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Eric Feigl-Ding Profile picture
@DrEricDing
Mar 20, 2021 • 29 tweets • 20 min read • Read on X
B117 variant is now *dominant* in the US. I’m 99% certain that another surge is on the way in April or May. Why? The more contagious #B117 is surging—now crossed the 50% threshold of all cases, in addition to pockets of others variants. 🧵 #COVID19
washingtonpost.com/opinions/2021/… Image
2) Just Wednesday, #B117 has hit 50% of all cases in the @my_helix database nationwide. It’s been exponentially surging for weeks. Image
3) @ashishkjha is right- “No matter where you live, it is too early to relax restrictions that continue to have a critical role in controlling this pandemic. From CA to ME, FL to Seattle, the #COVID19 winter is not yet done—highly infectious variants are threatening new storms.”
4) “But the latest national data, which show case rates have plateaued, indicate that we are not there yet. Over the past week, we have seen about 50,000 new cases reported daily. That’s not far from the **height of the surge last summer**”
5) Unfortunately, the public has been served the "it's-under-control" nonsense, pictured on panel A. But the reality is that it is exponentially even it growing slowly - because that’s how ever exponential function starts. It always sneaks ups.

(Figure by @GosiaGasperoPhD) Image
6) Take Alberta 🇨🇦 for example—people dismissed it for weeks. But the data is playing out exactly and predicted...

(Figure by @GosiaGasperoPhD). Image
7) We had predicted the graph above long ago... here was over a month ago... does it look familiar? It’s almost exactly the shape of the graph above.
8) Back to the US — Florida #B117 is hovering around 51% range. Florida’s decline has now stalled. Image
9) But there is a new champion in #B117 lead— 61% #B117 in Georgia, where cases has been rising daily for last 5 days. Image
10) And how is Michigan doing in #B117? It tops even Georgia. Michigan #B117 is now 62.5%. How is Michigan cases doing? Also surging in March. ImageImage
11) it was previously predicted that #B117 would pass 50% previously (@K_G_Andersen’s group) on March 23rd nationwide in the US.

We just passed it early... 6 days early. Damn.
12) Almost every epidemiologist agrees a 4th surge is coming. It is almost inevitable. The only question is how bad will it be. Maybe not that bad if we vaccinate faster. washingtonpost.com/opinions/2021/…
13) What makes me sad is that, aside from Australia, New Zealand, Vietnam, and Taiwan (all ~zero Covid countries) we never act fast enough until it is much too late. Leadership failures.

Correction- this figure is by @vb_jens. Image
14) But there are other variants to worry about too. In he UK and France, the South Africa #B1351 is also rising steadily. Here is a good thread 🧵 on their rise in the UK. The SA variant is the most problematic in vaccine lab studies so far.

Image
15) Notably, in the large study of Pfizer and NIH-Moderna vaccinated people, the 🇿🇦 #B1351 variant is the most troublesome. (This thread 🧵 below has been vetted and concurred by 2 immunology colleagues).

Good news is #B117 responds well to the vaccines! so take it!
16) I also want everyone to look carefully just how gosh darn PERFECTLY ACCURATE the Feb 1st model by @GosiaGasperoPhD was to the reality currently. Her forecasts were always exactly as predicted.

Hence let’s please not relax too soon. Surge is coming.
Image
17) This is why even with vaccinations, we have to be vigilant — relaxing everything else in terms of mitigation is a recipe for disaster until we have vaccinated up to vaccine herd immunity thresholds — likely 85% range for #B117 given its higher contagiousness.
18) And please continue to mask even if vaccinated due to residual chance of carrying virus. And definitely do NOT rely on prior #COVID19 infection for sufficient protection. It’s only 47% in the elderly!
19) Notice the sharp dropoff in the protection from reinfection by age. It’s only ~80% under 65, but only 47% in those 65 or older!

