Globally, the end of the pandemic isn't near.

More than a million lives depend on improving our response quickly.

Don’t be blinded by the light at the end of the tunnel. There isn't enough vaccine and the virus is gathering strength & speed. Global cooperation is crucial. 1/
India’s surge is a reminder that the virus is learning about and adapting to us faster than we're learning and adapting to it. Covid, fueled by variants, is an ongoing & increasing risk. The pandemic is more severe than ever—more transmissible, more deadly, more human fatigue. 2/ Image
Dazzling scientific progress resulted in Covid vaccines that are more effective than many experts dared to hope. But although Israel, the UK, and, soon, the US will have a new reality with the virus largely tamed by vaccines, global vaccination lags badly. 3/ Image
Even in the best of circumstances, vaccines take months to control the virus. And we’re in far from the best of circumstances. Globally, vaccines would not crush the curve in the short-term even if there were enough of them—which there aren’t. 4/ Image
It takes weeks to months to roll out vaccines and weeks for protection to kick in. Vaccines don’t help people already infected with Covid and probably don’t help much after exposure. To stop spread now, we need to mask, distance, reduce travel, and prevent superspreading. 5/
Our current vaccine infrastructure can’t be relied on to meet the needs of the world. Countries with excess supply can make a dent, but vaccine production needs a step-function increase. Until much more vaccine is available, masks, distancing, less travel are all essential. 6/
All types of vaccines that are proven to be effective need to be scaled up as rapidly as possible. Novavax, J&J, AstraZeneca and others are all important, but mRNA vaccines are the most promising. They are our insurance policy against variants, boosters, and production delays. 7/
mRNA vaccines are also quicker to scale up, and they’re likely safer and more effective. Handling is getting easier, and cold chain problems can be addressed. They’re our best hope for an end to the global pandemic. But current capacity is nowhere near the global need. 8/
Yes, rosy estimates show there'll be enough vaccines in 2021, but companies missed 2020 production projections by 96% & overall production is at only 1/4 of projection for 2021. Variants, boosters, safety signals, production delays all very real risks. 9/ Image
We can’t bet lives and global recovery on uncertain vaccines and production. Regional mRNA manufacturing hubs are crucial to provide the best vaccines globally ASAP. Doing so will take longer than we wish, which is why we must start right now. 10/
India, South Korea, Singapore, Brazil and other countries in Latin America, South Africa, Senegal, Rwanda all have potential to establish vaccine manufacturing capacity and could become providers of vaccines globally. CureVax might be another resource. 11/
Transferring mRNA technology is essential. The technology is outlined in this fascinating @nytimes piece. The pandemic is the world’s most important problem. We should act accordingly. 12/
Transferring technology and stepping up production globally is the most important step the Biden administration can take to help end the pandemic. US taxpayers funded the Moderna vaccine. Not sharing this technology puts us at risk if even more dangerous variants emerge. 13/
Variants, wow! Check out the stunning march of B117 across the US. Even with more than half of our adult population fully vaccinated, we still face risk of outbreaks, and unvaccinated people are facing more danger than ever. 14/ Image
In the 1918 pandemic, in many places, the second wave was deadlier than the first. I’m concerned we’re at the most dangerous phase of the pandemic yet. Covid is deadlier, more transmissible, in more places, circulating at higher levels, and there’s more human fatigue. 15/
Globally, there were 1.8 million deaths reported from Covid in 2020. At the current rate, there will be even more deaths in 2021. But this isn’t inevitable; pandemics aren’t natural disasters. We can control Covid. Effective action can save at least a million lives this year. 16/
Variants remain the biggest wild card, but we’ve learned a lot about the virus and how to limit its impact. Protection measures work. 17/
Six steps we must take now to deal with explosive spread globally.
1. Protect health care & healthcare workers
2. Mask up
3. Distance and avoid superspreading
4. Continue essential services, including schooling
5. Vaccinate, especially HCW and older people
6. Learn and adapt
For each of these six, we need a focused, well-managed, accountable approach. We MUST do better protecting health care and health care workers. Doing so will save lives from Covid and from diseases that become deadlier when care is disrupted. 19/ Image
It’s possible to beat infectious diseases. These stories of success give me hope. If we work together across borders to fight Covid and invest in preparedness, we can save millions of lives. 20/
Covid has shown us the costs of failure, but a safer and healthier future is possible. 21/end

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More from @DrTomFrieden

13 May
The Last Pandemic?

The Covid pandemic has killed 3+ million people and driven 115M people into extreme poverty. It will cost the world $22 trillion by 2025. And it didn't have to happen.

