taking the expected seasonality of this SEASONAL virus seriously!
Instead, we've assumed our efforts are responsible for decreased cases this summer...
1/x
I worry very much that people are confusing the fact that this virus has transmitted in the summer for it not being very seasonal.
This is a grave mistake and misinterpretation...
2/x
The 'force of infection' of this virus is massive! Think of it like the momentum that the virus has to transmit
The huge number of susceptible people is what is allowing the virus to maintain transmission through the summer months - when other coronaviruses go to near zero.
3/x