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Abraar Karan Profile picture
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29 Dec 20, 6 tweets, 4 min read
First reported case of #COVID19 #B117 variant in the United States in a Colorado man with no relevant travel history to UK. What this suggests is community transmission of new variant.

latimes.com/world-nation/s… Image
2/ New variant is thought to be more transmissible but not more severe in terms of the disease it causes. BUT- more transmissible can very much be more problematic than more fatal (see thread/tweets below)

3/ Longer thread here linking to a number of articles as well as different responses by various countries in terms of travel restrictions (which ultimately make less sense/are less efficient for control when you already have community transmission) re #b117 #covid19 variant
4/ What does this mean? Literally doubling down on all the efforts we have been pushing to control community transmission

• consistent masking
• stopping clusters (avoiding indoor crowds & gatherings)
• improving ventilation of indoor spaces
• vaccines
• smarter testing
5/ cont
• supporting frontline workers w/ paid time off/staggered work shifts/ safer isolation & quarantine options/ hazard pay

• creating better systems for hospitals to share critical resources/ transfer patients

• political leaders making tough calls but the right ones
6/ Also important implications here for number of vaccinations needed to reach a herd immunity threshold with a more transmissible variant — this is a problem when we already have a painfully inefficient vaccine rollout here #covid19 #B117

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More from @AbraarKaran

Abraar Karan Profile picture
31 Dec 20
1/
mRNA1273 (Moderna) vaccine- Phase 3 trial

2 doses, 28 days apart (black arrows)

28,207 in per-protocol analysis

Primary end-point: preventing symptomatic infections w/ onset at least 14 days after 2nd dose

Overall: 94.1% vaccine efficacy

nejm.org/doi/full/10.10… Image
2/ Key secondary end-point: preventing severe #Covid19 disease

Vaccine group- 0 severe cases

Placebo group- 30 severe cases

Vaccine efficacy of 100% in preventing severe disease
3/ "In addition, although our trial showed that mRNA-1273 reduces the incidence of symptomatic SARS-CoV-2 infection, the data were not sufficient to assess asymptomatic infection" (cont)

#covid19
Read 6 tweets
Abraar Karan Profile picture
29 Dec 20
THREAD

1/ Read this. This is "global health"? This is our "solidarity"? This is extractive.

Vaccines produced in South Africa & tested on South Africans are then deemed safe, & first given to Americans, British, & others in wealthy countries.
nytimes.com/2020/12/28/wor…
2/ "Poor & middle-income nations, largely unable to compete in the open market, rely on a complex vaccine sharing scheme called Covax."

But as the article mentions, this 'aid' is conditional; some countries are not "poor enough" to qualify, but also can't afford enough vaccines
3/
Within South Africa (& many countries), the wealthy will buy vaccines to protect themselves.

The poor are in a gamble w/ their lives.

**“We’ll all be dead then,” said Prudence Nonzamedyantyi, 46, a housekeeper from the same township.** (quote from the article)
Read 10 tweets
Abraar Karan Profile picture
29 Dec 20
Check out this new piece from Ed Yong in @TheAtlantic on pandemic year two

Thanks to Ed for having me share some of my thoughts here alongside a number of colleagues

We have an immense year ahead of us

#covid19
2/ “There will be a whole lot of pain in the first quarter” of 2021 --Anthony Fauci told Ed in this piece.

I agree. I am hopeful that summer 2021 will be our first major exhale in a while.
3/ One of the most consequential parts of reaching a better summer 2021 is going to be our vaccination strategy, which we aren't doing well right now. Read this thread below

Read 7 tweets
Abraar Karan Profile picture
26 Dec 20
New #covid19 variant #B117 has led to vastly different responses around the globe.

Japan, for instance, has stopped all foreigners from entering until the end of January— they had detected cases of B117 as of Friday. washingtonpost.com/world/2020/12/…
2/ Canada as of now has restricted all incoming flights from the UK until January 6th #covid19

gov.uk/foreign-travel…
3/ France eased restrictions for certain categories of people as below #covid19

gov.uk/foreign-travel…
Read 12 tweets
Abraar Karan Profile picture
26 Dec 20
Some thoughts on new UK variant #b117 (not a virologist- purely from a public health response view)

1/ Seems this was inevitable & we will see more variants of concern over time. We will constantly have to re-evaluate response measures #covid19
2/
if vaccines turn out to be less effective against new variants (big “if” here), this will be another reminder that fundamentals of public health + multilayered strategy always name of the game— a vaccine is one part of that- not the whole strategy. No short cuts #covid19
3/
Better masks & personal protective equipment for the general public is well overdue; we know masks work; we know aerosols contribute to spread; we know not all masks have effective aerosol protection- better masks are a win-win, & aren’t affected by new variants
#covid19
Read 9 tweets
Abraar Karan Profile picture
24 Dec 20
1/
 Currently reading a book about the history of epidemics and society.

“What made the bubonic plague especially fearful was that it presented communities with the antithesis of the “art of dying”...death from plague was sudden; people died alone.”
2/
Ask any doctor- especially those working ICUs— about the pandemic deaths that separated families from loved ones. Patients died with nurses and doctors by their side; but many without their families.
3/ I remember one especially terrible case I had cared for in an emergency department back in April. The whole family had been infected as they lived in a multigenerational home; a son was sick in the ED; his father died alone in an ICU at the same time.
Read 4 tweets

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