A new report could be pivotal in efforts to prevent the next pandemic. 1/
The Independent Panel for Pandemic Preparedness and Response (@TheIndPanel) was created last year by @WHO to ensure the world is better able to address health threats such as Covid. They released a sweeping new report. 2/
Because the recommendations detailed in the report are so important, I’m going to highlight some of them in the hope that the story of Covid isn’t repeated. Read the report here: 3/
Read 24 tweets
16 Apr
Benefits, Risks, and Future of Vaccines and the Pandemic

Our vaccine safety monitoring system works. Reports of blood clots led to quick investigation, quick action, and transparency about what is known, not known and next steps. Vaccines remain our way out of the pandemic. 1/14
Global collaboration has been critical throughout the pandemic. Public health and medical experts around the world are collaborating to determine whether the events associated with AstraZenenca vaccine are the same as these events which may be associated with the J&J shot. 2/14
Tech transfer is crucial. The pandemic is the world’s most important problem. mRNA technology is our best solution. Create high-quality manufacturing platforms and hubs around the world to improve vaccine access. mRNA technology is an insurance policy against the pandemic. 3/14
Read 14 tweets
9 Apr
The US vaccination campaign is facing a fundamental challenge: getting the vaccine where it’s needed most. Millions of Americans are still unprotected, many of them at high risk of severe illness. Our 4th surge is beginning. Lives are at stake. 1 of thread/
1 in 3 people in the US have gotten at least one dose of vaccine—but that means 2 in 3 haven’t. Millions of people age 50-64 and 65+ who haven’t yet been vaccinated can still get Covid and are at much higher risk of severe illness or death, especially with the new variants. 2/
Some states are doing much better than others reaching older people: NH, VT, ME, RI, CT, MA, SD have given >1 dose to more than 85% of residents 65+ years old. In TN, WV, MS, Alabama, HI, and PR that proportion is less than 70%. 3/
Read 18 tweets
2 Apr
Covid Epi Weekly: The Centrality of Equity

Lots of good news on vaccines, but the virus and variants are gaining ground. Variants are spreading rapidly in the US, driving (along with premature opening) the fourth surge that’s now underway. 1/
I had planned to stop Friday night threads, but couldn’t help sharing thoughts on this week’s developments—there have been so many.

Fourth surge is building. Cases up 8%, test positivity up to 5.1%. Michigan situation worse, other states could follow. 2/
News on vaccines just keeps getting better. CDC study of mRNA vaccines found that Pfizer and Moderna vaccines blocked 90% of infections. Vaccinated people won’t spread much disease. HUGE implications for guidance for fully vaccinated people and the trajectory of the pandemic. 3/
Read 22 tweets
27 Mar
Covid Epi Weekly: An Epidemic of Vaccine Inequity

As predicted, a US 4th surge appears to be beginning, fueled by variants and reopening. Cases up 7%. Positivity inching up, to 4.7%. Because of vaccination, deaths won't increase substantially. We must solve vaccine inequity. 1/
Michigan hospitalizations are increasing rapidly esp. among 40-49 y.o. Middle and high school 30% increase in cases associated with outbreaks in tandem with increased community transmission. Fewer people staying home, similar to prepandemic levels. Harbinger of spring surges? 2/
Important new data on the mental health harms of the pandemic in the US. Large increases in depression and anxiety, especially among young people and those with less education. Treatment hasn’t kept up. At least 12 million more Americans are struggling.3/
Read 23 tweets
26 Mar
It's very unlikely that SARS-CoV-2 was created in a lab. The genetic information strongly suggests that the virus evolved naturally.
Is unintentional lab release a possibility? Yes, as the review commission has noted.
The last human case of smallpox was the result of a lab error in the UK. It is believed—though not proven—that a flu strain accidentally released in the former Soviet Union in the 1970s spread around the world.
Read 6 tweets

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