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Eric Topol Profile picture
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17 Feb, 4 tweets, 3 min read
We haven't even started with the nose yet
science.sciencemag.org/content/early/… @ScienceMagazine
Blocking transmission 💯
This would help and should be given priority for clinical trials
And then there's the nasal vaccines for mucosal immunity
Thanks to @rorydevries @mosconaporotto @RLdeSwart @BarryRockx @bart_haagmans @alabiac and their colleagues for this important contribution

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Eric Topol Profile picture
18 Feb
For a window to the pandemic in Israel, and unique perspective, you may find our new podcast (+ transcript) with @segal_eran enlightening medscape.com/viewarticle/94…
w/ @cuttingforstone @Medscape
I'll summarize a few of the many essential points /1
—They demonstrated how essential flattening the curve is when, during 2 surges, there was ~25% excess mortality that could have been averted
—B.1.1.7 is now 80-90% of infections. Its arrival in Israel helped their decision to go forward with very aggressive vaccination /2
—At peak of their vaccination initiative, exceeding their projection, it was equivalent to vaccinating 10 million Americans/day
—Already w/ age >60 (>90% are vaccinated), there has been 55% fewer cases, 40% fewer hospitalizations, 35% fewer deaths /3
Read 4 tweets
Eric Topol Profile picture
15 Feb
1. Asymptomatic #SARSCoV2 carriers after vaccines, as aptly drawn by @nataliexdean (adapted @TheEconomist)
Even w/ the most highly effective vaccines (below), there'll likely be carriers, who can transmit, because shots aren't expected to achieve sterilization/mucosal immunity
2. The likelihood may increase over time after vaccination (with less circulating IgA levels, non-secretory) and with variants that have heightened transmissibility (like B.1.1.7).
frontiersin.org/articles/10.33… and @VirusesImmunity
3. An intranasal vaccine would be ideal for that but they have taken a back seat to shots, even though they provide perfect complementarity. Single dose potential striking in experimental model cell.com/action/showPdf…
Read 4 tweets
Eric Topol Profile picture
8 Feb
1. Instead of booster shots for the troublesome variants, why don't we develop bNAbs—broadly neutralizing antibodies—that are pan-coronavirus?
nature.com/articles/d4158…
Dennis Burton, my @scrippsresearch colleague, and I wrote about this @nature today
2. Coronaviruses, unlike HIV and influenza are "evasion-lite." Whereas HIV constantly evolves inside hosts w/ 100,000 different strains, and influenza has marked sequence variability. The marked success of the vaccines vs the #SARSCoV2 spike protein shows how it can be outwitted
3. A schematic of bNAbs—pan-virus vaccines has been furthered by a recent @PNASNews report of an HIV neutralizing antibody this is 5,000 fold more potent pnas.org/content/118/3/…
Read 7 tweets
Eric Topol Profile picture
6 Feb
1. The B.1.1.7 variant could prove to be our last major obstacle to achieving containment of the virus in the US. But it isn't getting enough respect. Many states are eliminating their effective mitigation measures such as mask mandates and on gatherings.
2. This variant increases 70-100% every week to crowd out other lineages and become dominant. In Germany, it is presently 5.8% (like San Diego) and here is their projection (via @kakape).
We are in the lull zone.
3. @CarolineYLChen talked with 10 experts
propublica.org/article/why-op…
@svscarpino @alliblk @datcummings @cmyeaton @Dr_KFO @PhilFebboMD_CMO @mtosterholm @larrybrilliant @llborio
TLDR "It’s really hard to thread this needle without sounding like a prophet of doom" —@angie_rasmussen
Read 9 tweets
Eric Topol Profile picture
2 Feb
Pretty striking now with 6 Phase 3 vaccine trials, adding Sputnik today:
Not a single death or hospitalization in the vaccine arms due to covid-19 in over 75,000 participants
Updating my table
For Sputnik, "moderate to severe" endpoints were 20 in the placebo group, 0 in the vaccine arm (100% reduction); not broken down by severe only
More on this w/ @AstraZeneca new data from today, preprint, and @FT coverage via @jburnmurdoch
Read 4 tweets
Eric Topol Profile picture
2 Feb
From serology studies it is estimated that 80 to 100 million Americans have had covid-19 infections. New data from @florian_krammer and colleagues suggests that, with + antibody testing, 1 dose of vaccine may be a viable strategy to achieve protection medrxiv.org/content/10.110…
Which is why many people getting their 1st dose of the mRNA vaccines have the expected side-effect profile of the 2nd dose. In the mRNA vaccine trials, only 2-3% of the participants were determined to be seropositive after enrollment.
I've been advocating the use of rapid, quantitative antibody testing to promote the optimal use of our vaccine supply, limited in the short term, while assuring maximal protection:
Read 4 tweets

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