Thread by @LizSzabo

@theNAMedicine @PublicHealth LIVE: Speakers at @theNAMedicine webinar on variants include some heavy hitters of science: @CarlosdelRio7, @angie_rasmussen, Dr. David Ho of @Columbia & @MonicaGandhi9 .

@theNAMedicine @PublicHealth @CarlosdelRio7 @angie_rasmussen @Columbia @MonicaGandhi9 Live: @angie_rasmussen: Viruses have smaller genomes but mutate much more than complex cells.

@theNAMedicine @PublicHealth @CarlosdelRio7 @angie_rasmussen @Columbia @MonicaGandhi9 Live: @angie_rasmussen: Mutations are scattered randomly through coronavirus genome, although the ones of most concern relate to the spike protein, which helps virus enter our cells.

@theNAMedicine @PublicHealth @CarlosdelRio7 @angie_rasmussen @Columbia @MonicaGandhi9 Live: @angie_rasmussen is explaining viral variants. (I'm so glad I'm not being tested on this.)

@theNAMedicine @PublicHealth @CarlosdelRio7 @angie_rasmussen @Columbia @MonicaGandhi9 (Side note: In an interview, @ShivPillai4 told me 10 of the coronavirus's 29 genes are geared toward blocking type 1 interferon, an important immune system protein. Blocking interferon is like knocking out your fire alarm and sprinkler system.)

@theNAMedicine @PublicHealth @CarlosdelRio7 @angie_rasmussen @Columbia @MonicaGandhi9 @ShivPillai4 Live: Now Dr. David Ho of @Columbia is talking about variants at @theNASEM webinar. I'm in awe just to hear from Dr. Ho, who developed the HIV drug “cocktails” in the 1990s, which transformed AIDS from a fatal disease into a chronic condition.

@theNAMedicine @PublicHealth @CarlosdelRio7 @angie_rasmussen @Columbia @MonicaGandhi9 @ShivPillai4 @theNASEM Live: Now Dr. David Ho of @Columbia is talking about variants at @theNASEM webinar. This slide shows that convalescent plasma still works against B.1.1.7, but not B.1.351. Highlights that patients can get reinfected with B.1.351.

@theNAMedicine @PublicHealth @CarlosdelRio7 @angie_rasmussen @Columbia @MonicaGandhi9 @ShivPillai4 @theNASEM Live: @astrazeneca vaccine efficacy was only 10% against variant, compared to more than 70% against original coronavirus, Dr. David Ho said.

@theNAMedicine @PublicHealth @CarlosdelRio7 @angie_rasmussen @Columbia @MonicaGandhi9 @ShivPillai4 @theNASEM @AstraZeneca Live: Dr. David Ho on variants: B.1.1.7 is becoming dominant in most of the U.S., but it's being outcompeted in New York by B.1.526

@theNAMedicine @PublicHealth @CarlosdelRio7 @angie_rasmussen @Columbia @MonicaGandhi9 @ShivPillai4 @theNASEM @AstraZeneca Live: @MonicaGandhi9 notes that variants may reduce our antibody response, but that T-cells may provide protection that's harder to measure.

@theNAMedicine @PublicHealth @CarlosdelRio7 @angie_rasmussen @Columbia @MonicaGandhi9 @ShivPillai4 @theNASEM @AstraZeneca Live: How do vaccines stack up against viral variants? @MonicaGandhi9 notes there are 9 vaccines in the world, including Chinese and Indian vaccines not included in this chart.

@theNAMedicine @PublicHealth @CarlosdelRio7 @angie_rasmussen @Columbia @MonicaGandhi9 @ShivPillai4 @theNASEM @AstraZeneca @MonicaGandhi9 : Authorized vaccines are all super effective against severe disease and death. They differ in terms of how well they prevented milder disease in trials (although it's hard to compared, b/c studies were done at different times, w/ different variant populations).

@theNAMedicine @PublicHealth @CarlosdelRio7 @angie_rasmussen @Columbia @MonicaGandhi9 @ShivPillai4 @theNASEM @AstraZeneca @MonicaGandhi9: A good T-cell response seems to prevent severe covid infections. Notes that people who survived 1918 flu pandemic still had strong T-cells even 90 years later.

@theNAMedicine @PublicHealth @CarlosdelRio7 @angie_rasmussen @Columbia @MonicaGandhi9 @ShivPillai4 @theNASEM @AstraZeneca DIVERSITY in vaccine trials. @MonicaGandhi9 notes that @Pfizer vaccine trials had 21% of volunteers over age 65, 35% were obese. In @Modernatx also included 25% over 65, 37% were people of color. @JNJNews vaccine tested in South Africa, Latin America, the U.S.

