A country that has prevailed vs B.1.1.7
Those states that were in trouble?
No longer the case. In descent or flat.
Overall cases are down 30%, hospitalizations and deaths down ~10% over the past 2 weeks
Here's the lineage (variant) map of the US through the pandemic, based on 360,000 sequences. Dark blue is B.1.1.7 that became dominant throughout. The only other major variant competing now is P.1 (Brazil) at 2% prevalence
outbreak.info/location-repor…
By getting nearly 150 million Americans vaccinated, the US averted pronounced surges, the worst seen in many countries, such as the UK and Israel, and throughout most of Europe
Instead, we just had a B.1.1.7 bump.
Had Americans not come together to get all the vaccinations done, including many days getting shots for well over 1% of the whole population, this would not have been the case.
But we've still got work to do. With >50,000 new cases a day we are nowhere near containment like the UK and Israel. That 5-15X gap is associated with a 10-15% more population vaccinated. If we can get that done, summer will be a time to celebrate.

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More from @EricTopol

5 May
Most important new report today, and highly encouraging: Real world vaccine effectiveness (E) in >380,000 people in Qatar to B.1.1.7 (UK) and B.1.351 (South Africa) variants, *100% E vs severe illness both*👍 @NEJM
nejm.org/?query=feature… Image
Text and Extended Table
1. One dose is not sufficient, especially B.1.351 which has a significant immune evasion property (most of all variants to date)
2. E vs infection of any type (PCR +) very solid 75% for B.1.351 ImageImage
Updating the evidence table for the essential point that we have vaccines that provide protection against all variants Image
Read 5 tweets
2 May
We are fortunate that vaccines induce such a strong immune response and provide protection from all of the virus variants that have evolved to date
Case in point
Had our vaccines not been protective vs B.1.1.7 (UK), the variant with >50% increased transmissibility and increased lethality, the country, w/ >147 million vaccinated, would not look like this right now
wsj.com/articles/u-k-c… @Brabbott42
Another real world evidence case in point
Brazil's success vs P.1 in decreasing morality with Sinovac and Astra-Zeneca vaccines
medrxiv.org/content/10.110…
Read 4 tweets
1 May
What may we expect from vaccination of 10-15% more of the US population?
7-day averages compared with UK and Israel shows a 5-15X difference in outcomes
Adding 2nd dose vaccination rates
Graphs of the data show the inter-country vaccine-outcomes gradient
@OurWorldInData
Read 4 tweets
30 Apr
Just published @ScienceMagazine
"After one dose, individuals with *prior infection* showed enhanced T cell immunity, antibody secreting memory B cell response to spike and neutralizing antibodies effective against B.1.1.7 and B.1.351." 👍
science.sciencemag.org/content/early/…
These findings are important to reinforce 2 points:
1. People with prior covid infections benefit from vaccination
2. Lack of evidence that a 2nd dose is necessary for confirmed prior covid
"second dose vaccination... post infection individuals offers no additional enhancement"
Other points:
3. Prior covid + 1 dose appears to be more protective than no prior covid + 2 doses, vaccines "skewed" to Ab response
4. 4-fold T-cell response to infection
5. "Large protective margin" vs B.1.351 (SA), the variant w/ most immune evasion
Read 5 tweets
29 Apr
Confirmed Prior Covid + 1 shot mRNA vaccine = Fully Vaccinated (FV).
Strong evidence to support👇
But many people w/prior covid are getting 2nd dose, unnecessary side effects
CDC/gov't needs to certify this for international travel and other FV activities
May even be better than 2 doses nejm.org/doi/full/10.10…
More on unnecessary side effects and action vs variants

nejm.org/doi/full/10.10…
Read 4 tweets
29 Apr
And it’s about time
More from @POTUS speech on vaccinations
A dose of hope
We can't let our guard down
"the @NIH, I believe, should create an advanced research project agency for health"
Read 4 tweets

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