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Monica Gandhi MD, MPH Profile picture
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30 Mar, 4 tweets, 2 min read
A city turning against itself over schools: "Critics of San Francisco’s brand of liberal politics have long pointed to a disconnect between elected officials’ lofty rhetoric about social justice, and the reality of a city where fabulous wealth lives
nytimes.com/2021/03/29/us/…
side-by-side with extreme poverty & despair, exemplified by the homelessness, drug abuse & mental illness on the city’s streets...Amid the chaos 1 thing has remained clear: A large share of the city’s public school students are unlikely to see the inside of classrooms this year"
On the other hand and a piece of bright news, Oakland students (youngest) did return for in-person learning yesterday. "As a kindergartner, he “doesn't remember what it’s like to be in a classroom,”"
sfchronicle.com/local/article/….
Poignant reminder for SF/Oakland & teens.. "analysis. found teenagers' demand for care for mental health skyrocketed last year amid pandemic.. % of claims for intentional self-harm nearly doubled in March/ April.. overdose claims increased by >100%"
medpagetoday.com/pediatrics/gen…

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More from @MonicaGandhi9

Monica Gandhi MD, MPH Profile picture
31 Mar
If I may cheat on the T cell for a moment and tell you about memory B cells and how excellent they are, I would appreciate it if no one told my T cells. Memory B cells also form part of the adaptive immune system; they develop after an infection, go and hide out in your "germinal
centers" (like your lymph nodes) and then they quietly sit there and also quietly circulate for a very long time but are able to be stimulated to produce active antibodies if they see that infection again. One of my favorite papers ever took a cohort of 32 nature.com/articles/natur…
people born before 1915 who had been exposed to 1918 flu. Nearly 90 years later (this paper published in 2008), they found circulating B cells that could generate potent neutralizing antibodies to the 1918 strain of flu (by the way, the influenza virus mutates WAY faster than
Read 8 tweets
Monica Gandhi MD, MPH Profile picture
31 Mar
More details on 12-15 trial here: Although the Pfizer mRNA vaccine has been authorized down to the age of 16 by the FDA, was not previously studied in those younger than 16. Now we have data from participants 12-15 years old.
pfizer.com/news/press-rel…
This Phase 3 trial enrolled 1131 participants who got the vaccine and 1129 participants who got a placebo shot. Showed 1) the Pfizer-BioNTech COVID-19 vaccine demonstrated 100% efficacy against symptomatic COVID-19 (e.g. there were 18 COVID-19 cases, all among placebo recipients
and none in those who got vaccine; 2) the vaccine induced robust antibody responses, exceeding 16-25 in prior trials but didn't mention if the trial measured our beloved T cells. Super effective, safe, good immune responses & should be ready soon.
Read 4 tweets
Monica Gandhi MD, MPH Profile picture
30 Mar
Cases continue to be weighted at a greater "threat" level than hospitalizations or positivity rate. Since metrics don't align, state can be testing in a Dark Green Zone, have a Light Green/Yellow Positivity Rate, but have a Dark Red Threat Level on Cases per 100K. Let's look at
NY, NJ, PA, MI, OH (19% of the U.S. population), where NPIs are still being maintained:
Last 7 day cases -- 160,406 (Dark Red Zone) of the 422,980 or 38% of the cases
Last 7 day tests -- 2,072,485 (Light Green Zone) of the 8,032,744 tests or 26% of the tests
Positivity Rate -- 7.7% (Yellow Zone)
Last 7 day hospitalization admissions -- 10,751 (Light Green Zone) of the 33,714 hosp. admissions or 32%.
So, good to see positivity rate, hospitalizations, tests all yellow-light green. Would be helpful to take those metrics into account.
Read 6 tweets
Monica Gandhi MD, MPH Profile picture
29 Mar
Another tweet on how hospitalizations for COVID-19 right now are lower than that of influenza in past year due to vaccines. 4 data sources:
1)gis.cdc.gov/grasp/COVIDNet…
2)gis.cdc.gov/GRASP/Fluview/…
3) cdc.gov/flu/about/burd…
4) cdc.gov/coronavirus/20…
As the vaccines take hold, the reduction in 65+ hospitalizations is apparent in COVID. For MMWR Week 11 (w/e 3/20/21) COVID hospitalizations are less than the 2018/2019 and 2017/2018 Flu Seasons in 65+ and less overall than the 2018/2019 Flu Season. Flu The never tested for at
the level of COVID, but, as the data indicates the positivity rates for those who did get a Flu test were much higher than where we are with COVID, now.
Overall
COVID -- 5.7 per 100k -- 382,473 cases on 8,411,837 tests or a 4.1% positivity rate (as reported by the CDC)
Read 6 tweets
Monica Gandhi MD, MPH Profile picture
29 Mar
Wanted to break down this CDC study today to show you how remarkably effective these vaccines are- simply,
-Without vaccination, you would expect among 1000 people to see 162 infections
-With full vaccination among 1000 people, you would see 1 infection
cdc.gov/mmwr/volumes/7…
This MMWR article looked at data from healthcare personnel, first responders, and other essential and frontline workers across six geographic regions in the U.S. from December 14, 2020–March 13, 2021 since vaccines were being rolled out in these groups early.
In total, this analysis involved 3950 participants (in Arizona, Florida, Minnesota, Oregon, Texas and Utah) who have never had COVID-19 before by laboratory tests 2,479 (62.8%) received both recommended mRNA doses and 477 (12.1%) received only one dose of mRNA vaccine by the time
Read 9 tweets
Monica Gandhi MD, MPH Profile picture
27 Mar
GREAT NEWS on what we are all eyeing carefully as scientists, public, media: Are hospitalizations per case decreasing in light of vaccines which defang virus . YES, massively. Let's look at statistics from two data sources
healthdata.gov/Health/COVID-1… and
cdc.gov/coronavirus/20…
CASES:
57k cases 7 day average, +7% from prior week
CDC compared to closest 7 day average was July 23, 2020: 63k
Peak of 7 day average 250k cases on January 11, 2021
Currently down -77% from the peak on cases.
TESTS:
1080K tests 7 day average, -10% from prior week July 23, 2020
week 7 day test average was 858K. Test positivity rate was 4.7%; July 23, 2020 positivity rate was 7.3%
Peak of 7 day average was 2.0 million in tests on January 18, 2021
Cases and test positivity: Currently down -46% from the peak on tests. Currently 57k cases vs. 63K July 23
Read 18 tweets

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