With is manuscript from ⁦@PaulBieniasz⁩ and co, that from ⁦@RealMcCoyLab this AM⁩, data from ⁦@10queues⁩ yesterday and the prelim data from South Africa,

The variants we are seeinv have evolved to escape antibody.
biorxiv.org/content/10.110…
How and where to be determined.

Thus far it’s a mixed bag about how much they are resistant to serum from wave 1, and vaccinee serum while slightly reduced in potency, still works. (Good news!)
But these mutations, partic 501Y (Uk, Sa and Brazil) and 484K (SA and Brazil) do completely abolish the activity of some specific individual RBD antibodies.

More alarmingly the SA variant is insensitive to about half of wave 1 sera tested.
The changes also have resulted in higher affinity for ACE2. This could be a secondary effect or part of the mechanism of escape. And may well underlie any increased transmisson.
Escape/resistance mutations are selected when a microbe replicates in the presence antibodies or drugs at concentrations that only offer partial activity.
This is why most virologists I know are worried about changes to the vaccine regimens in the UK.

And it is why we need to slam down transmission while we are vaccinating.

If we don’t get a handle on this now, this WILL keep happening and the vaccine efficacy will be reduced
Also, at the risk of sounding like a very broken record, this is PRECISELY why short term control of the pandemic by naturally acquired herd immunity as advocated by the #GBD is such scientifically illiterate nonsense.
The UK variant may well be the least resistant of the variants at moment, but it spreads fast.

Even if we stop new variants coming into the country, I would be unsurprised if E448K appears here too.

biorxiv.org/content/10.110…

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More from @stuartjdneil

1 Jan
I am becoming deeply troubled over the cavalier way the UK vaccine roll out is being changed on the hoof.

We have 2 approved vaccines that work to induce protective immunity.

They are both safe

I understand the haste to get them into as many people as possible.
But the phase iii data doesn’t exist to support their use in combination.

They are not quite the same immunogen. So homologous and heterologous boosting may accentuate different responses. And it might matter which order.

We do not know anything about this.
Next the timing

AZ boosting at 3 months turns out to boost higher Ab levels - another ‘serendipitous’ thing to fall out of the trial. Fine. But how protective is one shot?

And changing the Pfizer regimen, based reanalyzing the data to look for an answer they want. Probably true
Read 5 tweets
23 Nov 20
We need a good hard look at the numbers and the longevity before we conclude that this is less effective than the mRNA based ones. bbc.co.uk/news/health-55…
Firstly it seems to rise to 90% when the first priming dose is lower. This might mean that less is more, and potentially anti-adeno responses might limit the boost. If so this is serendipitous as it will halve the cost of production of round 1
Secondly, in this trial they have evidence of reduced assymptomatic infection in vaccinees, suggestive of less transmission. This is something that we don’t know for the other vaccines thus far.
Read 7 tweets
19 Sep 20
There a lot of scientists in reflective mood as we face up the prospect of an autumn second wave of SARS CoV2 and what it may or may not mean, and in particular whether we can or even should contemplate further lockdowns. So I’ll add my twopenneth’ 1/n
At the beginning we didn’t heed the warnings from China and Italy until it was too late and we ended up playing catch up with a rapidly spreading virus that we didn’t understand. 2/n
The ability to test samples and act on that knowledge was rapidly outstripped by resources and the govt were woefully slow to alleviate bottlenecks in testing, diagnostics and PPE, all of which had been highlighted when wargaming a pandemic 2 years earlier. 3/n
Read 27 tweets
11 Mar 20
So hysteria helps noone. The point of flattening the curve is you mitigate the impact of SARS-CoV2 but minimize the the long term damage to the country. The way we get on top of this is by aggressive community testing and isolating infected people. 1/n
@PHE_uk job will made much easier if everyone follows the instructions: wash your hands, stay home and avoid visiting vulnerable people if you’re feeling ill. 2/n
More specific measures (eg sportscevents gatherings etc) should be brought in, but a Chinese style lockdown is not possible in a Western democracy. And ask yourself - what did Italy’s implementation of local lockdowns achieve? Very little it seems. 3/n
Read 5 tweets

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