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Michael Mina Profile picture
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28 Feb, 4 tweets, 1 min read
Interesting fact

I’ve not been PCR tested-Yet I helped start what is now the highest (?) throughput PCR lab in the world

Wouldn’t know where to sign up / don’t have time to stand in line for a test w results days later

I do have access to simple rapid at-home tests, 2x/wk

1/x
I’m not special. If I don’t have time to stand in line, millions and millions of others do not have time to do this.

If I’m not readily aware of how to sign up - millions of others aren’t. Sure, Google will tell me, but not everyone can just figure it out.

2/x
Testing is simply not equitable in the US and access is limited

Nearly 65% of Americans have never been tested. Not bc they don’t want to, but bc it’s not simple. Testing is a public good - we must make it simple!

At-home tests will improve equity and our public health response
I have at-home tests bc they are demos. Companies send them to me. They are unfortunately all awaiting FDA EUA. Yet they work extremely well. Including new molecular “lab-quality” RNA rapid tests, as well as Ag tests

I just want everyone to have this ease of testing, at home.

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More from @michaelmina_lab

Michael Mina Profile picture
26 Feb
THREAD: NEW INFORMATION!

A first of its kind national survey out today from @CCDD_HSPH @TheCOVIDCollab and @HartSurveys on at-home rapid testing

What did we learn?

86% of Americans are willing/eager to use at-home rapid tests – BUT awareness of rapid antigen tests is low

1/x
This week Congress is considering $46B for testing, including for rapid tests. What does America think about that?

85% of Americans want government to fund these tests & distribute them. Strong support for rapid tests across political spectrum: 94% of Dems and 74% of Repubs.
But support for testing doesn’t come at any price. Willingness to test at-home decreases as $ increases. At $25 (price of the only two currently EUA authorized rapid at-home tests), only 33% of Americans would test themselves regularly.
Read 11 tweets
Michael Mina Profile picture
18 Feb
On TTI as a control measure:

Early 2020, we said contact tracing would not control community spread against #COVID19 once cases got high

Yet when cases got high, it was blasphemy to suggest lab PCR+contact tracing not useful to control spread.

Data is now catching up.

1/
The tweet thread above by Denis Nash @epi_dude is terrific and contains lots of wonderful data!

For me, It highlights the need for us to re-evaluate what it is we are doing. When our actions weren't working to slow spread, should we have kept forcing the same actions?

2/x
I worry that we get into group-think mentality and peer pressure is immense to "stick with the consensus"...

but when consensus is to stick to a failing test-trace-isolate as control, against our own warnings to our future selves... maybe we should've bucked the trend?

3/x
Read 8 tweets
Michael Mina Profile picture
13 Feb
NEW RESEARCH

Knowing if #COVID19 cases are going up v down is needed for decision making but changes in testing make it difficult to know

We found Instead of case counts, the distribution of Ct values gives a NEW way to estimate epidemic trajectory!

1/
medrxiv.org/content/10.110…
Essentially, we created a barometer that gives the growth rate (or decay rate) of an epidemic based entirely on whether the distribution of viral loads in ppl at a single time in a population is averaging high (epidemic growing) or low (epidemic declining).

2/x
This property of epidemics (when they are going up, detected virus loads are higher on average) has caused massive confusion.

The virus itself isn’t changing nor are the actual virus loads inside of individual people...

3/x
Read 9 tweets
Michael Mina Profile picture
10 Feb
Terrific write up!

Perhaps the most thorough reporting I’ve seen on the controversies surrounding rapid tests

An extremely important point @GiorgiaWithAnI covered is one at heart of the confusion but previously not covered well..

See short thread

1/x
nature.com/articles/d4158…
I’ve spoken on sensitivity and why rapid Ag tests shouldn’t be compared to PCR

Nevertheless, we’re stuck comparing to PCR. So, to deal w this, “we” have taken to comparing rapid antigen tests to PCR results below specific Ct values that may represent contagious virus loads

2/x
In many studies, Ct of <30 or <25 are considered to be likely contagious or “high virus”, respectively

HOWEVER this is bad. We must stop assuming this

Not all labs are the same

A Ct 25 in many labs may = a Ct of 18 elsewhere

This happened in Liverpool w Innova evaluation

3/x
Read 7 tweets
Michael Mina Profile picture
8 Feb
The new variant B.1.351 is evading immunity, infecting ppl already vaccinated w AZ vaccine

I’m concerned for the others too since all have very similar design against original Spike

This should be a wake up call

#Rapidtests needed for contingency plans

nytimes.com/2021/02/07/wor…
Good thing is the mRNA vaccines provided exceptional efficacy. But that was also when plasmablasts (temporary antibody producing cells) were fully abundant. We don’t know the efficacy after a few months after they all die off. Hopefully will remain very high and protect. But..???
We also do not know (or at least so far I haven’t heard) whether people are getting severely ill or not. If the AZ vaccine prevents severe disease w the new variant, then that can be good enough. I wish this part was reported so far.
Read 5 tweets
Michael Mina Profile picture
4 Feb
Short thread:

Cases are starting to plummet quickly.

This isn’t from vaccines (yet).

Possible we may be starting see a combination of seasonality on our side and likely seeing herd effects kick in.

1/x
On seasonality:

We knew in the summer that this virus was going to roar back in the fall. It did!

While coronaviruses collectively have a broad window each year, We can see that each individual coronavirus in the graph 👆has only a few months when it peaks. And then drops

2/x
This virus started really hitting us hard a second time in November. Oct-Jan may well be this viruses peak transmission window. We could be entering a reprieve from its grasp, at least for a while. If so, could help us get vaccines out and control spread quickly.

3/x
Read 10 tweets

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