BREAKING—A new #SARSCoV2 variant (aka B.1.1.248) identified by Japan 🇯🇵 in ✈️pax from Brazil 🇧🇷. This new one has both the more infectious N501Y mutation (not affect vaccine), as well as the disruptive E484K mutation that escapes neutralizing antibodies.🧵…
2) Why are we so worried about this one? Because like the SA B1351 variant, this new one also has the E484K mutation. In a recent study by @jbloom_lab, E484 mutation (inside the #SARSCoV2’s spike’s critical receptor binding domain) seemed to escape neutralizing antibodies—bad.
3) More on the E484K mutation. Escaping neutralizing antibodies could mean some convalescent plasma, some antibody drugs, and maybe even vaccines could be disrupted a little. But need more studies to prove it
4) To be clear, B11248 (Brazil origin) and B1351 (SA origin) are not the same as the infamous B117 infectious variant from 🇬🇧. The B117 does *not* have the E484K (see top post’s figure that doesn’t show it in B117’s row). But the B117 is the one worrying Denmark 🇩🇰 CDC right now.
5) again, the N501Y mutation (shared by all three) seems to bind the human ACE2 receptor more strongly, and more infectious, but doesn’t seem to affect the vaccine says new study. But beware many headlines don’t make it clear it’s only this mutation that doesn’t vaccine affect.
6) that said, within the same person, this fraction that escape antibodies also changes over time. On day 18, there was a lot of escape w/ E484, but on day 94, much less. Hence lots of uncertainty about vaccine or MAB drugs long term.
7) That said, BioNTech founder says it only takes them 6 weeks to synthesize a new mRNA vaccine for any new variant. Tricky question is how much clinical testing needs repeated / how long before it can be deployed: 10 mo w/ Phase 3 again? Or shorter P1&2?…
8) How much affect? the E484K shows a 10x reduction of neutralization (“neutralization” = stopping the virus)
by various antibodies compared to wildtype (common #SARSCoV2) in some patients —a rather bad thing. It means the virus with E484K is worrying for “immune escape”.
9) Is it common in Brazil 🇧🇷 yet? We have no idea because Brazil doesn’t really sequence. We only know of the new #B11248 strain because Japan sequenced it, upon request for help by Brazil from Japan.
10) That said, some rare people are not affected by E484K mutation as much (instead by G446V, which thankfully not in the 3 above variants). But this person was only 1 out of many—most people did experience a degree of escape from neutralizing antibodies.
11) E484K is not just a 1 time fluke. Italian virologists decided to see what mutations can help the virus escape from patients w/ convalescent plasma immunity. So they soaked the virus w/ CP over 12x times to force evolution—80 days later what appeared? ➡️Mutation *E484K arose*!
12) Side note—Air travel ✈️ is a great modern thing, but they also helps bridge continents for viruses during a pandemic. We know US’s NYC spring 2020 record outbreak was due to virus coming from Italy and Spain (not China). I worry now about these new worrisome variants.
13) Many experts think maybe it’s the use of synthetic monoclonal antibody drugs and maybe CP in a few chronically sick immunocompromised person long term that drove the evolution of the virus in such ways to adapt. This is why we must end the pandemic w/ #ZeroCovid to win this.
14) Dr Tedros is now warning about the new variants. This is unusually large move.

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More from @DrEricDing

13 Jan
JUST IN — "Camp Auschwitz" insurrectionist of the Capitol siege was just arrested this morning in Newport News, VIrginia.
2) this guy was just arrested. Image
3) We cannot have a repeat of the fascism from WW2. This is @Schwarzenegger’s speech was so powerful.
Read 11 tweets
13 Jan
📍On Feb 14 2020 on CNN interview in Lafayette Park— I said US cases 10x higher.

➡️I got hate messages for being a “fear monger” alarmist. Some even spread misinfo I wasn’t an epidemiologist (Harvard, Dept of Epidemiology, Doctor of Science 2007, 🤷🏻‍♂️)

...What a crazy sad year 😢
2) Lots of hate last Jan 2020... so much denialism...…
3) Another perspective in Salon.…
Read 5 tweets
13 Jan
We broke 4000 deaths again today. 2nd time ever. We are headed to 5000 deaths/day before end of Feb.

➡️We need to vaccinate at **least 1 mil/day**. But if the B117 variant takes hold & becomes dominant in US, we will need to have *2 mil/day vaccinated*. Honest reality. #COVID19 Image
2) This is why I’m so worried. The B117 went from 9% to now 45% of sequenced #SARSCoV2 in Ireland 🇮🇪 within 3 weeks. England 🏴󠁧󠁢󠁥󠁮󠁧󠁿 is also completely overwhelmed. We know it is here in US and spreading.
3) the more infectious B117 variant will literally take over if given the chance. Denmark 🇩🇰 CDC is extremely pessimistic that they tested 11k samples in just 1 month for B117, and now think it’s takeover be unstoppable by Feb/March.

Ps. USA has sequenced just ~750 in 1 month.
Read 8 tweets
12 Jan
WORRISOME... this is not a good #COVID19 signal in Boston area wastewater.

This is also much much worse than spring 2020 surge.

(HT to @BiobotAnalytics and its immigrant founder @NewshaGhaeli) Image
2) Wastewater is very predictive. It was also used to identify the #SARSCoV2 was in Italy by December 2019. People didn’t know if true but later proven true by November case of COVID.
3) Indeed, the Italy wastewater signals for #COVID19 were proven true.
Read 5 tweets
12 Jan
Sobering—CNN reporter @sarasidnerCNN crying on air after seeing devastation at California 10 hospitals full of #COVID19 patients and witnessing countless parking lot funerals. This reporter has been to war zones & covered bombings. But COVID is next level.
2) “we are literally killing each other”.…
3) LA situation is so dire, healthcare emergency rationing and care prioritization has been instituted for ambulance 🚑 service.
Read 6 tweets
12 Jan
BREAKING—AP is reporting that former Michigan Gov. Rick Snyder @onetoughnerd and others have been told they’re being charged in in the Flint water lead poisoning scandal.

Wow. About time for accountability.
2) Many years ago I fought against lead poisoning around the time of Flint water crisis.… Image
3) Some said it was it was impossible to prevent Flint. We know the Michigan govt and fed govt had the data. It just wasn’t getting out.… ImageImage
Read 7 tweets

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