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Eric Feigl-Ding Profile picture
@DrEricDing
Jul 11, 2021 • 27 tweets • 14 min read • Read on X
⚠️New #COVID19 recommendations amid spike in #DeltaVariant ➡️All Mississippi residents ages 65+ & anyone with chronic conditions, should avoid all indoor mass gatherings **regardless of vaccination status**. Good. Delta is ~4x more severe than old strain🧵 mississippitoday.org/2021/07/09/msd… Image
2) The rapid rise of Delta variant cases and virus outbreaks combined with the state’s low vaccination rate led the Mississippi Department of Health to release a slew of new COVID-related guidelines on Friday.
3) The new recommendations, which will stay in place through July 26, also include:

📍All unvaccinated Mississippians wear a mask when indoors in public settings.

📍All Mississippians 12 years of age and older get vaccinated.
4) State Health Officer, Dr. Thomas Dobbs, said that these were decided on because Mississippians collectively have not done what it takes to protect us all, and wants to give the most vulnerable individuals the best guidance so they can survive Delta surge the state is facing.
5) “At this pace, and given the sort of external dynamics that are in play here, we’re going to remain vulnerable for a long time,” Dobbs said.
6) “I don’t think that we’re going to have some miraculous increase in our vaccination rate over the next few weeks, so people are going to die needlessly.” ⚠️
7) “And so when we look at who our most vulnerable people are, it’s going to be the people 65 and older, or who have chronic medical issues.”
8) Where is the evidence that #Delta is ~4x or more severe than old strain? There’s actually 3 studies. One key study from Singapore Ministry of Health actually found #DeltaVariant to have 4.9x higher odds of oxygen, hospital admission, or death!

europepmc.org/article/ppr/pp… ImageImage
9) In this same study, the Singapore researchers found #DeltaVariant to have much higher viral load than other major strains. Thus, the higher severity is indeed very likely. Both lab and epidemiology supports it. This is also likely one reason why Delta is so transmissible too Image
10) Before i add more studies on #DeltaVariant in this thread 🧵, I want you all to consider that all these countries are more vaccinated than Mississippi and other Southern conservative state. Yet they are still seeing rapid surges. And accompanied by hospitalization ⬆️ in 🏴󠁧󠁢󠁥󠁮󠁧󠁿
11) “2 dozen” countries with **near vertical rise** in #COVID19 cases. Let that sink in. #DeltaVariant is damn serious.

12) We honestly need to mask regardless of vaccination status too. Here is direct proof, again from detailed analysis from Singapore. Lots of transmission events from vaccinated to unvaccinated.
13) Also notice the large number of asymptomatic transmission (many among vaccinated) in the Singapore outbreak analyses. This is why we need to mask - and do more testing in hotspots even when no symptoms. Masking vaccinated is key to stop chains of transmission to unvaxxed. Image
14) before I hear one more nonsense comment about “vaccines don’t work”, I want to share this ⬇️. Umbrella ☔️ example is best — it does protect you from rain, but not all water. Doesn’t mean umbrella is useless. You should wear a raincoat (mask) and water resistant clothes too.
15) and in this case with surging #DeltaVariant (equal to a violent thunderstorm ⛈ coming in), you need to do all protective measures: vaccinate, wear mask, ventilate, air disinfection, mass test, contact trace, avoid indoor gathering, and shield elderly. #Delta going vertical. Image
16) And indeed, sick frail older folks who are vaccinated are possibly much more prone to #COVID19 infection after vaccination. A preprint. Though note, it doesn’t mean young people don’t get breakthroughs (just not due to these factors). medrxiv.org/content/10.110… Image
17) But but but… do these elderly vaccination breakthroughs cases lead to hospitalizations??? …unfortunately—YES. The authors note: “Post-vaccination infection in frail older adults was not entirely benign, with 30 out of 120 (25%) in this group presenting to hospital.” Wow. ⚠️
18) Okay, more good news & bad news from the same study:

📌Good news—vaccines prevent infections & hospitalizations overall

📌Semi-good / Semi bad news—vaccines increase the likelihood asymptomatic infections. Good it’s mild, but bad for testing pickup & stopping silent spread! Image
19) Why is asymptomatic infections so bad even if it’s mild? Because the properties of a silent #COVID19 infection means it’s less likely to be testing identified & less likely to be isolated to stop it. This is why vaccinated people (many asymptomatic) must mask! CDC is wrong!
20) this is why I staunchly stand by my comments in May…

