It has been a long tiring and, in many ways, terrifying week in the US. The events in DC have nevertheless obscured the growing public health crisis, which even with vaccines available can be expected to get WORSE over the short term - a thread
Where are we right now? Daily deaths cleared 4000 this week. That will get worse. How do I know? Because the deaths are the results of infections in the past, and infections got worse in the last few weeks. I'm so sorry, but it is coming
The amounts of infection now are so high, and the comparative vaccination rates so low, that we have to be prepared for a coming surge into healthcare across the nation. It is already going to be bad enough. It might well be worse given the threat of more transmissible variants
The variant B.1.1.7 which was first detected in the UK, is certainly IMO more transmissible. That has a bunch of consequences that we should prepare for even if it is not in your town yet and it *is* in the US, in at least some places, if rare for now. But that will change
B.1.1.7 has run rampant through the UK, at a time that country had *relatively* firm restrictions in place. I know the UK’s restrictions have not been all they might be, but that’s for another thread – still they were stronger than those in much of the US.
The higher transmissibility of B.1.1.7 means more people need to be vaccinated to control the disease. Very roughly speaking (and with a lot of assumptions) it takes the critical vaccination threshold to control transmission from ~60% to ~75%.
That’s not nothing especially when you are struggling to vaccinate people At All
B.1.1.7 is now outside the UK. Look at Ireland (HT @VanGennepD ) There are likely multiple introductions, but seriously, look at it. It is reasonable to suggest B.1.1.7 is a major driver in that, given available genomic data (figure from @Worldometers) 
And Israel – a world leader in vaccination, with a history of switching between lockdown/not lockdown. Now closing up again in the face of B.1.1.7 even as population immunity builds to impressive levels nytimes.com/2021/01/07/wor…
We are very very far from out of the woods. We've got more in our corner now in the form of vaccines, but so has the virus. Most places have a year of the experience of underestimating it
When are you gonna change? /end
When are you gonna change? /end
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