Also semi good news is that protection seems to be as good over 7 months. But not that high.

thelancet.com/action/showPdf… Image
20) meantime—I’m more worried about #P1–here is the ominous study on #P1 variant that is now everywhere in 🇧🇷... it is 2.52x faster transmission that old wild common type of #SARSCoV2. That is 152% increase! #B117 is only 40-60% faster.

medrxiv.org/content/10.110… Image
21) Another Brazil 🇧🇷 #COVID19 research group puts #P1 transmission at 2x faster than old strain (instead of 2.5x above), but they estimate a way worse whopping 25-60% reinfection rate! Ugh.

I’m honestly not sure which is worse. Both models really bad. bbc.com/news/amp/healt…
22) to be clear—the Pfizer and Moderna vaccines works against #B117–lots of studies. But for the #P1 and #B1351 variants, neutralization of the pseudovirus in lab by vaccine sera shows slight issues with #P1 and bigger issues with #B1351. We need to urgently chase #ZeroCovid. ImageImage
23) I’m a big fan of the J&J single dose vaccine — it not only grows stronger over time, but it also has good efficacy in both South Africa and Brazil! (Albeit before #P1 became heavily dominant in Brazil).
24) But I’m worried about #P1 and #B117 most of all. #P1 especially because it poses both potential reinfection risk and possibly faster transmission than even the already faster #B117 (see above). We need to keep #P1 contained in Brazil and squash out all 🌎 scattered #P1 cases.
25) Because we can’t let what’s happening in Brazil keep happening... or let it happen to other countries.

The world needs to unite together during a pandemic with the 3 Musketeers’ “ALL FOR ONE, ONE FOR ALL” motto. Or else we will sink as one planet. Image
26) Now the US needs to share its vaccine stockpile and vaccine excess orders with the world. And send aid to Brazil 🇧🇷. Or else we will all drown under the variants.

Let’s unite to fight this pandemic... all for one, one for all!

God help us.
27) I’m so tired... been trying to warn about this exact #B117 for over 6 weeks. So so tired.
28) things in South Florida are going as well as can be expected... #B117 variant surging there.

Why do we ignore this warning sign? I didn’t suffer through a doctorate in epidemiology by age 23, just so that DeSantis can pretend to govern in a pandemic.
sun-sentinel.com/coronavirus/fl…
29) #B117 update—Germany entering a new stricter lockdown after #B117 is growing and fueling another increase across EU.

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More from @DrEricDing

Eric Feigl-Ding Profile picture
Jun 16
📍 THE 17 FIRED MEMBERS OF CDC’s VACCINE ADVISORY COMMITTEE (ACIP) speak out…

📍“As former ACIP members, we are deeply concerned that these destabilizing decisions, made without clear rationale, may roll back the achievements of US immunization policy, impact people’s access to lifesaving vaccines, and ultimately put US families at risk of dangerous and preventable illnesses.” 🔥

Full text:

Vaccines are one of the greatest global public health achievements. Vaccine recommendations have been critical to the global eradication of smallpox and the elimination of polio, measles, rubella, and congenital rubella syndrome in the US. They have also dramatically decreased cases of hepatitis, meningitis, mumps, pertussis (whooping cough), pneumonia, tetanus, and varicella (chickenpox), and prevented cancers caused by hepatitis B virus and human papillomaviruses.1 Recent scientific advancements enabled the accelerated development, production, and evaluation of COVID-19 vaccines, leveraging novel technologies that are estimated to have prevented approximately 1.6 million hospitalizations and 235 000 deaths in the US alone.2
For more than 60 years, the Advisory Committee on Immunization Practices (ACIP)—codified in the federal regulations (42 USC 217a: advisory councils or committees)—has served as a panel of experts that reviews the most up-to-date evidence on vaccines and monoclonal antibodies (eg, against respiratory syncytial virus [RSV]), providing sound recommendations to the US Centers for Disease Control and Prevention (CDC) regarding how vaccines should be used. ACIP recommendations are the cornerstone of the immunization program in this country. First, they serve as guidance and are the national standard for the use of Food and Drug Administration (FDA) authorized and licensed vaccines, providing a unified and trusted approach to vaccinations for the diverse array of immunization providers across the US. Second, they ensure science-based and tested immunization schedules that are optimized for well-timed protection against serious diseases. Third, the recommendations affect insurance coverage and safeguard broad access for vaccines. Fourth, ACIP’s continued monitoring of disease epidemiology and scrutiny of vaccine safety inform timely updates to recommendations that have maintained the trust and protection of the population. This transparent and ongoing surveillance of vaccines is one of the most stringent around the world, historically making the deliberations and decisions of this committee a beacon for immunization programs globally, while also serving as the foundation for recommendations harmonized with leading medical organizations in the US.3,4
ACIP committee members have always been selected through a rigorous process based on their expertise in immunology, epidemiology, pediatrics, obstetrics, internal and family medicine, geriatrics, infectious diseases, and public health. Historically, committee members were chosen because they worked at hospitals, clinics, health departments, universities, and other organizations where they dedicated themselves to caring for patients, conducting research, and helping to prevent and treat infectious diseases. Members’ deep understanding of immunization issues ensured that vaccine policies were grounded in scientific evidence, aligned with the needs of economically, socially, and medically diverse US communities, and always considered the public value, trust, and acceptability of vaccines.
Despite recent suggestions to the contrary, health care providers and the US public trust ACIP. For the past 18 years, the National Immunization Survey has shown that 99 of every 100 children in the US have received at least some recommended vaccines by 2 years of age, consistent with acceptance of ACIP recommendations implemented by trusted clinicians (National Immunization Survey - Childof Healthy People 2030).…Image
2) Full text part 2:

