Thread by @zhanghe_goh

This tweet thread is about the #Covid_19: Updates from Singapore webinar on 26 Feb 2021

I've been busy so this is ~ a month after

It will be followed by a tweet thread documenting a more recent episode that was last week

#Covid_19 : Updates from Singapore is a webinar organised by @WHOGOARN and @NUSMedicine

And moderated by @profdalefisher, Prof. David Allen, and Dr. Louisa Sun

We are joined tonight by Dr. Peter Karim Ben Embarek

Qns on:
1) #Olympics : @profdalefisher doubts that herd immunity will be achieved by July, which may make it very difficult to host, though small scale events may be held in the same way as #singapore's hosting of the upcoming #WorldEconomicForum

2) #medications and #vaccinations : @profdalefisher assures everyone that "the needle is very small" 😂

In his explanation on how #vaccines work, @profdalefisher also points out that interactions between #vaccines and #drugs with the #CovidVaccine are also not that common or significant

Dr. Sun now talks about the roles of ivermectin and colchicine in #Covid_19 --she doesn't see them as a game-changer

3) The role of #Covid_19 #vaccine in pregnancy: this is a timely question; trials are currently underway

By Prof. Allen
4) Concerns over #autoimmunity : interestingly there have not been any reports of #autoimmune problems arising from the #Covid_19 #vaccine

Conversely, #Covid_19 (the disease, not the vaccine) itself may actually be a concern if one gets infected

Related to this, a question about immune-mediated disorder following swine flu vaccines

Interestingly #DrFauci advised caution about using the #vaccine in certain subgroups of patients before (e.g. patients with history of #Guillain_Barre) , but later rescinded his comment after experts disputed this stand

5) Would #Sinovac be more effective than other #vaccines?

It's theoretically possible given the science but it seems this has not yet been borne out by current #phase3 trials data

Now for updates by @profdalefisher

He's excited that the global situation looks much better in the past month (Feb), largely due to the life-saving #lockdowns that have happened across the world

This trend is evident in the #Americas, in #Europe (but not necessarily in #EasternEurope), in #Asia, in #MiddleEast, in #Africa, and in the #WesternPacific.

* Decreasing trends are not homogeneous across all regions

@profdalefisher highlights some countries working on #ZeroCovid approach

#Cambodia--seems to have a cluster recently

#Thailand--intense #BorderRestrictions

#Vietnam--seems to be having a #ThirdWave

#Malaysia--still having several thousand cases / day

In #Singapore, vast majority of cases are #imported

"A reflection of what's happening outside our borders," says @profdalefisher

Prof. Allen observes that decreasing trends are visible in countries that have not yet undergone significant #vaccination efforts

@profdalefisher points out that it's true--there are tried-and-tested (pun intended) strategies that are known (and that have been shown) to work, after all

Dr. Sun brings up #D614G, which has actually been known since January.

She puts this issue into perspective and reminds us that new strains are found all the time; we have to be patient and wait for scientific consensus to develop on these strains

Dr. Sun next compares and contrasts different #COVID19 strains, and explains the underlying science and nomenclature

Watch here, at the ~ 35 min mark:

Increasingly data seems to suggest that #B117 could indeed likely be more transmissible, though Dr. Sun reminds us that real-life scenarios are often more complex

Dr. Sun reminds everyone that "traditional" measures (e.g. #SocialDistancing !) continue to be effective in guarding the spread against #SARSCoV2 (the virus responsible for #COVID19 )

Dr. Sun now addresses the possibility of #ImmuneEscape but also points out that any data at the moment remains in vitro

While concerns have been raised over #reinfection, the risk remains low.

#VaccineEfficacy against different strains remains untested. Dr. Sun points out that the #vaccine likely remains effective against #B117.

Regardless, Dr. Sun points out that the important end goal of #vaccines is really to reduce severe disease and #mortality.

Ultimately, Dr. Sun reminds us of the importance of perspective!

The next segment of the show is with Dr. Peter Karim Ben Embarek, who was under enormous pressure to come up with a hypothesis of #SARSCoV2 's origins

(As @profdalefisher points out, this was a highly politically-charged undertaking!)

One of the major challenges lay with gathering data

Scientists always want more data, but data sharing among different institutions and even countries in #healthcare is extremely difficult

In the next segment we have an update on #vaccines by Prof. Allen, which he summarises on this slide

Taken from 1.00 hr mark

In vaccination trends, most of #SouthEastAsia seems to remain unvaccinated (or no vaccine data is present)

Evidence of the benefits of getting #vaccinated is increasing, especially in countries where #vaccine rollout has been prevalent e.g. #Israel

The next step lies in expanding the patient population that's eligible for #vaccination

- Elderly
- < 18 yo
- Pregnant
- Immunocompromised
- Allergic

Why #vaccinate after infection?

In cases with mild infection, there may be low levels of circulating antibodies which may decrease over months

In the #UnitedKingdom , the strategy seems to be to #vaccinate the population now, and then administer the 2nd dose ~ 3 months later, without fear of compromising the efficacy of the #vaccine

Amazingly, there have been very few #AdverseEvents associated with the #vaccines, and no deaths have been reported!

The cost / benefit ratio is clearly in favour of the #vaccine

Unfortunately there are a couple of challenges associated with #vaccine rollout
- Supply and logistics
- Public education (which this thread and the webinar attempt to do)
- Wastage 😢

And we end with the pandemic song of the month:
A change is gonna come

By the "King of Soul", Sam Cooke

Watch here:

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