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Ashish K. Jha, MD, MPH

@ashishkjha

2 Apr

As we start April, lets make it our transition month

We start with rising cases, deaths

Lets end it with falling infections

By keeping public health measures in place

And vaccinating!

1 in 2 Americans likely has some immunity to SARS-CoV2

By May 1, should be 3 in 5

Thread

50% of Americans with some immunity today?

Seems high, no?

Actually, pretty reasonable

Based on CDC, others, probably 30% of Americans have been infected

And now, about 30% of Americans have at least 1 shot

Assuming random overlap, gets us to about 50% with immunity

This is why our spike in cases much less scary (so far) than that in the EU

Higher population immunity (infections + vax) here blunting a lot of the effect of B.1.1.7

Each week, vaccines add another 2.5% of Americans to pool of folks with some immunity

Read 5 tweets

Ashish K. Jha, MD, MPH

@ashishkjha

18 Mar

Over past week, number of infections in U.S. has stopped declining

At about 50K infections every day

About where we were at height of summer surge

Why the stall?

Suspect B.1.1.7 is now starting to really have an effect

And states are opening up

This is a problem

Thread

Problem with national data is it misses underlying state trends

A month ago, every state saw declining cases

Today, 15 states have more cases than 2 weeks ago

19 states have a higher test positivity than 2 weeks ago

And even hospitalizations are inching up in some places

2/6

Not a surprise

B.1.1.7 -- probably represents about 40% of infections in US today

Means about 20,000 infections identified today were likely from B.1.1.7

It will become the dominant variant in next couple of weeks

So what's the problem? Look at Europe

3/6

Read 7 tweets

Ashish K. Jha, MD, MPH

@ashishkjha

25 Feb

@RanBalicer

So far, we've had a lot of great clinical trial data on COVID vaccines

But now, we have a new study from my friend @RanBalicer that examines a simple but critical question

How do these vaccines perform in the real world?

Short answer: fantastic

Thread
nejm.org/doi/full/10.10…

@ClalitHealth

Ran and colleagues from @ClalitHealth looked at about 600K (!!!) vaccinated people and examined how they did against 600K matched controls

There's a lot of interesting stuff here

I'm focusing on effects 7 days after the 2nd dose -- when vaccine has had a chance to work

2/4

First, they found that vaccines reduced ALL infections (not just symptomatic ones) by 92%

That's a big effect -- as good as seen in trials -- and that was for all infections, not just symptomatic ones

Second, hospitalizations from COVID fell 87%

Here's the key point on that

Read 6 tweets

Ashish K. Jha, MD, MPH

@ashishkjha

24 Feb

@foreignaffairs

COVID-19 pandemic has changed global public health

It accelerated longstanding trends – from rise of global science to a confident, dynamic Africa

In @foreignaffairs I lay out how US can't just reverse Trumpism

Instead, it must chart a new path

Thread

foreignaffairs.com/articles/unite…

It’ll be tempting for Biden team to pick up where President Obama left off

It won't work

We need to do more than simply reverse the shallow and dangerous Trump-era “America First” approach

In the last 4 years, the world changed

And the pandemic accelerated those change

2/9

@AfricaCDC

3 major factors have caused these major shifts

1. Democratization of knowledge generation & consumption globally

2. Growth of digital technologies that alter global public health

3. Rise of regional organizations like @AfricaCDC, fundamentally changing how GH is governed

3/9

Read 10 tweets

Ashish K. Jha, MD, MPH

@ashishkjha

23 Feb

So phenomenal news from today's testimony from J&J executives

They will ship 20M of these single-shot vaccines before end of March

Every calculation I've done assumed no J&J vax until April

Ah you say -- but don't I want Moderna/Pfizer? Aren't they better??

No

Thread

@PostOpinions

We will see more J&J data from FDA review this week but everything we've seen so far says these are excellent vaccines

Here's my @PostOpinions on why you should get any of the three you can get

2 of 3

washingtonpost.com/outlook/2021/0…

@arishapiro

and here's my conversation with @arishapiro on @npr about how J&J vaccine is getting a bad rap

Basic point is that these vaccines are terrific.

3/4

npr.org/sections/coron…

Read 5 tweets

Ashish K. Jha, MD, MPH

@ashishkjha

23 Feb

For 78 days in a row

the 7-day moving avg for number of daily deaths from COVID was above 2000

Over the weekend, it fell under 2,000 for first time in nearly 3 months

By next week, it'll be at 1500

And its falling a bit faster than I was expecting

Why?

Thread

First, predictions

By March 10, we should be under 1,000 daily deaths

By St. Patrick's Day, 750

And we could keep dropping

Amazing

Why?

Because infections are falling

But why faster than expected?

Two reasons

1. Hospital capacity easing

2/5

Overburdened, packed hospital means death rates rise

Opposite also true

As crowding burden eases, doctors, nurses have more time for each patient

Based on data, proportion of infected people dying weeks later is falling

This is good

And there is a 2nd reason to be optimistic

Read 6 tweets

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