College reopenings and #COVID19 risk—for those who say opening in person schools are safe—new CDC study:

US counties with university in-person instruction had a 56% ⬆️ in incidence, comparing the 21-day periods before and after classes started. 🧵
cdc.gov/mmwr/volumes/7…
2) U.S. counties with large colleges or universities with remote instruction experienced a 17.9% decrease in incidence of #COVID19
3) Counties without large colleges or universities (n = 3,009) experienced a 6% decrease in incidence in #COVID19 during similar time frames.
4) NET DIFFERENCE between in-person instruction countries versus non-university counties with in-person instruction:

📌were associated with an increase of 14.4 cases per 100,000 (p<0.05)

📌an increase of 2.4 percent test positivity (p<0.05) .
5) even adjusting incidence for the influx of full-time students (larger county population when students in town), in-person instruction university counties were associated with an excess of 10.6 cases per 100,000 people. #COVID19
6) We’ve know schools and university closings reduce transmission and R value by 38%. It is well established in a large SCIENCE journal paper.

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More from @DrEricDing

25 Jan
BREAKING—First U.S. case of highly transmissible Brazil 🇧🇷 coronavirus variant identified of the so-called #P1 variant—involves “a Minnesota resident with recent travel to Brazil”. It was detected through random surveillance of blood samples. #covid19 washingtonpost.com/health/brazil-…
2) P1 is very similar to the South African #B1351 variant — both have the E484K mutation. For the 🇿🇦 variant, Moderna found 6 folder lower antibody neutralization for people vaccinated than compared to normal #SARSCoV2.

E484K mutation shown to have high immune escape. See 🧵
3) worrisome was blood from 48% of people previously recovered from #COVID19 in the 1st 2020 wave in South Africa did not recognize new #B1351 🇿🇦 variant — “complete immune escape”.

Worry is the E484K mutation both 🇿🇦 & 🇧🇷 variants share. ?
Read 5 tweets
25 Jan
BREAKING—US has added South Africa 🇿🇦 to list of restricted travel countries because of the new #B1351 variant. Also, all “international travelers to US must provide proof of a negative test within 3 days of travel to airlines prior to departure." #COVID19
2) IMHO as an epidemiologist, a test 3 days prior to travel (plus 8-16 hours of international travel time itself) alone is not in any way fool proof. We know one can test negative for 4-6 days after exposure before either symptoms or positive test. Many Trump WH staffers did so.
3) We also need rapid testing upon boarding and testing upon arrival. While not foolproof either, it adds another layer to Swiss Cheese model.

➡️I previously called this my multilevel castle defense strategy of not just relying on outer wall but also most, inner keep, etc. Image
Read 4 tweets
25 Jan
⚠️CONCERNING—Millions of doses of #COVID19 vaccine shipped by Trump WH/HHS are missing. Nobody knows why yet. Biden coronavirus task force have spent first days in office working overtime to solve puzzle. So far, one hasn’t emerged. (by @ErinBanco) 🧵
thedailybeast.com/millions-of-co… Image
2) “According to data from CDC, 41.4 million doses have been handed out to the states. Only 21.8 mil have been administered. Bottom line: Doses should be flowing, they said But instead, states are complaining of vaccine shortages.”
3) COVID ACT NOW has just added a state by state vaccine tracker with shots delivered. Nobody sure why the big discrepancy in shipments vs shots administered. covidactnow.org/?s=1550490
Read 11 tweets
25 Jan
BREAKING—Good & bad news—The Moderna #COVID19 vaccine fully protected against the UK 🇬🇧 #B117 variant... but was 6x less efficient at neutralizing the South African #B1351 variant in lab test. Moderna is testing a newly synthesized booster for it—3rd shot. washingtonpost.com/health/2021/01… Image
2) To be clear—6x less efficient doesn’t mean no protection against #B11351, it’s still good but not as good as before. As a precaution, Moderna announced it will launch two new studies—including adding a third shot of its current vaccine to boost its two-dose regimen.
3) press release is very cautiously worded—“6-fold reduction in neutralizing titers was observed with B.1.351 variant relative to prior variants. Despite this reduction, neutralizing titer levels w/ B.1.351 remain above levels expected to be protective.”
investors.modernatx.com/news-releases/…
Read 22 tweets
25 Jan
BREAKING—Mexico 🇲🇽 President Andrés Manuel López Obrador (AMLO) has contracted #COVID19. He says he has mild symptoms thus far.

I’ve been warning for months Mexico has a serious uncontrolled epidemic. @HLGatell dismissed and says it was fine cuz hospitals weren’t full. Image
2) Rewind to June 21 2020, I was very worried and warning about Mexico’s 50% positivity that matched the high numbers of NY (state) & average 7 day positivity of Spain and Italy. Positivity reflects both limited testing and/or caseload—both worrisome. @MaxCRoser super worried too
3) Here is a good review of what happened after.
Read 9 tweets
24 Jan
Mulling 🇬🇧 disclosure that new #B117 variant could increase #COVID19 deaths ~30%. 🇬🇧 is expected to prolong & tighten lockdown—Schools may close until Easter, overseas travelers maybe quarantined in hotels for 10 days. I’ve looked at data—it’s worrying. 🧵
nytimes.com/2021/01/24/wor… Image
2) Notably, 6 out of 10 studies conducted on the mortality risk show significantly increased risk of #COVID19 death, ranging from 28% to 91% higher relative risk. They are circled in red below. A 7th (purple) study also shows a 30% increase, albeit not quite sig, but compatible. Image
3) Notably, I want people to focus on the two studies from @LSHTM - circled in green. These were prospective cohorts that used full Cox models that detailed followed individual person-time from beginning to end—much better than others. These 2 show 28-35% #COVID19 death increase. Image
Read 13 tweets

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