The headlines, all of a sudden, are everywhere. UK study showed antibodies to the coronavirus decline so we're all doomed. No immunity, no vaccines, no herd immunity.

People, we have enough real things to worry about. Do not worry about this. 1/x

nytimes.com/2020/10/27/hea…
First of all, antibody levels are *supposed* to drop after the infection clears. Imagine if they didn't: Your blood would be a sludge of every type of antibody to every pathogen you've ever encountered. Hence my surprise yesterday at this paper 2/x

In the British study, in 27% of people who were positive at first, they dropped below detection limit. But the test has 84% sensitivity, and we know not everyone makes really high levels of antibodies after coronavirus infection (although nearly everyone makes some) 3/x
In other words, it's not really a surprise that some people's levels drop too low to be detected. But that does not mean that
a) they have none at all
b) they don't have memory B cells that can't make more as needed
c) they don't have T helper and T killer cells. 4/x
Also, and this is an important point, this study is looking at seroprevalence at a population level, not at an individual level. Among individuals, studies from Portugal, Iceland and NYC have now shown stable levels for months. (Links in the article) 5/x
If somehow the immune response is still flimsy, despite all these caveats, that may still be enough. In monkey studies a little bit of immunity went a long way toward blunting serious illness, if not preventing infection altogether. 6/x
None of this means anything for vaccines. We know vaccines can be tweaked to elicit immune responses much stronger than from natural infection. We'll know for sure when vaccine trials are complete, but for now, there is no reason to worry--at least not about this study. 7/x
Don't just take my word for it. The article explains in detail the biological explanations for why you shouldn't worry. Please read it and rest easy. 8/x

Thanks to @profshanecrotty @Anto_Berto @SCOTTeHENSLEY Paul Elliott at @imperialcollege

nytimes.com/2020/10/27/hea…
Gah, I somehow ended up with 4 white men in this piece, despite also reaching out to multiple women. I did better in this other piece that pubbed today, and will try again. Tomorrow's another day?
nytimes.com/2020/10/27/hea…

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More from @apoorva_nyc

28 Oct
The perfect antidote to unwarranted fears about declining antibodies: Solid data showing the opposite. Here's news from Ania Wajnberg @florian_krammer et al that antibodies persist for at least five months. 1/x

science.sciencemag.org/content/early/…
@florian_krammer I've written about earlier data from this team, here in May, showing that most people, regardless of sex, age and severity of illness make decent antibodies: 2/x

nytimes.com/2020/05/07/hea…
@florian_krammer Or here in July, when they reported data from 20,000 people showing the antibodies persist for at least 3 months. 3/x

nytimes.com/2020/07/22/hea… Image
Read 4 tweets
27 Oct
A quick thread on what this new article showing worrying signs of autoimmunity in some Covid-19 patients means 1/6

nytimes.com/2020/10/27/hea…
In about 70% of people who were severely or critically ill with Covid-19, Emory researchers saw what are called "autoantibodies" -- auto meaning self. Instead of binding fragments of viral RNA, these antibodies glom onto human DNA. 2/6
Normally DNA is cloistered inside the cell. But under high inflammation (as in acute viral infection), cells can explode, strewing the arena with DNA fragments, and confusing antibodies. Their presence may explain some aspects of severe Covid 3/6
Read 6 tweets
26 Oct
ICYMI: On Thursday, we published a story suggesting that elementary schools, especially, do not seem to be seeding clusters of infection. As all articles on this topic do, it made some people angry, so... a thread for people who did not bother to read it or maybe misread it. 1/x
First, what the article did not say. It did not say kids don’t get infected or that they don’t transmit. They do, on both counts. It did not say that schools are fine to open no matter what is going on in the community. 2/x
Community prevalence is important because if it’s high, it means some number of kids and staff will arrive at school infected, making it more likely that they will spread the virus to others. 3/x
Read 12 tweets
23 Oct
BREAKING: Universal mask use could prevent nearly 130,000 deaths from Covid-19 by next spring, and without mask use, the death toll could top 500,000, acc to new estimates. 1/x

nytimes.com/2020/10/23/hea…
These are extremely rough approximations, susceptible to all the flaws of modeling studies, but plausible nonetheless, experts say. We’re already seeing a fall surge. The trends will continue through to a peak in Jan, and hold at high levels till March, acc to the model. 2/x
If states ease all social distancing mandates, the death toll could hit a million by spring. But more plausibly, if states put some restrictions back in place because of rising rates, the number might be closer to 500K. 3/x
Read 6 tweets
19 Oct
NEW: The Great Barrington Declaration has received a lot of attention, especially from the Trump administration. How did they gain access? And what exactly do they envision? 1/x

nytimes.com/2020/10/19/hea…
Here are some of the main pts: 1) protect the older/vulnerable while letting young people get infected
2) No testing of asymptomatic people
3) No contact tracing. 2/x
BUT how exactly would this work? How do you define, let alone "protect the vulnerable," when a third of the population has underlying risk factors? And how do you physically separate them from the rest of the population? 3/x
Read 7 tweets
19 Oct
In August I wrote a story questioning whether PCR tests are too sensitive. Many clinical microbiologists and others took issue with the piece because they saw it as undermining the PCR. This Medium post raises some of those points: 1/x

medium.com/@aminkina/covi…
The post makes some very important points about PCR, including the huge variability across machines of cycle thresholds (Ct) and even from sampling method. 2/x
The FDA's own analysis confirms this concern. See, for eg, this recent attempt at figuring out the analytical sensitivity of some of the tests with an EUA, the range is very wide: 3/x

fda.gov/medical-device…
Read 12 tweets

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