Great thread. There are 2 problems with much of the variant coverage.

On one side, we have:
🚨🚨🚨OMG MUTATION☣️☣️☣️

On the other, we have:
Nothing to worry about here, because (T cells/herd immunity/scientists are being negative again)

Neither side is 100% wrong or right
Here's what we know:

Yes, variants have emerged. Yes, they are a problem.

Some, like B.1.1.7 are more transmissible and more virulent.

Some, like B.1.351 and P.1, may have *some* capacity to *partially* evade adaptive immunity (B cells/T cells).
But we can address both of these threats:

-Continuing to take precautions (masks, distancing, ventilation, etc) to reduce exposure risk

-Getting vaccinated ASAP. No variant has shown the ability to *completely* evade adaptive immunity. Vaccines still work against the variants.
Neutralizing antibodies, which are most the commonly measured metric, are not the totality of the immune response. A variant with the ability to evade some antibody neutralization in the lab does not mean that it's capable of evading protective immune responses.
Data from clinical trials shows that, in fact, all the vaccines retain the ability to protect against severe disease caused by all the known variants. We should be concerned about the variants, but we can do something about them.

Take precautions.
Get vaccinated.
At the same time, don't discount the importance of the variants or the possibility that other variants could emerge. When the virus replicates, it acquires mutations. "Double mutants" aren't surprising. What we need to watch out for are mutations that give the virus an advantage.
Advantages include:
-Increased capacity to evade immunity
-Increased fitness (ability to replicate)
-Increased infectivity (ability to cause an infection)
-Increased pathogenicity (more virulent)
Variants with mutations that offer any of the above advantages *could* emerge...IF THE VIRUS KEEPS HAVING OPPORTUNITIES TO REPLICATE.

If we can get transmission down, it won't have those opportunities.
So don't respond with fear or panic to every hyperbolic OMG MUTATIONS headline or tweet that you see.
And don't have a false sense of security when someone tells you to chill out because we have T cells or we've already reached herd immunity or it's all media hype.
What you should do is somewhere in between.

New variants will emerge if we don't take action now. So do this:

-Take precautions to reduce your exposure risk. Risk reduction is additive, so apply as many as you can (see chart from me & @syramadad).

-Get vaccinated ASAP.

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More from @angie_rasmussen

5 Apr
So I was very privileged to get vaccinated with J&J/Janssen this morning. I was originally supposed to get Pfizer. Let me explain why I switched, even though J&J is slightly less effective overall. A short thread:
Last week when I made the appointment for me and my husband when we became eligible, I was elated to get access right in time for a big life change: moving my family to Canada.
Many of you know I’m moving to Canada later this month to start a lab @VIDOInterVac. I’m so excited about this but I couldn’t help but think: will I be able to get my second dose of Pfizer in Canada?
Read 13 tweets
2 Apr
For all those wondering how variant mutations can screw up antibody responses, have I got the preprint for you!

Buckle up for a long ride down epistasis & biochem road, thanks to this great study by @Dr_MattMcCallum and colleagues in the @veeslerlab & collabs at @Vir_Biotech.
First, some background. All the variants have different constellations of mutations in SARS-CoV-2 spike. This is the protein on the surface of the virus particle (virion) that bind the receptor ACE2 and allow the virus to enter & infect cells.

It looks like this (h/t @profvrr):
As you can see from the above virion, spike is a 3D structure on the surface of the virion. Antibodies bind all over the surface of the spike protein. Some of these bind to important parts of spike that render the virus non-infectious, or neutralize it.
Read 36 tweets
31 Mar
BREAKING: Major and Champ Biden are dogs who do normal dog things
And all the people saying normal dogs don't poop in the house has never owned a senior dog or a pug of any age.
Also BREAKING: Ripley thinks Major and Champ seem cool and she’d like to compare indoor pooping techniques with them at some point
Read 4 tweets
31 Mar
I’ll always make time for @apoorva_nyc, especially about great news like this: top line trial results show safety, robust antibody production, & 100% efficacy in 12-15 year olds!
W/ the wise & wonderful @VirusesImmunity, @JenniferNuzzo, & Kristin Oliver.
nytimes.com/2021/03/31/hea…
Approach the efficacy data cautiously, because it was based on just 18 cases, all in the placebo group, but this is what we’d expect to see: the vaccine works in adolescents at least as well as in adults (maybe better, at least in terms of antibody responses).
While this data still needs to be evaluated by FDA and we need to see the full trial data, parents of teens can rest easier knowing their kids will likely be able to get vaccinated before school starts in the fall.
Read 5 tweets
30 Mar
Barely out and already my feed is filling up with (some pretty racist) complaints that this report is incomplete and dissatisfying.

But did you really expect a 2 week mission to yield a definitive answer about SARS-CoV-2 origins?

Origin investigations take years, even decades.
The purpose of this mission was really to lay the groundwork for collaborative studies moving forward.

Like it or not, that requires working cooperatively with China.

Like it or not, @WHO isn't equipped to conduct an audit of WIV's freezers or records or interrogate its staff.
This report contains some new information: about excess mortality, ILI, environmental testing, retrospective sample testing, animal testing. It also acknowledges there is a lot more to do.
Read 9 tweets
21 Mar
2 things have been troubling me lately:

1. The notion that recognizing the nuances & uncertainties of SARS-CoV-2 transmission is somehow "denying" that respiratory transmission occurs.

2. This is all @WHO's fault for giving bad guidance.

Are these true? Let's look at the data.
1. SARS-CoV-2 is a respiratory virus. That means it infects cells of the respiratory tract in both the upper (nose) and lower (lungs) airway. Naturally, this means you become infected after exposure to virus via inhalation, direct contact (droplets), or indirect contact (fomites)
Infection occurs not from exposure to purified virus, but from virus that's emitted in particles of saliva and mucus that an infected person exhales (or speaks, sings, etc).

Go outside on a cold day and breathe out. That cloud of steamy breath? Those are respiratory particles.
Read 48 tweets

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