Thread by @EricTopol

Why it is time (never too late) to get super-serious
1. Holiday surge after holiday surge is small potatoes compared with a superspreader strain.
B.1.1.7 is here, <1%, but will be dominant in the weeks ahead
It is a strain, by definition:
jamanetwork.com/journals/jama/…

2. The "superspreader" strains B.1.1.7 and 501Y.V2
Because they are more infectious (X%, but much more than D614G ,which had only a modest transmission ⬆️)
More people will get sick
More people will get hospitalized
More people will get #LongCovid
More people will die

3. Over the next several weeks, these new strains will become the dominant ones in the United States, just as they have in the UK and other countries. Exponential spread. Why we need to contain the virus and vaccinate 24/7 like there's no tomorrow.

4. The issue of vaccine resistance is not binary. It is unlikely that the new strains will prove to have any vaccine sig "resistance." Even if 501Y.V2 (E484K is 1° concern) has any, it is likely to be small. With vaccines we make lots of clones of antibodies to the spike protein.

5. We need to fully determine the response of these new strains to neutralizing antibodies, and not just by a point mutation (e.g. N501Y) but all the mutations and their interactions. That also becomes important for better vaccine designs in the many months (?years) ahead.

6/f. We desperately need more genomic surveillance. We only picked up these new strains well after other countries did with "UK variant" and "South Africa variant." What about a "US variant"? We need to stay ahead of the virus.