Thread by @sdbaral

Additional context as why I have more optimistic view of variants of #COVD19 over the next six weeks across North America/Northern Europe

Host-Agent-Environment is commonly used framework for infectious diseases

Host -- us
Agent -- SARS-CoV-2
Environment -- conditions around us

https://twitter.com/sdbaral/status/1358774006258798594

With introduction of the #COVID19 variants

Agent -- Increased transmissibility with variants (more likely to bind receptor cells, higher VL, ? longer infectiousness)

Host -- increased immunity, ? increase in contacts with release of restrictions

Environment -- seasonal changes

Many models seem to directly assume that increased transmissibility will increase transmission and will increase case counts at population level.

But transmissibility is not the only determinant of transmission. Ie, see the epidemiological triad from two tweets ago.

Increased transmissibility could enhance replacement where variants become dominant forms of SARS-CoV-2 and still not increase transmission to the point of dramatically changing the trajectory of cases and associated morbidity and mortality.

I think that's what will happen.

My optimism doesn't change the need for active public health strategies.

I am just cheerier as I go about that work.

So let us:
1) get people vaccinated
2) reinvest in public health infrastructure, IPAC in health/work places
3) Improve structural supports for folks on margins

Potential Indicators:
1) Hospitalization/Severity rates by VOC compared to wild-type
2) Evidence of changing trajectory of hospitalization/ICU admissions over coming weeks.
3) IPAC adherence in businesses that remain open
4) VOC case counts by exposure type to inform reopening