There were 225,000 new cases identified yesterday

Sat through Monday, cases will dip (usually do)

But we are now seeing Thanksgiving effect

Based on yesterday's cases alone

Expect 5K-6K hospitalizations 12/11 (if hospitals can accommodate)

and 4,000 deaths on 12/26

Thread
225K yesterday is starting to incorporate Thanksgiving infections

After every holiday, we see cases rising Thursday/ Friday after

I expect next week’s case numbers to climb higher

Thanksgiving surge just beginning so things could get worse

But there is hope here

2/5
They could get worse because after every holiday weekend, the surge begins Thursday/Friday after

And keeps going for a while

So we could easily get to 250K cases a day and keep rising

But here's what might help

In some places, people are starting to respond

3/5
Folks are starting to pull back activity. A little

Governors starting to put in restrictions (MI, RI, CA, etc)

Places like ND have some population immunity from all their infections

And may be, therapy with antibodies begins to help some high risk folks

We can hope

4/5
Bottom line

Thanksgiving surge is starting to show up

225K cases from yesterday means 5-6K hospitalizations (in a week) and 4K deaths (in 3 weeks) likely

Whether things get worse remains up to us

Mask up, avoid indoors, & ask your elected officials to do more

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More from @ashishkjha

1 Dec
There is something funny happening with COVID hospitalizations

Proportion of COVID pts getting hospitalized falling

A lot

Just recently

My theory?

As hospitals fill up, bar for admission rising

A patient who might have been admitted 4 weeks ago may get sent home now

Thread
So what do I mean "proportion of COVID pts hospitalized falling"?

For months, you could reliably predict new hospitalizations

How?

By taking cases 7 days prior, multiplying by 3.5%

That is

3.5% (1 in 29) of those diagnosed today will be hospitalized about 7 days later

2/10
LOTS of caveats to this formula

Not all states report new hospitalizations (formula takes that into account)

Could build a 10 day lag formula (3.7% hospitalized by 10 days)

All data I report are 7-day moving avgs from @COVID19Tracking

3/10
Read 17 tweets
1 Dec
Scott Atlas resignation from @WhiteHouse comes not a moment too soon

His time was marred by barrage of misinformation, from promoting anti-mask quackery to falsehoods about testing

He repeatedly tweeted disingenuous "data" & promoted widespread infections as a strategy

Thread
He supposedly was a policy expert, but in my 2 decades of working on US health policy, he was never a serious player

Scott rose to prominence saying on TV what pandemic experts would never say

And found a buyer for his herd immunity strategy in @realDonaldTrump

2/3
.@ScottWAtlas elevated @SunetraGupta, Bhattacharya & @MartinKulldorff...herd immunity advocates who wrote shameful "Great Barrington Declaration"

They claimed to promote "protect the vulnerable" & let others get infected strategy...but didn't do much to protect vulnerable

3/4
Read 4 tweets
23 Nov
If its Monday -- it must be more vaccine news

@UniofOxford / @AstraZeneca vaccine results posted

This is largely more good news

Overall efficacy of 70% but one dosing regimen was 62%, other 90%

A key result reported was safety: no severe adverse events reported

Short thread
What do these results mean and is this actually good news?

Why yes it is

First, I don't fully understand why two dosing regimens were so different in efficacy

One possibility is vector immunity

This vaccine uses adenovirus vector (virus to deliver the genetic material)

2/4
Less efficacious arm used full dose of vaccine in both shots

More efficacious arm was half dose followed by full dose

It MAY be that the full first dose generated immunity against vector, causing second dose to be less effective

We don't know but will need to sort out

3/4
Read 5 tweets
23 Nov
Daily reports tell us what happened last week, 2 weeks ago, 4 weeks ago

This is why folks are worried about what's next

Today's 7 day moving avgs

167K cases, 3600 new hospitalizations, 1460 deaths

What does this tell us about upcoming weeks?

It says we have a problem

Thread
Today's 167K cases? infection happened last week

Today's 3600 new hospitalizations?

Infections happened about 12-15 days ago

Today's 1460 deaths?

Infections happened about 3+ weeks ago

And that's why we have a problem

2/4
About 3.5% of identified cases get hospitalized

CFR right now about 1.7%

So today's new cases will cause:

5000 new hospitalizations in 10 days

2900 new deaths in 3 weeks

Corollary

Today's hospitalizations were cases 10 days ago

Today's deaths were cases 3 weeks ago

3/4
Read 7 tweets
22 Nov
Slaoui, speaking to @jaketapper, lays out an aggressive vaccination timeline

If he's right, we'll see virus spread starting to slow from growing population immunity by end of January into February

And much better by March

How?

Short thread
By end of January, based on timeline laid out:

50M vaccinated

And I suspect 60M infected, recovered by then

Obviously overlap between groups

So likely at 30%+ population immunity by 1/31/2021

That'll slow spread

By end of Feb, probably 40%+

Not "herd immunity"

But

2/4
Herd immunity not like a light switch

As population immunity builds, spread slows

By 30-40% immunity, spread becomes meaningfully slower

When we get to HI threshold, infections won't "disappear" overnight

But they will stop being self-sustaining

3/4
Read 4 tweets
20 Nov
Today was a very, very odd day

I testified before @SenateHomeland

They held a hearing on hydroxychloroquine.

Yup, HCQ

In the middle of the worst surge of pandemic

HCQ

It was clear how our information architecture shapes questions of science and medicine of COVID

A thread
There were 4 witnesses.

3 who strongly supported HCQ

They believed thousands of Americans were dying from lack of HCQ

And then, there was me

This split was not a reflection of evidence or the consensus in medicine

It reflected ability of the majority to seat more witnesses
The hearing was a testament to how politicized science has become

I shared evidence of studies that have failed to find benefit of HCQ

3 other witnesses shared personal experiences

And suggested my testimony was reckless because it would deny people access to lifesaving HCQ
Read 9 tweets

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