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A Marm Kilpatrick Profile picture
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15 Jun, 4 tweets, 1 min read
Nice thread @EdMHill describing modeling from 1 of 3 teams on possible outcomes in UK that guided recent decision to postpone re-opening.
Big takeaways:
-I wish US gov had been open to scientific guidance in 2020
-Big uncertainty in behavior changes w/ re-opening
cont.
-Big uncertainty in relative transmissibility of delta (b.1.617.2) variant & vaccine effectiveness for transmission (not symptomatic disease). PHE-UK has provided fantastic real-time analyses of available data, but some critical data, that could be collected, are missing.
-Importance of limited vaccine supply. US can't seem to give away vaccine even with beer, lotteries & more. In UK (& most, but not all, of world) every dose is precious & in-demand.
*Clarification - thread describes modeling from 3 modeling groups not one.

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More from @DiseaseEcology

A Marm Kilpatrick Profile picture
26 May
Why hasn't B.1.1.7 fully displaced other variants in US? What other variants are persisting/growing?
Thread
B.1.1.7 has risen to relatively high frequencies in many states, but hasn't exceeded 90% in any of them & may be falling in several.
Data here from @my_helix
GISAID sequences via fantastic outbreak.info for US as a whole suggest B.1.1.7 now stable @70%, P.1 is growing, B.1.526 frequencies are stable. But variable sequencing means finer resolution is better for understanding frequency dynamics, spatial variability & nuance.
Statewide scale is still too large but better than whole US.
Here's FL. Similar pattern as whole US - P.1 growing & B.1.526 stable, leading to slight recent decrease in B.1.1.7
Read 9 tweets
A Marm Kilpatrick Profile picture
26 May
Yesterday I posted the tweet below as a joke.
Today I found so much bullshit (@callin_bull) it blows my mind.
Exhibit 1: The press release itself: investors.modernatx.com/news-releases/…
Yup, they claim 0 vs 4 cases = 100% efficacy.
Exhibit 2: NBC, USA today both parrot 100% efficacy claim.
Exhibit 3: Moderna CEO claims vaccine prevents infection (see quote). Note: there was no data presented from study on efficacy against infection (despite that being #1 reason to vaccinate kids). Only symptomatic disease (4 cases total), antibody response, & side effects.
It's worth noting that efficacy wasn't a primary endpoint of this trial - translation: the study wasn't trying to measure efficacy so there's no need for Moderna CEO to spout bullshit. Where is NIH partner telling them to cut the BS?
Read 7 tweets
A Marm Kilpatrick Profile picture
22 May
What is the trajectory of viral load dynamics & test sensitivity post-INFECTION?

We're 17 month into the pandemic &, shockingly, this Q is still only partly answered.
Recent paper using a study design I proposed 12 months ago provides detailed look & raises many questions.
Background
We know that ~3-6d following infection COVID-19 symptoms start (the incubation period). doi:10.1136/
bmjopen-2020-039652
We also know that people are infectious before symptom onset - this has been one of the greatest challenges in controlling SARS-CoV-2.
Read 25 tweets
A Marm Kilpatrick Profile picture
21 May
How effective are vaccines vs severe & all disease, death, infection, & transmission?
Very nice collection of studies assessing different aspects of vaccine protection by Julia Shapiro (on twitter?) @nataliexdean @betzhallo @ilongini & 2 others.
Thread
medrxiv.org/content/10.110…
Study has data on many different measures of protection:
all infection (symp + asymp), all symptomatic (mild+severe), severe, hospitalization, death, & transmission,
for 8 vaccines: Moderna, Pfizer, Novavax, Astrazeneca, Sinopharm, Sinovac, Sputnik, J&J,
3 variants&
1&2 doses
For those wanting to understand relationships among different vaccine efficacy measures more, recent preprint @mlipsitch @kahnrebecca, lays it out nicely. doi.org/10.1101/2021.0…;
Read 17 tweets
A Marm Kilpatrick Profile picture
20 May
Should vaccinated people stop wearing masks?
Happy to contribute to article @B_resnick w @MonicaGandhi9 @AbraarKaran @DocJeffD @DrJeanneM
Short thread w/ my perspective on how to navigate CDC guidance on masks post-vaccination.

vox.com/science-and-he…
1st: Protection from vaccination is NOT 100% (no surprise to anyone that follows me to hear this)
So, despite being vaccinated, I'm still going to wear a mask in what I consider high(er) risk situations - indoors w/ dozens of households, unless community transmission is VERY low.
What is very low? My perspective: CA (where I live) has tiers based on daily cases/100K. Lowest tier is <2/100K. If we assume there are 5 infections/case & people are infectious for 10d, this translates to 1/1K. Pretty low. If everyone is vaccinated, risk ~10x+ lower so <1/10K.
Read 11 tweets
A Marm Kilpatrick Profile picture
4 May
Interesting thread @trvrb on growth of B.1.1.7, P.1, B.1.351 in US
I worry about key assumptions underlying these analyses:
-sequences are random sample of state/US infections (definitely not)
-trends in sequences represent local transmission rather than changes in imported cases
Many of the P.1, B.1.351 numbers are very low & introduced cases can make a substantial contribution to total count. Increased transmission elsewhere (e.g. Europe, S America) & constant introductions can lead to apparent increase in US for foreign variants.
In addition, increased detection of introduced cases can also bias results towards observing a local increase of an introduced variant.
Are cases (not frequencies) of P.1 really increasing in many states as @trvrb suggests? Possibly.
Read 6 tweets

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