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

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More from @ASlavitt

6 Jul
COVID Update: There is potentially news out of Israel worth paying attention to.

One implication is when it makes sense to boost again in the US. 1/
Some very preliminary data shows a reduction in vaccine efficacy to mild disease— potentially somewhere between 60-80% (still >90% vs serious). 2/
Does this mean Delta is evading vaccines more than we thought? Data on the vaccines v Delta is still quite solid & this could be an outlier.

But if the data hold, the most likely conclusion is not that Delta is escaping the vaccine. It’s closer to the opposite. 3/
Read 11 tweets
4 Jul
COVID Update 7/4/21: Today is the day early in the Biden Administration where the president hoped Americans would be able to gather in small groups again after 18 months.

The odds did not seem good back then & many were skeptical but we were motivated by what we couldn’t see. 1/
It’s almost hard to remember what a shit show (sorry) it was 6 months ago. No vaccines in inventory, no appointments, bizarre rules to qualify, not enough places or vaccinators. And only 40% said they would take a shot if they could get one. 2/
When we got there, the public had been told 100 million would be vaccinated by the end of January. No one trusted a thing they heard.

I was asked to speak to the public on a regular basis. Biden had one expectation. Tell people the truth, whether the news was good or bad. 3/
Read 18 tweets
1 Jul
1/ COVID Update: Summer 2021 and the Delta variant, mask wearing and “following the science.”
2/ That phrase “following the science.” What does it mean?

It means relying on the data
It means using the best judgment we have at the time
It is useful that help us assess risk, not provide guarantees

What doesn’t it mean?
3/ It doesn’t mean:

Providing us certainty when none exists
Saying there is zero risk
That there won’t be adjustments as more is learned
Read 14 tweets
24 Jun
I want to talk about the Biden’s $1.2 trillion infrastructure bill & what it means.

Some will say this bill represents “only 2/3” of the American Jobs Act proposals. Yes it reflect compromise.

What do we get in exchange for that compromise? So much.
Big picture:
1-This is the first infrastructure bill in years. It has always theoretically been of interest to both parties but no one could get it done.
2- This is a show of strength for a functional democracy when we badly need it.
3- There is more that can be done as needed.
In substance:
This is the most significant investment in green technology in history:
-A national electric of 500,000 vehicle charging stations including rural communities
-largest federal investment in public transit & passenger rail in history
Read 7 tweets
24 Jun
I want to reflect on a simple conversation I overheard. It reminds me that this last period of time has been so hard for so many. And we are still on edge because the crisis was so unexpected & the diminishment of risk feels so uncertain and so many people are still at risk.
This week @askdrfitz asked a man (Richard) at federal vaccination center what he planned to do now that he was vaccinated for an upcoming @inthebubblepod.
Richard has worked in food services his whole life. He thought before answering her & said maybe he would find a way to go part time.

When asked why he said “You know I have some deferred dreams.”
Read 8 tweets
29 Mar
Know a person who hasn’t made up their mind yet on getting vaccinated.

Why get vaccinated in 4 slides of data.
1. COVID-19 is far worse than the flu in the number of severe and critical cases. Even if you are part of the 1/3 without symptoms, you help the virus find people in the yellow & red bars.
2. The clinical outcomes from COVID-19 can effect you or those you inadvertently infect in so many different ways.
Read 5 tweets

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