This does not suggest the population is so distrustful that it warrants dismantling the process by which vaccines have been recommended. ACIP standard procedures have minimized the risk of alleged conflicts of interest and biases. For decades, members of ACIP have undergone a thorough application and review process to participate. Proposed members submitted letters of support from other known experts and peers, completed an interview process, underwent a background check, and disclosed financial interests that might be considered a conflict, including any professional or financial relationships of immediate family members. Historically, it has taken up to 2 years for nominees to be approved to join ACIP.
Once part of the committee, ACIP members spent significant time preparing for meetings, reviewing the scientific evidence, and chairing work groups that, along with many CDC public health officials, led to the final recommendations that were determined during public meetings, which also included opportunities for public comment. Recordings of these meetings, agendas, and presentations were publicly available. Additionally, members agreed to ongoing monitoring and disclosure throughout their tenure. For example, potential conflicts of interest were reviewed throughout their time on the committee. Statements about potential conflicts were required during each meeting and before each vote, and members recused themselves from voting if any conflicts were identified. These disclosures have also recently been posted on the CDC website for public scrutiny. ACIP was among the most stringent and transparent of the federal committees, and we hope those criteria will apply to any new members joining the committee.
The abrupt dismissal of the entire membership of the ACIP, along with its executive secretary, on June 9, 2025, the appointment of 8 new ACIP members just 2 days later, and the recent reduction of CDC staff dedicated to immunizations have left the US vaccine program critically weakened.5,6 These actions have stripped the program of the institutional knowledge and continuity that have been essential to its success over decades. Notably, the ACIP charter specifies that committee members serve overlapping terms to ensure continuity and avoid precisely the disruption that will now ensue. The termination of all members and its leadership in a single action undermines the committee’s capacity to operate effectively and efficiently, aside from raising questions about competence.
Compounding these concerns, recent changes to COVID-19 vaccine policy, made directly by the HHS secretary and released on social media, appear to have bypassed the standard, transparent, and evidence-based review process.7 Such actions reflect a troubling disregard for the scientific integrity that has historically guided US immunization strategy. The newly stated strategy to replace ACIP members with individuals who will “exercise independent judgment, refuse to serve as a rubber stamp, and foster a culture of critical inquiry” is already leading to warnings by academic and scientific institutions, professional organizations, and the public who for decades have known well that these sought-after qualities precisely characterized the now-dismissed members of the ACIP.5
3) Part 3:

