More from @EricTopol

Eric Topol

@EricTopol

6 Mar

The spectrum of covid illness and effect of the vaccines in clinical trials
1. The trials were designed and powered for protection from mild to moderate illness. Not severe infections. Not asymptomatic infections. Not hospitalizations or deaths. Not #LongCovid.

2. The Table summarizes the data to point out how few severe endpoints occurred. The largest N of endpoints was in the J&J trial and <10% fell into the "severe" category. All together for over 152,000 participants, <100 severe endpoints.

3. We registered concern last fall about this matter, that there will be inadequate events/statistical power to judge severe infections and outcomes nytimes.com/2020/09/22/opi…

Read 11 tweets

Eric Topol

@EricTopol

24 Feb

@JNJNews

The @JNJNews vaccine FDA briefing documents are out, so we now can see how well this single adenovirus vector vaccine dose works
fda.gov/media/146217/d…
1. It is efficacious, overall 66%, but not as high as the mRNA vaccines (even in US with D614G strain).

2. While 85% efficacy was seen for severe infections, there was some falloff in participants > 60 yrs of age

3. A look at asymptomatic infections (carrier state) suggests the efficacy for reducing that is similar to overall efficacy

Read 7 tweets

Eric Topol

@EricTopol

23 Feb

There's a problem with labelling the California variant (B.1.427/B.1.429) "increasingly dangerous" when there isn't even a preprint published and we're watching dramatic descent in cases, hospitalization and deaths despite its high frequency
latimes.com/science/story/…

@nytimes

More @nytimes on this today, without the "dangerous" stuff.
But I am not convinced there is any meaningful functional difference for this "California variant" in light of above comment (the real laboratory is what is going on in California)
nytimes.com/2021/02/23/hea… by @carlzimmer

@NewsfromScience

And @NewsfromScience
“If I were a reviewer, I would want to see more data from more infected people to substantiate this very provocative claim” -- Prof David O’Connor @dho (+1)
sciencemag.org/news/2021/02/c… by @meredithwadman

Read 4 tweets

Eric Topol

@EricTopol

21 Feb

@Nadav_Eyal

Preprints weren't enough.
Now we've got the "leaked" report + cognitive bias.
We all want to see vaccines block spread—faster end of the pandemic and need for masks
The leaked Israeli Ministry of Health report, 1st reported by @Nadav_Eyal, then by @techreview. gets much attention

@Nadav_Eyal

The bold conclusion above is not only based on "sketchy" data, according to @Nadav_Eyal, but now being promoted as breaking news by @bloomberg

It's certainly possible that the vaccine achieves ~90% reduction in spread, but we're not there yet— even though it's the news we all want to see. Nothing like the combo of a "leaked" report and hunger for good news.

Read 4 tweets

Eric Topol

@EricTopol

18 Feb

@segal_eran

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