#COVID19 #CoronavirusStrain Getting lots of questions about whether this “new” strain(s) or the “UK” variant is resistant to Abs or whether people who have recovered are susceptible, etc. Related but distinct questions, which I will try and break down 1/
#Coronavirus First, regardless of whether you have immunity via past COVID infectx or thru vaccinx, now is NOT the time to let up on😷, social distancing & hand hygiene. Now is the time to STEP UP these #PubHealth measures, which will mitigate whatever the virus throws at us 2/
#coronavirus Secondly, there is no ONE “new” strain. The “UK” variant differs from the WA1 (614G) ref strain in at least 8 places on the Spike protein - the major target of our neut antibodies. The S. African & Japanese (via Brazil) variants have at least 7 & 11 differences, 2/
#CoronavirusStrain | in their spike proteins. These strains independently acquired their mutations, some of these, common to >= 2 strains (at positions 501, 484, 417, del in S1 NTD) are concerning from multiple strands of circumstantial and indirect data. 3/
#CoronavirusStrain | Science, in this case, can work like a Grand Jury. We gather evidence, perhaps enough to indict but not enough yet to convict. In civil cases, the standard is preponderance of evidence (as opposed to beyond reasonable doubt for criminal cases). . . 4/
#CoronavirusStrain | I say we are pretty close to indictment. Some of these mutations are MORE likely than not to play a role in increased transmissibility & replication kinetics. NONE of these mutations will render current vaccines ineffective. This is a False Dichotomy. 5/
#CoronavirusStrain | Vaccines work! All the more reason to get vaccinated FULLY ASAP. I’m calling it & saying there is something we don’t quite understand yet. It worries me that some of these mutations can independently arise in animals, humans, and lab experiments. 6/
#CoronavirusStrain | In summary, let’s not wait to convict before taking precautions, let’s indict and proceed with caution. What precautions? That’s a while other thread. #BeSafe #WearAMask

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More from @VirusWhisperer

24 Aug 20
My apologies. Let’s try one better for the general public.
#AAT Explainer. Many people get infected with #SARSCoV2, the virus that causes #COVID19. Of the ~20% that are symptomatic, some get very sick, some die. Who gets really sick and dies is hard to predict. (1/n)
Yes, we know that some risk factors such as Age, Chronic Lung Disease, Obesity, Smoking, etc. are associated with severe COVID-19 disease. But for a given individual, it is hard to predict. Some apparently healthy 40 yo can die & >80% of 80 yo who get infected can survive. (2/n)
Thus disease severity can differ widely in #COVID19 patients, even amongst those we deem to be at high risk. This is the conundrum. In addition to the risk factors already identified, can we find a better way to predict & treat those who will get more severe disease? (3/n)
Read 8 tweets
24 Aug 20
#SARSCoV2 re-infection can happen. "Hong Kong researchers sequenced the virus from both rounds of infection & found significant differences in the two sets of virus, suggesting that the patient was infected a 2nd time.” HK patient got re-infected by 🇪🇸 clade after vacation there.
Should we be REALLY that surprised though? 5-15% of #COVID19 recovered patients make little to no detectable Nabs. Re-infection induces Ab response, patient remained asymptomatic (all good news) but high virus shedding (Ct~ 26) more concerning. Was the patient infectious? 🤷🏻‍♂️(1/3)
That people can get reinfected with #SARSCoV2 & that reinfection would result in mild/asymptomatic #COVID19 cases is not surprising despite the many limpid explications regarding naturally declining Ab titers. The❓is whether asymptomatic reinfected persons are infectious. (2/3)
Read 4 tweets
17 Aug 20
To compare the neutralization potency of #COVID19vaccine sera or convalescent plasma , we need standardized reporting metrics and assays, so meaningful cross-cohort comparisons can be made. Our preprint
medrxiv.org/content/10.110… reinforces this need (1/n)
#SARSCoV2 entry is complex as shown below. In addition to the ACE2 receptor, various endosomal, cell surface, and exogenous proteases can facilitate productive viral entry. These pathways are not mutually exclusive and are dependent on cell-type and tissue milieu. (2/n)
Standardizing virus neutralization assays (VNAs) requires taking these proteolytic activation pathways into account. The optimization that allows for "out-of-the-box" use is shown in Fig 2D (below). We have sent out >25K of these std VNA to labs across the globe. (3/n)
Read 10 tweets
16 Apr 20
Let’s out the original name behind this “promising oral #COVID19 Tx” Richard Plemper @GSUIBMS @GeorgiaStateU discovered & characterized #EIDD-1931 as a broad-spectrum orally efficacious drug against flu & RSV in 2018! See bit.ly/3aeH2OI. In 2019, ... 1/n
#COVID19 #Treatment 2/n: In 2019, he led the group that made an even better version, #EIDD2801, that showed all the good properties you want in a drug for clinical development (Sci Trans Med Oct 2019 bit.ly/2RJeBBH. 👇...
3/n: This #EIDD2801 is the same drug that shows promising efficacy against the #COVID19 virus (#SARSCoV2) in bit.ly/3cqhLSN. Great job @timothysheahan @Baric_Lab 👍 #ittakesavillage Richard Plemper laid the groundwork so #EIDD2801 can now be in clinical trials!
Read 5 tweets
4 Apr 20
#COVID19Pandemic 1/n: Email from 王陸海|WANG Lu-hai, Professor at China Medical Univ in Taiwan, & alumnus of Micro Dept @IcahnMountSinai, sent to our Chair Dr. Peter Palese. I got permission to tweet the relevant part, showing Taiwan's role in this pandemic's response: see thread
#COVID19Pandemic 2/n: "Taiwan is doing well in this pandemic for three main reasons, one, detected the early sign and did not believe in Chna's report and number, two, did not follow WHO's advice early on and three, has had SARS experience 17 years ago, . . .
#COVID19Pandemic 3/n: so has been prepared medically. Taiwan sent a message to China WHO and US in early January warning the virus could spread from person to person, got a response from WHO: "recived". Meanwhile WHO still told the world the pneumonia could be contained . . .
Read 6 tweets
15 Mar 20
#COVID19 Rx & Prophylaxis (1/n): Physiologically-based pharmacokinetic (PBPK)—in English: No BS, Science&Math based—models from in vitro and animal data suggest that Hydroxychloroquine at proper dosage is effective against #SARSCoV2. academic.oup.com/cid/advance-ar…
#COVID19 Rx & Prophylaxis (2/n): in antiviral therapy, it’s almost universally true that whwm treatment is initiated earlier, the better the outcome. The most dramatic example being “PREP” for HIV. If drug is already in your system, at the proper level, BEFORE virus exposure,
#COVID19 Rx & Prophylaxis (3/n): prevention of HIV infection is almost 100%. So, enough dithering with defensive medicine and worrying about indemnity. Treat early if possible, consider prophylaxis for highest-risk front-line responders. We need ID,ER, ICU docs&nurses.
Read 5 tweets

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