I wrote about the variants @nytopinion today, concluding:
"The science of virus variants and evidence from our vaccine armamentarium should instill confidence that we’re moving toward the [pandemic] exit ramp"
nytimes.com/2021/04/13/opi…
Why should we be confident about our ability to prevail over the virus variants?
All variants are innocent until proven guilty.
Most are scariants. A handful are real.
A thread to update what we know about them
My summary table, updated:
1. The magnitude of B.1.1.7 higher lethality now in question with new @TheLancetInfDis paper (for review of all studies, see table by @_nickdavies: )
2. New York and California variants added
Mutation maps of the 5 variants
outbreak.info/situation-repo…
The spectrum of immune evasiveness compiled from lab study reports, with B.1.351 having the most observed to date, yet responsive to vaccines, and cross-reactivity observed for antibodies vs. this variant to others

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More from @EricTopol

14 Apr
New case report and correspondence @NEJM
nejm.org/doi/full/10.10… “Our case suggests that the rare occurrence of vaccine-induced immune thrombotic thrombocytopenia (VITT) could be related to the adenoviral vector”
If you have zero cerebral venous sinus thromboses (CVST) and low platelets after 182 million doses of mRNA vaccines but do see this, albeit very rarely, with at least 2 adenovirus vector vaccines, I think "could be related" is an understatement.
I am disappointed that ACIP is putting off any J&J vaccine recommendations for another 7-10 days to review more data, since it is unlikely that will change anything or the need to make a decision
Read 4 tweets
12 Apr
A new study @TheLancetPH today questions the higher B.1.1.7 lethality in a small sample of hospitalized patients with viral sequencing, before there was resource limitation thelancet.com/journals/lanin…
It is at odds with the prior multiple, much larger independent reports of higher lethality (~1.6X), as also pointed out in the accompanying editorial (Table), which were community-based and did not use whole genome sequencing thelancet.com/journals/lanin…
Another study @TheLancetInfDis confirms higher transmissibility of B.1.1.7 (as did the other, vs ancestral strain) and highlights its lack of reinfection risk (cf ancestral) thelancet.com/journals/lanpu…
Read 4 tweets
10 Apr
This is blatantly wrong, Jeff Zients @WhiteHouse, refusing to surge vaccines to Michigan as @GovWhitmer has pleaded for weeks. It is the singular US outlier, weeks ahead of any other potential hotspot. nytimes.com/2021/04/09/us/…
No, that's not how its done, Mr. Zients. Maybe you should review the data from Israel for how you surge out of a surge.
Where there's a fire, you put it out.
Read 4 tweets
7 Apr
Best V3 news for today (vaccine-virus-variants)👍
1. Prior covid + mRNA vaccine (@BioNTech_Group) -> very high levels of neutralizing antibodies against B.1.351 (South Africa) and P.1 (Brazil) variants @NEJM (N=6)
nejm.org/?query=feature…
2. The mRNA vaccine (@moderna_tx) and @Novavax elicit high levels of neutralizing antibodies versus the B.1.429 (California) variant, similar to B.1.17 (UK) which means not very much immune evasion @NEJM nejm.org/doi/full/10.10…
3. Neutralizing antibodies against the B.1.351 (South African, 501Y.V2) variant cross-react to the others, telling us if we need a booster vaccine by incorporating this code, it should be quite effective (501Y.V3 = P.1, Brazil) @NEJM
nejm.org/doi/full/10.10…
Read 4 tweets
7 Apr
The very rare brain blood cots—CVST—with the Astra Zeneca vaccine occur 50X more frequently than mRNA vaccines and are getting a lot of attention today, even before dueling press conferences of UK and EU regulators. Causality should not be in question.
The EU regulator's statement today asserting benefit of the AZ vaccine and that the CVST blood clots should be "listed as a very rare side effect of the vaccine"
ema.europa.eu/en/news/astraz…
As of April 4th, 169 cases of CVST and 53 splenic vein thromboses out of 34 million people vaccinated
Frequency ~1/100,000
And more in @kakape's thread
Read 5 tweets
2 Apr
One of the world's leading virologists, @RobertoBurioni, added a new role 5 years ago—taking on anti-science. There's so much we can learn from him. Our conversation (and transcript) here, w/ @cuttingforstone @Medscape medscape.com/viewarticle/94…
We discussed the variants, vaccines, and, notably, their potential for blocking asymptomatic transmission. Lots of optimism (which we need!): Image
Why did he take on the role of dealing with science skeptics and the anti-vaxxers? Image
Read 4 tweets

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