Thread by @MonicaGandhi9

I & others quoted in this LA Times article about the effectiveness of the vaccines against the delta variant (and LA & masks): Dr. Fauci "“If you are vaccinated, you have a high degree of protection — so you need not wear a mask, either indoor or outdoor"
latimes.com/california/sto…

Dr. Ghaly: "The data is clear: Nearly all new COVID-19 hospitalizations and deaths are preventable. The vaccines work and they protect us,” Me: "The rise in coronavirus cases in Israel may reflect the healthcare system there still testing...

vaccinated people for coronavirus infection, even if they have no symptoms.". If no symptoms & low viral load in nose (like 5 studies have shown us now), " I don’t call that a vaccine failure. I call that a success, because that’s exactly what your vaccine is supposed to do.

"It’s fighting the infection in your nose and bringing down the viral load, and you don’t get symptoms,” But in India during 2nd wave, "“If you’re surrounded by a lot of virus, like you would encounter when community transmission was high, vaccinated more likely to get a

‘breakthrough’ infection,” I say. Context everything at this point. With high rates of vax/immunity like in US, delta mainly limited to unvax'd & not circulating as high inoculum. WHO (11% of world fully vax's) has to give different recommendations than high vax places. Context

And if you test asymptomatic after vax more with surge testing, whatever variant is more fit (delta) will be one in nose like in this UK article (still calling it "India variant" (bbc.com/news/uk-englan…); critical to incorporate CT value to call "case"

https://twitter.com/MonicaGandhi9/status/1395572466949365761

Heard rumor @CAPublicHealth may follow LA County. My concern is that illness with delta occurring in unvax'd adults (children don't seem at increased risk); want to encourage vax. Telling unvax'd masks are needed with delta tells them vax doesn't work
washingtonpost.com/outlook/2021/0…

Moreover, concerned about impact on school openings if we essentially say all vaccines (including J&J which covered earlier) don't work to protect you & others. Why do we know vaccines reduce transmission? Many studies at this point show it but always had biological plausibility:

Many studies at this point show asymptomatic infection reduced massively by vaccines, which is how you transmit without knowing

Then study after study showing CT values of the PCR tests low if do swab noses of asymptomatic infection after vaccines and even if there is a mild breakthrough infection with cold like symptoms, 40% less viral load there
nejm.org/doi/full/10.10…

Then if you swab asymptomatic individuals after vaccination (like UK does and continues to do), CT values high. CT means cycle threshold. PCR machine has to go through many cycles if CT high to trigger machine as +, meaning viral load low, not infectious
sciencemag.org/news/2020/09/o…

Largest study to show: UK does much screening of vax'd. In SIREN study, 88% reduction in having virus in nose if exposed after vax where CT >30. That value is cut-off of when likely to spread it. So if asymptomatic, not likely to transmit- is that a case?
medrxiv.org/content/10.110…

Suggest CA follow hospitalizations closely now as severe disease uncoupling from cases. Moreover, if cases of delta occurring in unvaccinated pockets, would encourage vax among unvax'd with motivating messages (CDC mask guidance encouraged vaccinations)
time.com/6051290/cdc-va…