I am going to make time later today to please write out the history of measles to this group as I think it will be illustrative. We do not test for "asymptomatic infection" in ID for other viruses because they generally spread from person-to-person when they are symptomatic
(e.g. influenza which you know well; SARS, MERS - the 2 earlier coronaviruses that caused severe disease in humans in 2002-3, 2012 but went away from syndromic surveillance). Once there is a herd immunity reached from COVID-19 from widespread vaccination (& natural infection)
there would be no reason to test asymptomatic individuals anymore to see if they have SARS-CoV-2 in their nose and should isolate from others because vaccination prevents 95% (95%!) of symptomatic COVID-19 and nearly 100% of severe illness. Mass testing will cease after mass vax
I am very afraid this question seems to be becoming a political one for no reason (like immunity after a viral infection was a political debate early on for no reason). It is possible that some people like to be on TV & the addictive nature of doom is pushing them out on TV.
There is no reason to politicize this. Medicine/ID would not have 1) immediately worked on vaccines if this was not the way to get back to normal; 2) jumped up and down with joy when such effective vaccine data was released; 3) be pushing for mass vaccination so hard to get life
back to normal (normal means- eventually- no mask, distancing). So not sure if it is worth having this debate if it is a semantic one and trying to get people's minds into a groove of addictive fear. The results will prove themselves as in Israel with mass vaccination
Spending precious public health dollars on testing will no longer be indicated after mass vaccination achieved and the debate will go away on its own. Please try not to worry and look ahead with absolute certainty of being able to be close with loved ones, neighbors, friends.
But to be perfectly clear, we mass tested for SARS-CoV-2 because it can spread from person-to-person even when someone is asymptomatic so that was the REASON for mass testing now. But there won't be reason after virus is defanged with mass vaccination.
Asymptomatic spread is actually the Achilles heel of COVID-19 prevention which is why masks are recommended. But that is because people were not immune as they will be after vaccine; immunity takes this from bad virus to nothing virus (95% efficacy)
nejm.org/doi/full/10.10…

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More from @MonicaGandhi9

17 Jan
Oh dear. I didn't read the post that had incited such confusion on here from a fellow scientist because I think polemics against fellow scientists is unmerited but I am beginning to get a hint that she slandered me (which happened before on a hypothesis our group had that reduced
viral #inoculum reduces severity of disease). I will take a small break from Twitter now as I have so much work. But please remember this. Scientists usually write academically and their "fame" is very circumscribed within academic circles & they usually don't get listened to
by anyone else! So, it is tempting and exciting to become "famous" in a pandemic and be listened to by so many. And any scientist right now is as lonely and miserable as anyone else during COVID-19 because we are all human and connection is a part of human existence. So, that
Read 6 tweets
17 Jan
I am confused by twitter flurry. Let me message very clearly. Only healthcare workers and residents of long-term care facilities (and not all) will be mass vaccinated soon. After vaccination (3-4 weeks after 2nd dose), what two vaccinated people do around each other
is unlikely to be dictated by public health (safe). The vaccinated person (e.g. a health care worker) should mask/distance from their unvaccinated patients and out in public until mass vaccination is achieved for those unvaccinated. This is why getting more and more vaccinated
is the more important thing we can do right now. Nothing else is this important. Yes, the Moderna phase 3 trial data (Table S18, NEJM paper) and the Aztrazeneca/U of Oxford data (LD/SD group, Lancet paper) shows decrease in asymptomatic transmission, as does Israel real-world
Read 5 tweets
15 Jan
Wanted to summarize my favorite article which gives us data on how long immunity to natural infection or vaccination is expected to last (hint: years). Had chance to look at closely (sorry picture shows sperm, that is not related!). Dan J. Science. science.sciencemag.org/content/early/…
okay, so to remind us, there is innate immunity (non-specific immune response to infection that can actually get us in trouble with COVID-19 if too much) and adaptive immunity (humoral means antibodies; long-lived memory cells are B cells and T cells (CD4+ and CD8+) that will
protect us if we see the infection again. This study looked at 188 (80 male; 108 female) patients recovered from COVID-19 (93% mild; 7% hospitalized) over 8 months. Longitudinal samples assessed circulating antibodies, memory B cells, CD8+ T cells, and CD4+ T cells
Read 6 tweets
14 Jan
Johnson&Johnson published results of phase I/II study of vaccine today. This trial not designed to look at vaccine efficacy yet (not high enough #'s enrolled) - just safety & "immunogenicity" (defined by antibodies but we know memory T/B cells last long)
nejm.org/doi/full/10.10…
J&J product also an adenovirus vector (replication-incompetent so won't give you cold!) encoding FULL-LENGTH spike protein of #SARS-CoV-2. Like the full length so that pesky mutations shouldn't get in way. Enrolled in Belgium/U.S. and cohorts given either low dose or high-dose
vaccine, either 1 or 2 doses given 56 days apart. 805 people evaluated. Bottom line? Safe with 40% injection site reactions; very mild other reactions. Neutralizing-antibody titers in 90% on day 29 after the first dose, 100% by day 57 (2nd dose increased titer). Also measured
Read 5 tweets
13 Jan
Ok, let's do thought experiment. Why is #COVID-19 terrible and wreaked havoc? Because it can cause severe disease in some (vulnerable) unlike its cousins- the coronaviruses that cause colds. Say you don't believe the suggestive AztraZeneca nor Moderna data that shows asymptomatic
infection reduced. Say you don't think there is biological plausibility that a robust immune response blocks nasal infection. However, with vaccine >95% of population did not even get symptoms from COVID and nearly 100% did not get severe disease.
You have just turned this new virus into even less than a cold. How can we not be messaging hope and optimism after mass vaccination and pushing as hard as we can go get there? How can we not be messaging close contact after mass vaccination, crowds, in-person, etc.?
Read 4 tweets
9 Jan
Please allow me to go back to this question of "do vaccines prevent transmission?". What do vaccines do? Stimulate antibody (from B cells) and T cell responses (not often measured) and then a "boost" of 2nd dose helps stronger memory B/T cell to form.
Once you get vaccinated, should be able to block both the entry of the virus into your body & we certainly know symptomatic disease blocked by 95% (Moderna/Pfizer). However, latter trials just didn't look at asymptomatic infection & didn't swab every week because time of essence
But Oxford/AztraZeneca trial did swab every week & asymptomatic infection reduced substantially so we can say with relative confidence now that what is EXPECTED to happen will happen- the person who got the vaccine is safe from disease (what really matters) & spreading to others
Read 5 tweets

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