JUST ONE PERSON—UK 🇬🇧 scientists think one immunocompromised person who cleared virus slowly & only partially wiped out an infection, leaving behind genetically-hardier viruses that rebound & learn how to survive better. That’s likely how #B117 started. 🧵 wired.co.uk/article/chroni…
2) The leading hypothesis is that the new variant evolved within just one person, chronically infected with the virus for so long it was able to evolve into a new, more infectious form.

same thing happened in Boston in another immunocompromised person that was sick for 155 days.
3) What happened in Boston with one 45 year old man who was highly infectious for 155 days straight before he died... is exactly what scientists think happened in Kent, England that gave rise to #B117.
4) Doctors were shocked to find virus has evolved many different forms inside of this one immunocompromised man. 20 new mutations in one virus, akin to the #B117. This is possibly how #B1351 in South Africa 🇿🇦 and #P1 in Brazil 🇧🇷 also evolved.
5) “On its own, the appearance of a new variant in genomic databases doesn’t tell us much. “That’s just one genome amongst thousands every week. It wouldn’t necessarily stick out,” says Oliver Pybus, a professor of evolution and infectious disease at Oxford.
6) “New variants of Sars-CoV-2 are being created all the time but the vast majority of them go absolutely nowhere.
It was only when it became obvious that measures in Kent were failing that Public Health England realised the outbreak was being driven by a new variant.”
7) #SARSCoV2 isn’t the only virus that can linger for an unusually long time within the human body. Ebola virus RNA has been detected in the semen of men a year after recovery. Some people stay infected with norovirus – a common stomach bug – for more than six months.
8) “One man in the UK has excreted infectious poliovirus for at least 28 years. The man had been shedding mutated virus for so long that researchers writing about his infection said that he, and other chronic excretors, pose an “obvious risk to the [polio] eradication programme”!
9) “But the real problem isn’t chronic infection – it’s a situation where pandemic is so out of control that the virus has endless opportunities to mutate into new variants. That situation is a reality in the UK and in dozens of other countries with dangerously high case rates.
10) ““These are all edge cases, but if you have enough people infected over a long time, you run the risk of hitting those edge cases,” says Hodcroft. It is not surprising that some of the most worrying new variants – from Brazil, South Africa and the UK –
11) ...”emerged from parts of the world with relatively high levels of transmission. “When you have millions of people infected, with millions of viruses replicating in each one, there are lots of chances for the virus to explore new mutations and combinations,” says Lauring.
12) ““If we had control of the virus, we wouldn’t be seeing as many variants pop up, because there wouldn't be as many opportunities for evolution to happen.”
13) Since Sars-CoV-2 infects cells relatively quickly, in most cases it enters a host, replicates and then swiftly infects someone else, leaving little time for the virus to acquire many genetic changes.
14) When the virus enters the body of someone who is already immunocompromised, their body is constantly applying evolutionary pressure on the virus – pushing it to evolve into new and, in some cases, more infectious forms.
15) My take: the moral lesson is that, when given time and opportunity, the virus finds a way. The virus is a cunning mutating beast that will try every way to defeat us if we let it keep proliferating. We must stop it FAST, or else it will evade:
16) And the virus will even evade people who has had prior immunity and prior antibodies to the older common #SARSCoV2. Such as this example — here not even people were protected from severe disease even if with prior immunity. ?
17) Now just look where we are... #B117 is threatening to dominate the US soon next month as well. Florida especially.
18) It’s now growing so fast in Florida, #B117 is already at 10% of all cases. And doubling time in 9 days or maybe even less.
19) If we go for full suppression, then we can have this too

