Thread by @ASlavitt

COVID Update: A strategy I deploy & recommend when there’s a new study, particularly with explosive headlines about COVID.

It’s the same strategy I deployed last year when reading about how promising the vaccine trials were.

Wait it out a bit. 1/

We are all subject to that sinking feeling of seeing the headline:

“Study shows variant gains strength”
“Do the vaccines work against Lambda?”
“Breakthrough cases increase.”

Makes your ❤️ drop. None of us wants to relive the last year & that often flashes through our minds. 2/

There’s no doubt that these can be upsetting to see. In our minds, we want to compartmentalize COVID as either a threat or not a threat & it’s confusing to feel in between. 3/

But I can’t tell you how many times I see a worrisome headline overnight or in the morning & by afternoon (after I’ve called Fauci, the CDC & other scientists as I often do), it turns out to be far less concerning or at least proportional. 4/

The difference between this year & last year if you’re vaccinated is like the difference between climbing a mountain with no equipment & no visibility and climbing with the best safety equipment possible.

Nothing’s perfect but we have the tools to be as safe as possible. 4/

Last year any false move— intentional or accidental— could result not only in getting sick, but in furthering the chain reaction.

Now, getting sick is something we can protect ourselves from. 99.2% of COVID deaths are from people who are unvaccinated. 5/

This doesn’t mean that there won’t be breakthrough cases or more troubling mutations, or regional outbreaks.

There will be all of those things & we should take precautions. 6/

When I see these pre-prints, there are a couple of things to watch out for in these studies that aren’t as bad the headline writers write them.

Here’s a few from the last couple days. 7/

“A higher percentage of cases among vaccinated people”

—this has to be the case definitionally. As more people are vaccinated, a higher % of cases will be with vaccinated people. (If everyone was vaccinated it would be 100%.) The vaccine effectiveness is what matters. 8/

“Much more asymptomatic spread than we thought.” 9/

As we do regular testing & contact tracing we will find many more asymptomatic harmless cases. Doesn’t mean there are more necessarily. This is in the “if a tree falls…” school. Getting sick is what we should measure. 10/

Sports teams & other occupations or events with regular testing will show more asymptomatic and mild cases that we wouldn’t have seen. 11/

“Rapid spike in cases.”

This is a tricky one. In 2020, whenever there was a spike in cases, we knew it would be followed by hospitalizations & deaths. Now, we could very well see spikes in cases, but the cases are mild & we don’t see that rise.

The time lag is tricky here. 12/

The UK is seeing a spike begin in cases that could reach 10s of thousands. That is likely to happen here as well at some point.

The big question is whether hospitalizations & deaths follow.

(In Israel, there have still be only 35 serious cases & no deaths in over a month.)13/

Real bad news will sadly be with us for a while. Many are unvaccinated around the globe and will be for another year. There will be massive tragedies until this changes.

Here in the US, unvaccinated people are going to also be at risk. 14/

But the vaccines … those are as effective at hitting the target with as low a complication level as anyone could have imagined and so far, nothing has shaken that. 14/

Tomorrow tune into @inthebubblepod for my special conversation with @ScottGottliebMD. We cover all the scientific & policy ground you can imagine including potential reactions to real concerns if they emerge. /end