As former ACIP members, we are deeply concerned that these destabilizing decisions, made without clear rationale, may roll back the achievements of US immunization policy, impact people’s access to lifesaving vaccines, and ultimately put US families at risk of dangerous and preventable illnesses. Vaccines and the anti-RSV monoclonal antibodies are lifesaving, and people in the US deserve to have recommendations and broad access to use them to prevent serious diseases. In this age of government efficiency, the US public needs to know that the routine vaccination of approximately 117 million children from 1994-2023 likely prevented around 508 million lifetime cases of illness, 32 million hospitalizations, and 1 129 000 deaths, at a net savings of $540 billion in direct costs and $2.7 trillion in societal costs.8Finally, as individuals, we remain committed to evidence-based vaccine policy, both through our ongoing work in immunization science, public health, and medical education, and by supporting future efforts to keep America healthy that uphold scientific rigor and the public’s trust.
Read 4 tweets
Eric Feigl-Ding Profile picture
May 8
⚠️Tariffs On Medications Will Make America Sick

We might soon see the Trump WH impose tariffs on pharmaceuticals—patients will suffer and die.

During the past few weeks, President Trump’s on-again, off-again tariff wars have rattled the stock market, decimated many Americans’ retirement funds, and promised to send grocery prices soaring—and his administration hasn’t even gotten to critical pharmaceutical tariffs yet. But that will likely be the next shoe to drop.
Trump exempted pharmaceuticals from his first round of tariffs in early April, but recently declared that he intends to impose “a major tariff” on imported medicines “very shortly.” These tariffs, he claims, will prompt pharmaceutical companies to leave countries including China and India and begin “opening up their plants all over the place.”
Commerce Secretary Howard Lutnick said in a television interview in mid-April that these tariffs are coming in the “next month or two.”

What will this mean? 

Read on:
progressive.org/op-eds/tariffs…Image
2) The majority of brand name drugs used in the United States are imported. Even generic drugs often rely on ingredients and direct imports from China, including pain relievers and cardiovascular drugs used by millions.
3) The United States was already facing a drug shortage crisis before Trump’s tariff announcement. Now, his policies will drive upnot only the cost of medicines, but also other health care items such as X-ray machines and medical instruments.
Read 8 tweets
Eric Feigl-Ding Profile picture
Apr 10
It’s a trap: CATCH 22—if you register, ICE will deport you. If you don’t register, you’ve now committed a crime for the first time, and ICE will deport you. Trump doesn’t care if you’ve paid all taxes and followed all laws—ICE will deport you.

apnews.com/article/illega…Image
2) The Department of Homeland Security announced that it was mandating that all people in the United States illegally register with the federal government, and said those who didn’t self-report could face fines or prosecution. ***Failure to register is considered a crime***
3) Registration will be mandatory for everyone 14 and older without legal status. People registering have to provide their fingerprints and address, and parents and guardians of anyone under age 14 must ensure they registered. The registration process also applies to Canadians who are in the U.S. for more than 30 days, such as so-called snowbirds who spend winter months in places like Florida.
Read 4 tweets
Eric Feigl-Ding Profile picture
Apr 3
Now economists know how scientists felt back when he pushed “hydroxychloroquine”
2) HCQ preventing COVID deaths has been debunked— and it’s now been linked with deaths.

@JoshuaPCohen1
forbes.com/sites/joshuaco…Image
@JoshuaPCohen1 3) JPMorgan on Trump Tariffs: “The largest tax increase since 1968” Image
Read 6 tweets
Eric Feigl-Ding Profile picture
Mar 28
My god—Earthquake (a Richter ~7.7) causes a skyscraper to collapse in Bangkok. Hope all the construction workers made it out.
2) this skyscraper collapse was captured from a distant car’s dashcam while on a highway

3) another view of the collapse. For those who lived through 9/11, this collapse is a bit triggering.
Read 5 tweets
Eric Feigl-Ding Profile picture
Mar 27
Welp—kiss public health & medical research infrastructure in America goodbye for the next 4 years. RFK Jr plans to cut 10,000 jobs from Trump HHS. Image
2) this will not make America healthy again… not by a long shot. So dangerous and irresponsible.
3) “Kennedy is set to announce Thursday the planned changes, which include axing 10,000 full-time employees spread across departments tasked with responding to disease outbreaks, approving new drugs, providing insurance for the poorest Americans and more”.
Read 5 tweets

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