“Worrying is like rocking a chair. It give you something to do. It doesn’t get you anywhere”. Famous saying.

Worried about mutant COVID? Just follow what’s in our control: Masks, social distance, and get as many people in the world vaccinated as soon as possible.
Some of us discuss the mutant strains just to increase awareness and to keep people informed. The goal is also to make sure leaders are appropriately concerned and act. And to not make the same mistakes of months past. Not to make the public anxious.
My feeling remains the same. Once people are vaccinated even if the virus mutates the probability that it will have the ability to evade immunity from infection or vaccination adequate enough to cause severe illness and consequently this type of pandemic will be very rare.
*rare=very small

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More from @VincentRK

19 Dec
Even today someone is arguing that COVID death rate is only 0.1% & so it’s not a big deal.

Facts:
-True mortality is 1%

-Mortality is much higher if hospitals are overwhelmed

-0.1% of the US has already died from COVID

-310 million Americans are still at risk of getting COVID
-Young healthy people do have a very low mortality rate from COVID. Especially those less than 25.

-But the nation is not full of young, healthy people.

-We are in this together. For everyone around us. Our friends, family, neighbors, and fellow citizens.
-All restrictions are temporary.

-We have highly effective vaccines. Whatever concerns people had of long term harm to their freedoms is no longer valid. We do have end in sight.
Read 5 tweets
17 Dec
One common question in recent days: How come places with mask mandates & restrictions have also been affected with high rates of COVID?

A few thoughts:

1) We are dealing with an enemy that doesn’t play fair. So unless there is high compliance, it exploits the weakest link.
2) Unfortunately masks are only one piece of the puzzle needed to stop COVID. They work in concert with other measures including border control, testing, tracing, ventilation, social distancing, protecting vulnerable populations etc. They work as part of a coordinated strategy.
3)Some places did do well for months. But then when they relaxed, the virus came right back. Until we have herd immunity from vaccines, the COVID virus does not magically disappear with just a few months of compliance. Needs to be sustained. Thankfully we have an end in sight.
Read 9 tweets
15 Dec
What evidence did it take thalidomide, the most notorious drug of all time to be used by cancer doctors in the US?

A study of 84 patients with no control arm. Myeloma cancer occurs in about 4/100,000 people per year. And had a median survival of 3-4 years at that time.
1/
This is that study.

84 patients of whom 25% responded to therapy. Published in 1999. @NEJM nejm.org/doi/full/10.10…
I led a randomized trial which eventually got thalidomide FDA approved for myeloma in 2006, but that trial would not be published until 2005.

By then thalidomide was already used widely in the US, off label, almost exclusively for myeloma. @ASCO_pubs ascopubs.org/doi/10.1200/JC…
Read 5 tweets
15 Dec
Moderna Vaccine. The numbers speak for themselves as well. Deja vu.

As I said with the Pfizer vaccine: One of the greatest achievements in medicine of all time. We are grateful. @ASlavitt
Link to the full FDA briefing comment. fda.gov/media/144434/d…
Here is the primary efficacy table for the Pfizer vaccine. And link to the FDA briefing document. fda.gov/media/144245/d…
Read 8 tweets
13 Dec
When COVID vaccines are available, should adult patients with cancer or on chemotherapy get the vaccine?

My opinion: Yes
I posted this because I had many inquiries on DM. If further questions please DM.
Reply to FAQ on DM.

There is no reason not to give the COVID vaccine from a safety standpoint to patients with cancer. In some patients with advanced cancer the vaccine may not work as well. But that is still better than no vaccine.
Read 4 tweets
10 Dec
The way the immune system works is that specific immunity to anything (whether virus or bacteria; first infection or recurrence) will only kick in after the infection gets into you, & the innate (non specific) immune response cells presents the pathogen to your T and B cells
1/
So any vaccine, will only help you clear the pathogen quickly before it causes harm or disease. No vaccine can actually prevent the pathogen from entering the body in the first place. It can only help you clear the virus or bacteria quickly.

2/
So during the time span from when a virus enters the body and when it is cleared by the specific immune response, a person is at least theoretically infectious. But it will be much shorter time span if someone has pre-existing immunity from prior natural infection or vaccine
3/
Read 6 tweets

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