Reading this WSJ headline, there is an important clarification:

SARS CoV-2 and its variants are here to stay. But if we vaccinate 80% of the population, which is totally doable, then COVID-19 the disease is NOT here to stay.

1/ wsj.com/articles/as-va…
COVID-19 the disease has brought about utter chaos & turned the world upside down because of its ability to kill 0.5 to 1% of the people it infects, put ~10% of people it infects in the hospital, & leave some with long term consequences.

This won’t happen after vaccination.

2/
A respiratory virus that can easily spread is not enough to cause this kind of life-altering chaos. We already have the flu, the regular corona viruses, the rhino viruses and such.

SARS CoV-2 was new. It was new to the immune system and our bodies were attacked by surprise.

3/
It combined its 𝙣𝙚𝙬𝙣𝙚𝙨𝙨 to the immune system with its 𝙫𝙞𝙧𝙪𝙡𝙚𝙣𝙘𝙚 (the ability to cause severe disease & death) in some, and
𝙩𝙝𝙞𝙚𝙛-𝙡𝙞𝙠𝙚 𝙨𝙩𝙚𝙖𝙡𝙩𝙝 𝙩𝙤 𝙨𝙥𝙧𝙚𝙖𝙙 𝙦𝙪𝙞𝙚𝙩𝙡𝙮 by simultaneously causing asymptomatic illness in others.

4/
These important factors was the deadly combination that other viruses did not have. Flu viruses were not that virulent. The original SARS virus made everyone ill so people knew who was sick and who wasn’t.

5/
If we vaccinate 80% of the population, the ability of SARS-CoV-2 to catch the immune system by surprise is gone.

Yes, there may be mutant variants that circulate. But they won’t be able to totally surprise the immune system & cause what COVID-19 did.

6/
If we vaccinate quickly and globally as many people as possible, the ability of SARS CoV-2 to mutate into variants become less.

7/
My main worry is not mutant variants. Or even that the virus may morph into a new more lethal SARS CoV-3.

It is people continuing to die or get very ill from the original virus that landed on us last year when we have vaccines at hand.

8/
We need to vaccinate 24/7 not just our own countries but the world. And do what it takes to approve, manufacture, and administer the many effective vaccines that have been developed.

9/
From my understanding of immunology & plasma cells I find it inconceivable that we will have an enduring COVID-19 pandemic caused by SARS-CoV-2 or variants if we vaccinate 80%

The vaccines may not be a perfect match for variants but they will educate the immune system enough
10/
Variants may continue to cause problems. But not the pandemic.
Link to my thread on how the immune system operates and why vaccines will take away the ability of SARS CoV-2 to perpetuate the pandemic even if it mutates. 👇

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More from @VincentRK

7 Feb
Mutants or not. This is what is happening in the UK since the start of COVID vaccination. Vaccines work.
So while we sequence and find a particular variant is dominant, the numbers that matter are total cases and deaths. The UK is doing well with vaccination and offers a preview of what is likely to happen in the US in the next month. nytimes.com/2021/02/07/hea…
Read 5 tweets
6 Feb
Our group has posted guidance for myeloma patients on COVID vaccination. I recommend the same for 𝙖𝙡𝙡 𝙘𝙖𝙣𝙘𝙚𝙧 patients. msmart.org @MayoMyeloma @MayoCancerCare
Which vaccine? Whichever approved vaccine you are offered.
Should I worry about which day of chemo or should I hold chemo?

No. These chemo drugs work for a long time and you can never be fully free from their effect. You may lose your spot in line or keep waiting for the “perfect” opportunity. Just get the vaccine when offered.
Read 7 tweets
5 Feb
Even yesterday I heard from a close friend who lost an elderly parent to COVID. They were just hoping to get vaccinated. But it was too late.

Every delay costs lives. There were over 3500 stories like this yesterday across the country.
15,000 across the world.
The new Administration took over only 15 days ago. They have a lot to deal with in terms of decisions that were already made. I have full confidence in their approach. I hope they can turn the vaccine situation around in a month.
But it’s not up to the federal government. It’s everyone from states to local governments to hospitals that have to gear up to 24/7 vaccination. Especially if J & J is approved and we have sufficient doses to dispense. Planning has to start now.
Read 4 tweets
3 Feb
If we focus on getting as many people vaccinated as possible, and continue basic precautions till each country reaches herd immunity, COVID will be history, mutants and all.
COVID minus its ability to make people severely ill or cause deaths is nothing. Vaccines work. And that’s what they will reduce COVID to.
Every month will bring news of a new variant or mutant. But for vaccinated people the chances of getting seriously ill will be very low. Not zero. But very low. In the range of what annual influenza outbreaks are. Time will tell. But I’m optimistic.
Read 4 tweets
3 Feb
I will repeat: Not having Astra Zeneca COVID vaccine approved in the US is a blunder. A huge blunder. bbc.co.uk/news/health-55…
See thread by @DrEricDing on how the Astra Zeneca vaccine can cut transmission. This was totally expected. Basic immunology.
Once we knew results of the RCT that the Astra Zeneca vaccine was safe and at worst was 60% effective we should have moved. We knew quite well that there simple wasn’t enough Pfizer and Moderna vaccine to get the vulnerable vaccinated quickly.
Read 4 tweets
2 Feb
Breaking: Over 50% of Delhi is seropositive for COVID. @ndtv @divyanshu @rishika625 @GargiRawat @nramind @bimalarya

This supports my earlier thread on protection through cross reactive immunity. Otherwise the loss of life would have been 50 times higher. ndtv.com/india-news/cor…
The population of Delhi is 20 million. So far estimated deaths is 10,000. If 10 million have had COVID, we cannot reconcile the two numbers.

What are the factors besides lower age, less obesity, & underreporting that results in so much asymptomatic & mildly symptomatic COVID?
Of these 4 factors, low viral dose is likely not operational in India because of the lack of masking and the impossibility of social distancing.

There is also no special reason why innate immunity will be stronger & no data on unique genetic factors that protect Indian people.
Read 9 tweets

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