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More from @DrEricDing

13 Feb
We need to call Moderna vaccine by the true proper name of “NIH-Moderna vaccine”. It was mainly developed at Fauci’s NIAID. Moderna honed its mRNA tech via DARPA grants & also didn’t disclose federal support in patents, violating Bayh-Dole Act. HT @mattbc.
2) @mattbc is right in calling out this nonsense by Moderna to hide it got tremendous federal support for the vaccine in its patent. This is a violation of the 1980 Bayh-Dole Act. And @moderna_tx possibly violated it by not disclosing in 154 patent apps.
3) Moderna vaccine works folks. @KizzyPhD from the NIH is famously one of the co inventors of the vaccine. But this doesn’t change that Moderna needs to publicly acknowledge in its patents that its vaccine was taxpayer funded and NIH co developed, akin to Oxford-AstraZeneca.
Read 4 tweets
12 Feb
What is missing from this CDC school reopening priority list? Airborne virus guidance! Like almost nothing in 33 page document on ventilation except 1 paragraph on open the windows, but only if feasible. Ventilation should be #2 behind masks! #COVID19
cdc.gov/coronavirus/20… Image
2) Notably absent from new CDC guidance was ventilation. In one short paragraph, CDC suggested schools open windows & doors to increase circulation, but said they should not be “if doing so poses a safety risk or a health risk.” #COVID19 nytimes.com/2021/02/12/hea…
3) “C.D.C. gives lip service to ventilation in its report, and you have to search to find it,” said @j_g_allen, an expert on building safety at the Harvard T.H. Chan School of Public Health in Boston. “It’s not as prominent as it should be.”
Read 10 tweets
12 Feb
Worrisome—UK 🇬🇧 data shows suddenly higher #COVID19 positivity % in England 🏴󠁧󠁢󠁥󠁮󠁧󠁿 (where #B117 highly dominant) in children ages 5-9, in both boys and girls, sustained each week over 4 consecutive weeks. Ages 0-4 positivity also increasing. Israel 🇮🇱 has also seen kids case trend. Image
2) As noted by @dgurdasani1, this is all despite these data really underestimating infection in children (as they are based on symptom based testing). And positivity rates appear highest in early year settings (fully open) & primary schools (20% attendance).
3) Dr @dgurdasani1 believe it is related to schools in England 🏴󠁧󠁢󠁥󠁮󠁧󠁿.
Read 13 tweets
12 Feb

“We are now getting reports of people getting reinfected with a new variant—from 🇿🇦 (#B1351)—suggesting people who’ve had prior infection could get infected again.” says Chief Scientist Dr. Soumya Swaminathan. #COVID19
2) This comes on the heels of troubling data I highlighted last week from the placebo group of the Novavax 🇿🇦 trial that that people previously infected and have #COVID19 antibodies (seropositive) has no protection for #B1351 variant reinfection— not even for severe disease!
3) Last month, South Africa’s CDC also warned about likelihood of reinfection risk because of the lower virus neutralization seen by the E484K mutation in the #B1351 variant.
Read 13 tweets
12 Feb
Vaccinations have gone from 900k per day to now over 1.5 million.

I think Biden’s team under @aslavitt46 & @JeffZients @WHCOVIDResponse can push it to 2 million by the end of Feb / early March, and hopefully 3 million a day by mid April.

Let’s do it. #COVID19 (HT @CAPAction) Image
3) These PSA campaigns with @Adweek and @WarnerMedia and @GalGadot are also effective.
Read 4 tweets
12 Feb
Moderna says it has 631.5 mil doses of #COVID19 vaccines on order, of which a whopping 613 million are committed to rich countries like 🇺🇸 🇪🇺 🇯🇵 🇨🇦 🇰🇷🇨🇭🇬🇧 🇮🇱—almost none to developing countries. For COVAX, Moderna vaccine not listed among providers. Sad.
investors.modernatx.com/news-releases/… Image
2) Moderna says it has more countries not disclosed. Why? Poor countries likely wouldn’t hide it. The complete absence of Moderna from discounted COVAX vaccine providers shows where its values for humanity are. @moderna_tx — show you care. Donate to COVAX. gavi.org/sites/default/…
3) While most of COVAX vaccines to developing countries are Oxford AstraZeneca vaccines, Pfizer is also among them, even though it has ultra cold chain requirements. Moderna doesn’t need ultra cold storage. So @moderna_tx has no excuse. gavi.org/sites/default/… Image
Read 4 tweets

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