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30 Dec 20, 6 tweets, 3 min read
The Phase 3 @moderna_tx #SARSCoV2 vaccine trial is published @NEJM nejm.org/doi/full/10.10…
The historic cumulative event curve
Subgroup analysis, maintenance of efficacy across the board
The corrected link: nejm.org/doi/full/10.10…
The data for protection from severe events
30 placebo
0 vaccine
(that's when you can't do a confidence interval)
The encouraging data for suppressing of transmission after 1st dose by RT-PCR was included in the supplementary material and FDA docs

(slight differences 39 v 15 here; 38 v 14 FDA)

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More from @EricTopol

Eric Topol Profile picture
1 Jan
On our new podcast, we interviewed @angie_rasmussen, one of the leading virologists, who has been a guiding light during the pandemic. Thread here to summarize, transcript and audio medscape.com/viewarticle/94… @cuttingforstone /1
Current status
"We're essentially experiencing the equivalent of a 9/11 every day in terms of number of deaths; our hospital systems are overburdened. ...We're going to be dealing w/ this for some time to come, even after people get the vaccine, certainly #LongCovid is real." /2
On her strong efforts for dispelling misinformation
"My philosophy about public health is that you can't have it without the engagement of the public. And my philosophy about communication is that information empowers people to decide for themselves" /3
Read 12 tweets
Eric Topol Profile picture
28 Dec 20
We interviewed @SteveFDA and Peter Marks @US_FDA about the new vaccines
webmd.com/coronavirus-in… w/ @drjohnwhyte @WebMD @Medscape
Key points that we covered:
1. The EUA tightening that got the trials to full efficacy completion and better read on safety
2. Operation/Project Warp Speed was invented by Peter Marks (a star trekkie) to streamline and accelerate the path to a successful vaccine
More on that here washingtonpost.com/health/coronav… by @lauriemcginley2
3. Why didn't the vaccine trials study transmission (mucosal impact/ sterilization immunity)?
The requirement of the participants for daily nasopharyngeal swabs would have been cumbersome and slowed down the trial's critical question of preventing illness
Read 9 tweets
Eric Topol Profile picture
26 Dec 20
Countries the B.1.1.7 variant has been found in:
UK, Denmark, Singapore, Australia, Netherlands, Sweden, Spain, Switzerland, Lebanon, France, Israel, Italy.
Hard to imagine it has not reached US by this time
Add: Japan, Iceland, Belgium, Germany
Now add Ontario, Canada in a couple with no history of travel
Read 4 tweets
Eric Topol Profile picture
24 Dec 20
We've now doubled the peak hospitalizations from the previous 2 US case surges.
And it's no wonder the death toll again today is nearly 3,500.
@COVID19Tracking
Sure the virus is hard to contain, but that's especially the case when so little is being done
The @HHSgov declared covid as a public health emergency on Jan 31st
And @WhiteHouse a national emergency March 13th whitehouse.gov/presidential-a…
If that was emergency, then what is this?
The actions we could take beyond financial support that still has not been approved......
1. Distribute high quality (surgical or K/N95) masks to all households [@USPS planned 650 million distribution in April, blocked by @WhiteHouse]
2. Make mask mandates a national policy with enforcement
3. Provide free rapid home covid tests to all households for daily use
Read 5 tweets
Eric Topol Profile picture
23 Dec 20
1. Structural biology has been a standout in the pandemic, mapping the virus, antibodies and vaccines atom by atom. So I had a conversation with one of its leaders, Andrew Ward @WardLab1, my @scrippsresearch colleague soundcloud.com/prescrippsions…
2. Back in 2016, Andrew and his colleagues were the first to see and publish the coronavirus spike protein, via cryo-electron microscopy (a common cold virus, HKU1) nature.com/articles/natur… @nature
Note the team, which proved to be formidable
@McLellan_Lab @KizzyPhD Barney Graham
3. In the podcast, Andrew reviews how they came together. A next act was the famous 2P (2 proline substitutions) paper that was rejected 5 times before being published @PNASNews
Subthread about that here:
Read 14 tweets
Eric Topol Profile picture
21 Dec 20
The B.1.1.7 variant has 23 mutations
I spoke to Andrew Ward (@WardLab1) @ScrippsResearch today (podcast coming) about its structural biology. He thinks the N501Y (in common w/ South Africa variant) is the driver for increased transmission; he's not concerned re: vaccine efficacy
On @CNN @wolfblitzer, @NYGovCuomo just said the new variant transmits 70-fold the D614G and that it accounted for Europe’s 2nd wave. Both are wrong!
While the B.1.1.7 variant is thought to have been derived from accelerated evolution in an immunocompromised patient with covid (see examples in these 2 @NEJM reports), if the functional culprit is indeed N501Y, that might turn out to be a red herring
Read 4 tweets

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