COVID Update July 10, 2021: 2021 will be the year of the Unvaccinated Pandemic.

Vaccinated or not, there are implications for all of us. 1/
The most tragic toll will be in the countries that have not done mass vaccinations yet.

India, Australia, Bangladesh, E Asia, Africa— places that dodged COVID in 2020 and either couldn’t afford or didn’t make an effort to procure vaccines will pay the highest toll. 2/
In the US, we were racing against Alpha & largely beat it. But imagine if we had not. A new study from Yale points to 100s of thousands of lives saved & millions of hospitalizations by having vaccines beat alpha. 3/…
Take a moment to imagine that we were on the old schedule of vaccinations and still had only vaccinated a small portion of the country. Delta would wreaking havoc. Imagine if you were still prowling websites to get an appointment.

That’s what it’s like across the globe now.4/
Poor and intermediate income countries thanks to the US and G-7 & deals w Pfizer & others have billions of doses coming to them, but they won’t come quickly enough for Delta in most places. 5/
Imagine racing against someone who runs an 8 minute mile. That was 2020 COVID. Alpha runs a 7 minute mile. Delta runs a 4 minute mile.

In countries around the globe the time it takes to produce & distribute 8 billion more vaccines, or even several billion more, is too long. 6/
For many countries in the world 2021 the unvaccinated pandemic will be a bigger tragedy than 2020 was.

Tough measures, difficult to sustain, will be on order. We can assist with aid & equipment but we are going to feel quite helpless. 7/
Here in the US of course there are plenty of unvaccinated people, a number of partially vaccinated people, and people for whom vaccines could begin to wane. There are also breakthrough infections for vaccinated people.

Let me scope this briefly. 8/
(If you’re thinking this thread is already not brief, that’s a good point. Anyway…) 9/
There are people not vaccinated for a variety of reasons: by choice, because they’re considering it, or because it’s not available to them. 10/
People who have a condition that suppresses their immune response are everyone’s obligation to watch out for. Until we have an effective antiviral (which could be this Fall), precautions need to be taken around then. 11/
If you have a person with a condition like this that you are in contact with, you need to be vaccinated. They and you should consider wearing a mask and it should be N-95 or equivalent. 12/
Kids under 12 are another, but less worrisome challenge. They should be wearing a mask not withstanding their health outcomes are likely to be less severe & their risks are lower. The CDC & virtually every state believe in person education is safe with proper precautions. 13/
If you’re unvaccinated by choice & have never had COVID, you will race the 4 minute miler until you decide to get vaccinated.

If you have a question about it’s safety or efficacy, ask your doctor or a pharmacist (not someone on Twitter or Facebook). 14/
If you’ve only had one shot of mRNA or have had COVID but not been vaccinated, a good bet is that you are partially protected against Delta, but maybe only 1/3. 15/
If you’ve had any of the 3 major vaccines, your chances of getting sick with COVID or passing it along are low.

If under 50, the chance of dying from COVID are near zero and if over 50 are not zero but are tiny. 16/
(OK, it’s not at all brief but what do you expect I’m trying to be thorough & cover all situations. 🙄)

((Plus we both know you stopped reading at tweet 3))
Get your second shot if you only have had one. Delta is not impressed by one shot. 17/
If you have been vaccinated & live in an areas with high vax rates & low prevalence, you are very safe. You may choose to wear a mask for a variety of reasons but it’s safe not to. 18/
If I were in Las Vegas on the other hand, I would be wearing a mask.

I wouldn’t be in Las Vegas. 115 degrees & gambling with COVID isn’t my dream summer vacation. And if you’re going to Vegas, no need to stop by on your way home. Wave from the plane. 19/

In the US, cases are going to jump up from 10,000/day where it’s been back up to 40-50k. It could reach levels we saw last summer.

But with some exceptions I noted, it will be an unvaccinated pandemic in the US as well. 20/
Gratefully, many of the highest risk people have been vaccinated. The death toll won’t approach last year & overwhelmed hospitals, which contributed to mortality, will be less of a concern.

Delta is likely to afflict unvaccinated black & brown communities & those with higher risk factors the most lethally. 22/
Our vaccines are about as good a solutions as we could hope for. If you are lucky enough to have access to them, run don’t walk. 23/
If you know someone who hasn’t but who trusts your opinion, consider going door to door. I hear Congresswoman Green supports this. /end

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More from @ASlavitt

9 Jul
NEW: The CDC issues guidance on masking in K-12 schools for the Fall.

Vaccinated children do not need to wear masks; unvaccinated kids should per the guidance.

I know this raises questions & is a hot topic so I will hit a few points. 1/
It helps to begin with what CDC guidance is and what it isn’t. It provides the best recommendation based on the science but allows states, schools & individuals in some cases to weigh other factors. 2/
For example, CDC doesn’t set out to address the question of how to tell who’s vaccinated & who isn’t. Or other factors like school ventilation & desk configuration— all of which the speak about as “layers” of protection. 3/
Read 8 tweets
9 Jul
COVID Update: I deeply regret that we live in a world where I have to respond to Marjorie Taylor Greene.

But alas… 1/
Greene is now comparing Biden’s vaccination program to her new favorite topic: yes, Naziism.

The latest chapter in her Holocaust education fetish is not encouraging.

Cc: @HolocaustMuseum 2/
No one is in danger of asking Greene to teach a history class (or a public health class) (with the exception of Texas) anytime soon.

But she did learn one lesson well from the Nazis: dangerous propoganda. 3/
Read 11 tweets
8 Jul
NEWS: Pfizer to submit application for COVID specific booster to FDA. More here shortly.

Follow here if interested.
Having had a few conversations with the company and others about this, here is what I know. 2/
The first question is whether a booster will be needed and Pfizer believes that there is a significant boast in immunity if a third shot is given after 6 months.

This may be particularly useful among older people who are immunity wane faster. 3/
Read 13 tweets
6 Jul
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/
Read 16 tweets
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

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