What's the state of the pandemic in the US?

In last month

B.1.1.7 and other variants have become dominant

90M vaccines have gone into arms

Cases are up about 20%

Here's the key graph for US since Feb 1

Its a Rorschach test

I see it as mostly good news

Thread
Obviously state of pandemic varies widely from state to state (e.g. Michigan)

But here are the 5 largest states in US (by pop)

35% of Americans live here

NY high, slowly drifting down

FL, PA rising slowly

CA, TX low, staying there
And a few other things have happened

77% of people >65 have had at least 1 shot

44% of all adults too

And given this, I think we are likely to avoid a serious 4th wave

That doesn't mean we won't see spikes (see Michigan)

Or that we are at Herd Immunity (we aren't)

3/5
But everyday we don't see infections accelerating makes a serious 4th wave less likely

And we are about 4 weeks away from every adult who wants a vaccine getting their first shot (will vary by state)

At which point, the chances of a major national wave gets VERY low

4/5
So its all about the next few weeks

If you're not vaccinated -- be extra vigilant. You don't want to be infected days before you get the shot

And lets really focus hard on improving access in rural communities and communities of color

5/6
And lets engage skeptics to help address concerns about safety and effectiveness

To bring more folks on board to the benefits of being vaccinated

As we head into May, June, pandemic won't be over

But case numbers should decline further

With a really good summer to follow

Fin

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More from @ashishkjha

4 Apr
Since January, vaccine demand has outstripped supply

This will soon change

When?

Base on how things are going

By around May 5, every American who wants a shot will have gotten their first

And that's pretty close...and exciting!

So lets do some simple math

Quick thread
There are 255M adults in the US

According to latest @KFF report, 62% of folks have gotten the vaccine or want it ASAP

That's 158 M people

And another 17% want to wait and see = 43M folks

We've already given at least 1 shot to 105M people

2/4

kff.org/report-section…
That leaves 53M folks who want vaccine ASAP but haven't yet gotten it yet

We are vaccinating about 1.7M new folks a day

So on May 5, that should get us to 53M newly vaccinated

It may be a bit later if some of the 43M wait/see folks decide to get vaccinated now

3/4
Read 4 tweets
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
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
25 Feb
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…
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
24 Feb
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
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
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
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…
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

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