@theNAMedicine @PublicHealth @CarlosdelRio7 @angie_rasmussen @Columbia @MonicaGandhi9 @ShivPillai4 @theNASEM @AstraZeneca @pfizer @modernatx @JNJNews @MonicaGandhi9 notes that @JNJNews is testing a two-dose regiment of its covid vaccine.

@theNAMedicine @PublicHealth @CarlosdelRio7 @angie_rasmussen @Columbia @MonicaGandhi9 @ShivPillai4 @theNASEM @AstraZeneca @pfizer @modernatx @JNJNews @MonicaGandhi9 said there are four good reasons why covid vaccines will likely reduce virus transmission, not just symptoms/death.

@theNAMedicine @PublicHealth @CarlosdelRio7 @angie_rasmussen @Columbia @MonicaGandhi9 @ShivPillai4 @theNASEM @AstraZeneca @pfizer @modernatx @JNJNews LIVE: @MonicaGandhi9: "Are these vaccine working? These vaccines are working."

Vaccines are proving to be as effective in real world as in clinical trials, even as the B.1.1.7 variant was taking over.

@theNAMedicine @PublicHealth @CarlosdelRio7 @angie_rasmussen @Columbia @MonicaGandhi9 @ShivPillai4 @theNASEM @AstraZeneca @pfizer @modernatx @JNJNews LIVE: @MonicaGandhi9 Risk of asymptomatic infection was 80% lower after just ONE doses of mRNA vaccine. So vaccines definitely reduce clinical disease and dramatically lower infectiousness. "Do I think vaccines will stop transmission? Yes, I do."

@theNAMedicine @PublicHealth @CarlosdelRio7 @angie_rasmussen @Columbia @MonicaGandhi9 @ShivPillai4 @theNASEM @AstraZeneca @pfizer @modernatx @JNJNews @MonicaGandhi9: Look at this huge drop in hospitalizations for vaccinated people. "The real world data on these vaccines is amazing."

@theNAMedicine @PublicHealth @CarlosdelRio7 @angie_rasmussen @Columbia @MonicaGandhi9 @ShivPillai4 @theNASEM @AstraZeneca @pfizer @modernatx @JNJNews @MonicaGandhi9: No difference seen in T-cell response in blood of vaccinated people exposed to variants.

@theNAMedicine @PublicHealth @CarlosdelRio7 @angie_rasmussen @Columbia @MonicaGandhi9 @ShivPillai4 @theNASEM @AstraZeneca @pfizer @modernatx @JNJNews @MonicaGandhi9 said she's not that worried about variants. (Personal note: Is it OK that I'm still anxious?)

@theNAMedicine @PublicHealth @CarlosdelRio7 @angie_rasmussen @Columbia @MonicaGandhi9 @ShivPillai4 @theNASEM @AstraZeneca @pfizer @modernatx @JNJNews @MonicaGandhi9 said we still need to reduce transmissions as much as possible to stay ahead of variants. Says we need to focus on the positive. "Vaccine optimism can reduce vaccine hesitancy."

@theNAMedicine @PublicHealth @CarlosdelRio7 @angie_rasmussen @Columbia @MonicaGandhi9 @ShivPillai4 @theNASEM @AstraZeneca @pfizer @modernatx @JNJNews @MonicaGandhi9: Good news. If you're vaccinated and exposed to the virus, you do not need to quarantine.

@theNAMedicine @PublicHealth @CarlosdelRio7 @angie_rasmussen @Columbia @MonicaGandhi9 @ShivPillai4 @theNASEM @AstraZeneca @pfizer @modernatx @JNJNews Dr. David Ho of @columbia: New York variant, California variant and E484K mutation can all lower effectiveness of monoclonal antibodies.

@theNAMedicine @PublicHealth @CarlosdelRio7 @angie_rasmussen @Columbia @MonicaGandhi9 @ShivPillai4 @theNASEM @AstraZeneca @pfizer @modernatx @JNJNews Will vaccination put pressure on coronavirus to mutate? @angie_rasmussen says vaccination has been variable around the world and doesn't see evidence that vaccines or natural immunity are spurring mutations. Variants are popping up as convergent evolution.

@theNAMedicine @PublicHealth @CarlosdelRio7 @angie_rasmussen @Columbia @MonicaGandhi9 @ShivPillai4 @theNASEM @AstraZeneca @pfizer @modernatx @JNJNews @MonicaGandhi9 says that so far, Texas and Mississippi are not seeing big spikes in cases, even after getting rid of mask mandates. But notes Florida has huge number of B.1.1.7 mutations.