There's a persistent myth that pathogens become less deadly over time.
@rkhamsi & @dylanhmorris just reminded me of this since people are apparently acting assured that SARS2 can't become more deadly? Psh.
Short 🧵of history beginning w/hopes of an end to infectious disease
According to Frank Snowden's "Epidemics & Society", 'eradicationists' of the 60s & 70s foretold the end of infectious disease. We had some cures, and they said the bugs become less deadly over time. But like evolutionary psychologists(dis!), they didn't study evolutionary biology
If they had, they'd realize that evolution doesn't have directionality. Anyways, time proved them wrong. eg New strains of dengue evolved, and a second infection with a new strain can be deadly. The HIV epidemic showed that unknown viruses emerge from nature fairly regularly.
The moral of the story is that we need to get serious about surveillance. Everything changes. Evolution happens. SARS2 will evolve. Could become more transmissible, more deadly, resistant to drugs or vaccines.
All we can do is sequence it, track it and curb its spread.
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Azar just released a delusional, alternative history of Covid testing in the US. I’m mad because our testing failures allowed this outbreak to blow-up. We can’t fix our system if we ignore where it is broken. I suspect @PublicHealth agrees.
“It is indisputable that the United States has built the most extensive testing system and strategy of any major country,” says Azar.
False. Several countries have had percent positivity ~1% whereas US has never been below 5% and is >10% today. Refs KCDC & USA @JohnsHopkins
"The federal government got out of the way of test development in safe and sensible ways,” says Azar.
False. In Feb, CDC & FDA blocked labs from testing as the disease spread exponentially. I broke this story👇🏼& wrote more like it as the year wore on. nature.com/articles/d4158…
First 20 min of this delusional evaluation of the Trump Admin's response to Covid is all about blaming China, with some vitriol for WHO. "If a novel virus like this emerged in a Democratic nation, this epidemic would have never happened," says Azar.
As Covid spread in March, Azar says the government acted swiftly to control spread (they definitely did not). He says the key driver of the pandemic -- ready for it -- was thousands of Chinese workers flying to Italy.
Azar says it's a myth to say that if we had a better testing and surveillance system we could have curbed the virus in February.
(Why is this session even called 'lessons learned'?)
In contrast to the US, many low income countries were scaling up tests, building isolation centers, & enforcing quarantines BEFORE THEY EVEN HAD A HANDFUL OF CASES.
They don't have the luxury of relying on hospitals to care for floods of patients. nature.com/articles/d4158…
In 1995, Congolese Ebola discoverer @MTamfum treated Ebola patients with blood from survivors, despite being told not to by the CDC & WHO. 7 of 8 survived. nature.com/articles/d4158…
The NIH failed to replicate his findings in monkeys, but @MTamfum, "Professor Muyembe", didn't give up. “There should be a truth in here,” Muyembe told me.
He hired one of the survivors in his lab & convinced him to fly to the NIH in 2006, along with his sister & a grad student.
At the NIH, the student & other researchers isolated the survivors' antibodies. These antibodies became the basis for an experimental drug, mAB114, that @MTamfum pushed to test in the 2019 outbreak. It was HARD to conduct this trial. nature.com/articles/d4158…
☹️One of the most upsetting CDC reports yet: Wedding leads to 177 Covid cases & 7 deaths among people who weren’t even there.
Aug 7. Wedding w/55 guests in a Maine town with no corona.
A guest goes to a school meeting. Others go to jobs at a nursing home & jail, with symptoms.
Wedding screened for fever but guests don’t wear masks indoors. Wedding hosts don’t give health dept a list of phone # of guests. So contact tracing isn’t fast enough to stop spread.
After 23 days health dept determines that 30 of 55 guests were positive. By then it’s too late.
Because of the wedding:
-120 staff & residents of a care facility & correctional facility were infected & scared & may have long term health issues.
Lesson 1: Epidemics depend on context. “The outbreak of Ebola is a symptom; the root cause is political instability,” said @Tedros.
Many places are unstable. DRC is very. Since 2017, in Kivu provinces alone, 3860 people have been killed & 5274 abducted. kivusecurity.org
Many governments, including DRC, ignore or fuel conflict & poverty in east DRC. When the president barred eastern cities from voting “due to Ebola” the link between politics& the virus hardened. Next came attacks.
Does politicization of a virus in an election yr sound familiar?