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Monica Gandhi MD, MPH Profile picture
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7 Jul, 7 tweets, 3 min read
Let's be perfectly clear about the delta variant in our reporting, please- this strain is not spreading like wildfire across the US. This strain is spreading in highly unvaccinated regions without natural immunity. Please look at orange map in link below
covidactnow.org/?s=2016935
Clear reporting provided here (as always) by @DLeonhardt from the @nytimes in the article below. "In many urban and suburban communities, Covid continues to plummet. The rate of new daily cases has fallen below 3/100,000 residents in large cities like ...
nytimes.com/2021/07/07/bri…
Atlanta, Boston, Chicago, Detroit, Houston, Minneapolis, New York, Philadelphia, San Francisco and Washington.". Since I live in SF, news reporters ask me if our unvax'd children are safe from Covid - I say yes, please look at transmission + vax rates ("wall of immunity")
"Spreading in Arkansas and Missouri (each with >16 new daily cases/100,000 people) followed by Florida (10), Nevada (10), Wyoming (nine) and Utah (eight)".
Are you safe if vaccinated? Yes, I hope data from UK & Canada over last week (along with Ab, T cell data) convinces you
Are you safe if unvaccinated? No, there are hospitalizations, tragic deaths at a time when we have the solution (vaccines). Nothing that shows the effectiveness of the vaccines better than this graph against the worst outcome of Covid (otherwise, we would know it as a cold)
Have we done a good job at convincing people to get vaccinated? No, and we have to puzzle through how we can - with compassion, education, convenience, access, giving time off, kindness- message better. More than 3.2 billion doses of vax have been given
nytimes.com/interactive/20…
out worldwide & deaths from COVID plummet in places where that is so; the vaccine safety is shown by the sheer numbers of people who have received without incident & the effectiveness is clear. Now is hard part: message with compassion, clarity, acknowledge natural immunity/fear

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More from @MonicaGandhi9

Monica Gandhi MD, MPH Profile picture
8 Jul
Wanted to explain one more thing before I go for my break which is the difference between what T cells and antibodies do for you in terms of protecting you against COVID. T cells protect you against severe disease. We have already gone over how variants
rupress.org/jem/article/21…
unlikely to evade T cell immunity since 80-100 T cells line up across the spike protein so 10-13 mutations of variants can't evade that many T cells. You have the data in the T cell thread but here are the 2 best papers on this- 1st here
biorxiv.org/content/10.110…
Here is the 2nd paper on this. Variants can't evade our T cell response so we are protected against severe disease. That is why vaccines 92-100% protective against severe disease in the real-world or the trials variants or not
cell.com/cell-reports-m…
Read 10 tweets
Monica Gandhi MD, MPH Profile picture
5 Jul
Why is stressing vaccines work against delta so important? Because they do & because understandably saying they don't is making "anti-vaxxers" say don't take vaccine. I & Dr. Shafir & Dr. Hotez @PeterHotez interviewed for this piece
motherjones.com/politics/2021/…
"While the Delta variant is worth taking seriously—it does spread more easily..there isn’t enough evidence that it is deadlier than other strains. Crucially, they emphasized that the vaccines are proving to be powerful tools against Delta and other variants of this virus."
So far, "data also indicates that breakthrough infections, when they happen, tend to be mild or asymptomatic. In a recent study published in the NEJM for instance, researchers followed nearly 4,000 frontline workers for four months beginning in late 2020"
nejm.org/doi/full/10.10…
Read 4 tweets
Monica Gandhi MD, MPH Profile picture
5 Jul
"Britain’s recent rise in cases [many due to delta] has yet to be followed by a commensurate rise in hospital admissions or deaths. ..the widespread deployment of vaccines .. has weakened the link between infection and serious illness" so reopening 7/19
nytimes.com/2021/07/02/wor…
You can see that uncoupling here:
Or here is a nice illustration of this effect that vaccines are delinking cases from hospitalizations in the UK from the BBC (which is why following case counts is no longer the reliable metric of subsequent hospitalizations it used to be before vaccines) Image
Read 4 tweets
Monica Gandhi MD, MPH Profile picture
3 Jul
J&J VACCINE AND VARIANTS: Wanted to go over paper from yesterday. 19 million worldwide have received 1 dose J&J (including health care workers S. Africa as condition of trial who are seeing a lot of virus right now with high rates community transmission)
biorxiv.org/content/10.110…
Remember about J&J which is that - in its phase I/II clinical trial, antibody and CD4/CD8 (T cell) responses increased over time. Not that high at 2 weeks (which may account for lesser effectiveness in ENSEMBLE trial when looking at that time point)
nejm.org/doi/full/10.10…
Immune response increased over time out to 59 days when phase I/II stopped reporting. So, this study took participants from ENSEMBLE who had received 1 dose J&J (n=8, 47-91 years, 71 days after shot) and exposed their blood (test tube) to variants (alpha, beta, gamma, delta).
Read 7 tweets
Monica Gandhi MD, MPH Profile picture
3 Jul
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.
Read 13 tweets
Monica Gandhi MD, MPH Profile picture
2 Jul
"The Delta variant, which is now responsible for most coronavirus infections in England, is not driving a surge in the rate of hospitalizations there, according to data released by Public Health England on Thursday."
nytimes.com/2021/07/01/hea…
"The data suggest that countries with high vaccination rates are unlikely to see major surges in hospitalization rates from Delta. Nearly 75% of adults in England — including 95 % of those 80 or older — have had at least one shot, according to the agency’s numbers."
Here is the direct link to the PHE report discussed by the NYT today
assets.publishing.service.gov.uk/government/upl…
Read 4 tweets

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