📍Doctor says CDC "made a grave mistake" with relaxed mask guidelines.
21) Both WHO and Los Angeles and California Capital all recommend that vaccinated people should mask while #DeltaVariant surging. CDC does not. While I love CDC, the @CDCDirectoris wrong here. CDC much change directions while #DeltaVariant is surging.
22) Even if your country is vaccinated heavily, you’re not immune from #DeltaVariant causing hospitalization and deaths. As reminder, all critical indexes of hospitalizations, ICU ventilation beds, & deaths all rising in England 🏴󠁧󠁢󠁥󠁮󠁧󠁿! Elderly & vulnerable are at high risk. ImageImageImage
23) Sobering— “I’m hearing from my ER colleagues what they are facing now is worse than the surge they faced during the winter,” @meganranney said. #DeltaVariant summer winter is coming. wpri.com/health/coronav…
24) Sporting events are also very risky for high risk elderly folks, and those immunocompromised or have chronic diseases. Don’t risk it. Tell your family it’s too risky amid #DeltaVariant surge.
25) #DeltaVariant is more severe damnit! Forgot to add the other two severity studies— UK data from England and Scotland found 2.4x and 2.6x higher risk of hospitalization than #alphavariant, which is already 64% more severe than older. Thus 1.64*2.5x = Delta is 4x more severe!⚠️
26) Don’t believe me? Just read the exact report from UK govt scientists on #DeltaVariant severity…. The ~2.5x more severe than Alpha / ergo 4x more severe than older strains, is on par with Singapore data of ~4.9x more severe (see post #8 above).
27) we need to shield unvaccinated kids too… 7 kids in the ICU in one small state like Mississippi means countless at risk nationwide while #DeltaVariant surges.

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More from @DrEricDing

Eric Feigl-Ding Profile picture
Feb 26
BREAKING—FDA suddenly cancels meeting to update next season’s flu vaccines, with zero explanations. Any delays will jeopardize next year’s vaccine supply chain. Image
2) Folks who follow me know that I’m no bullshitter. I criticized past pandemic response right and left, and have called balls and strikes without bias. And I often say things that doctors & epidemiologists are whispering among themselves but don’t say publicly. (Cough cough) ⬇️
3) While I don’t recommend hoarding… I think stocking up on flu antivirals, which you can obtain prophylactically (preventively) from doctors if you ask nicely why you’re high risk, can be a good idea. I know many doctors, epidemiologists and virologists who do for their family.
Read 6 tweets
Eric Feigl-Ding Profile picture
Feb 26
Doctors are debunking RFK Jr’s claim that 20 hospitalized measles cases in Texas are there for mainly quarantine. Doctors on the ground say the 20 kids hospitalized are having trouble breathing. Oh and they are all unvaccinated against measles, which RFK Jr neglects to mention. Image
2) RFK Jr told Trump today there’s now 2 measles deaths.
3) RFK Jr is a tear with his FDA today. A dark Darwinian future lies ahead for America.
Read 4 tweets
Eric Feigl-Ding Profile picture
Feb 26
BREAKING—Reports coming in about potentially *2 measles deaths* in Texas, not just one, according to an HHS briefing to the White House today.
2) Earlier today, one measles death in an unvaccinated child was reported in Texas. Image
3) It seems to be RFK Jr who said it in an official Trump WH cabinet meeting today. Not saying he doesn’t lie, but he is now HHS Secretary
Read 6 tweets
Eric Feigl-Ding Profile picture
Feb 21
Woke or biology? There are actually more than the basic “male” XY & “female” XX sexes. Why? Because biology also creates people with single X chromosomes, or extra chromosomes like XXX, XXY, XYY, or XXX+, plus many 🧬genes. 👉All I’m asking is— please be kind to others. Thanks🙏 Image
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2) “The most frequent SCAs include Turner syndrome (45,X), Klinefelter syndrome (47,XXY), Trisomy X syndrome (47,XXX), and Double Y syndrome (47,XYY).”

pmc.ncbi.nlm.nih.gov/articles/PMC10…
3) “The phenotype seen in SCAs is highly variable and may not merely be due to the direct genomic imbalance from altered sex chromosome gene dosage but also due to additive alterations in gene networks and regulatory pathways across the genome as well as individual genetic modifiers.”
Read 5 tweets
Eric Feigl-Ding Profile picture
Feb 16
I'm shocked a lot of doctors don't know about this newer flu antiviral drug called Baloxavir (XOFLUZA)... that shortens your flu illness by 33%, and reduces your viral load by day 2, versus what a placebo takes 5-6 days to achieve. Baloxavir also seems superior to TAMIFLU (oseltamivir) for smashing your viral load on 2 day, achieving what takes Tamiflu 3-4 days. CDC even lists Baloxavir on their website as one of the top 4 drugs that it tracks whether it works against new flu strains (it works)Image
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2) "Baloxavir was associated with significantly more rapid declines in infectious viral load than placebo or oseltamivir (Figure 3A and 3B)."
nejm.org/doi/full/10.10…
3) Adverse events for baloxavir were no different than placebo. in fact theres even hints that it could be lower than Tamiflu.

"Adverse events that were considered to be related to the trial regimen were more common in oseltamivir recipients (8.4%) than in baloxavir recipients (4.4%, P=0.009)"Image
Read 13 tweets
Eric Feigl-Ding Profile picture
Feb 14
⚠️WORST FLU SEASON ever since 2002-2003 when we began to track flu (red, first graph). Worst hit this year are children ages 0-4 and 5-17. ▶️We also have significantly LOWER flu vaccine uptake this year, one of the lowest flu vaccine coverages (red 3rd graph). Indisputable facts. Image
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2) I don't need to tell you that certain US states have vastly lower vaccination rates than others. See map (lighter green, less flu vaccination coverage), and which have higher (darker green)...

If you want to see details and demographics on which state has the LOWEST flu vaccine coverage rates... the data is here.
cdc.gov/fluvaxview/das…Image
3) It’s not just the flu that is going around… Gaines County, TX, where the epicenter of the measles outbreak is, has one of the lowest measles vaccination rates too.
Read 7 tweets

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