1/ This is unreal. The study title is "Same-day SARS-CoV-2 antigen test screening in an indoor mass-gathering live music event: a randomised controlled trial." It is being cited as evidence that rapid antigen tests can make social events safe. But there are a couple problems...
2/ They gave rapid tests to over 1000 people and randomly divided those who tested negative into two groups. One went to a concert, where they were encouraged to dance and sing, and the others stayed home. I encourage you to read the entire abstract in the 2 pictures below.
3/ Results: None who went to the concert tested positive for Covid eight days later, but two of those who stayed home tested positive. Yay for rapid tests, right? Not exactly.
4/ You see, when they screened study participants with rapid antigen tests before the concert, NONE tested positive. That is to say, the rapid tests had ZERO effect on the results here.
5/ One would think this would merit a mention in the abstract, but the study authors apparently didn't think so. The study title indicates it's an RCT of rapid test screening for an indoor concert, yet there's no mention in the abstract that the rapid tests were irrelevant.
6/ Perhaps even more astonishing, nowhere in the discussion section of the paper do they mention that none of the rapid antigen tests were positive and that therefore no one was screened out of participating in the concert. Instead, they sing the praises of rapid tests.
7/ The authors do not let a little thing like the total irrelevance of the rapid antigen tests to the study's results prevent them from concluding their study provides evidence of the effectiveness of rapid tests as screening tools for indoor social events. You can't make it up.
8/ Though not mentioned in the study abstract, we are eventually told that concert attendees were required to wear an N95 mask at all times, except when drinking. I'm 100% for wearing N95 masks, but this is not likely to ever be adapted as policy in the real world.
9/ The ventilation was also extraordinarily good at the concert, maintaining CO2 at or below 800 ppm, much lower than the typical school classroom.
10/ In other words, the study was designed to give a result indicating the effectiveness of rapid antigen tests, & despite its failure to provide that result, the authors manage to come to the conclusion they wanted anyway.
11/ I should add that I'm open to the possibility that rapid antigen tests could be effective in preventing Covid transmission. But this study is a joke. It's disturbing that it was published by the Lancet & is apparently being taken seriously by prominent experts.
Addendum/ This study was funded by the events company Primavera Sound Group and YoMeCorono, which I know nothing about, but which appears to be funded by dozens of (mostly) Spanish corporations. yomecorono.com/en/empresas-qu…
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@StuartTurville has pointed out that WA delayed Covid spread longer than elsewhere in Australia. China has a somewhat similar immune history (as do other SE Asian countries). Perhaps BA.3.2 will do well in China once it arrives there? 2/4
I beg to differ! If it is not a sequencing mistake—and it looks clean—one of these BA.3.2 has something completely novel in SARS-CoV-2 evolution: an FCS-adjacent deletion!
One of the two QT repeats appears to have been deleted. I've never seen anything like this before.
Work by @TheMenacheryLab looked at a similar, more extensive, deletion. They deleted both QT repeats plus the next AA (∆QTQTN). In Vero cells (monkey kidney cells), it produced extra-large plaques & outcompeted WT virus—similar to furin cleavage site (FCS)-deletion mutants. 2/12
But in human lung cancer (Calu3) cells, the ∆QTQTN-mutant replication was dramatically reduced (2.5 orders of magnitude), and in infected hamsters disease was much milder. 3/12
There's a new BA.3.2.2 from South Africa today. For the most part, there's been little substantial change in BA.3.2 over the past few months—mostly synonymous mutations & very little happening in spike.
But this new one has 3 spike mutations & looks quite interesting. 1/7
For those not following closely, here's a 🧵 I made about BA.3.2 (not yet designated at the time) that I made some months ago, when it first burst upon the scene. 2/7
Attenuation of the SARS-2 furin-cleavage site (FCS) continues apace. It's beginning to look as if some form of FCS-weakening mutation might well become fixed in the near future. Collectively, they are at ~12% globally—a totally unprecedented level—& rising quickly. 1/4
In South America, this may have already happened. Recent sequences are scarce, but they nearly all have some sort of FCS-weakening mutation, mostly S:S680P in XFG.3.4.1, but with several others (S680F, S680Y, R683Q, R683W) contributing as well. 2/4
The enigmatic anti-correlation between S:∆S31 & FCS ablaters—clear since summer 2024—is strong as ever. Here are the recent CovSpectrum stats for T22N & ∆S31 among all seqs & seqs w/FCS weakeners.
How exactly a 1-AA deletion in a distant region affects the FCS is unknown. 3/4
There's been some speculation about why, despite persistent immune activation, germinal center activity, & overall elevated Ab levels, LC patients here had very low anti-spike Ab titers. I want to highlight one interesting speculative hypothesis & offer another possibility. 1/10
The ever-fertile mind of @Nucleocapsoid proffers the possibility that exosomes could be responsible for viral spread in some tissue reservoirs. I don't know much about this topic and so don't have much to say at the moment, but I'm trying to l learn. 2/
I'll offer one other possibility: the deep lung environment (or some other tissue reservoir) favors either an extreme RBD-up or extreme RBD-down conformation.
Background: The receptor-binding domain (RBD) of the spike trimer can be up or down. It has to be up to bind ACE2... 3/
A fascinating new preprint w/one very unexpected finding suggests, I believe, that a large proportion of Long Covid may be due to chronic infection in a particular bodily niche, which could be crucial for finding effective LC treatments. It requires some explaining. 🧵 1/33
First, a brief summary of the relevant parts of the preprint. They examined 30 people (from NIH RECOVER cohort) for 6 months after they had Covid, taking detailed blood immunological markers at 3 time points. 20 had Long Covid (PASC), 10 did not (CONV). 2/ biorxiv.org/content/10.110…
The PASC group showed signs of persistent, pro-inflammatory immune activation over the 6-month time period that suggested ongoing mucosal immune responses, including elevated levels of mucosa-associated invariant T cells (MAIT). 3/