The Reassuring Data on the Delta Variant. By I and @LeslieBienen and @citizen_oregon . There are 3 things concerning about a variant - transmissibility, whether increased virulence & whether evades vaccines. Virus likely more "fit" which we explain wsj.com/articles/delta…
but to public, the delta will become the dominant variant if more fit. So, 2nd question is whether the delta is more virulent. Luckily, there is CDC publicly-available data one can download & look at this. 1st step is to show hospitalizations not increasing in kids with delta
Then one wants to look at regions with prominent delta prevalence in the US and ask whether "hospitalizations per case" is increasing to see if more virulent. Luckily, not the case as shown by the chart in the paper - actually hospitalizations per case less with more delta
Then third question is whether it evades vaccines which we have good real-world data on that the delta doesn't as below
And also some amazing immunologic research showing that evasion is unlikely with this variant
And the effectiveness of these vaccines in the US are being shown as we speak as the unvaccinated comprise 99% of those hospitalized in the US with COVID
So, what is there to do? 1) Increase vaccinations among those eligible in US which will protect those not yet eligible (children) and avert hospitalizations 2) Global vaccine equity to stop these preventable deaths and stop variants from coming
Similar points made in the @NYT today about delta variant doesn't seem to be more severe & need to increase vaccination nytimes.com/2021/07/15/bri…
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Wanted to address one thing before I come back since I live in SF & saw despair that masks recommended again as feeling like we took a "step back" as my friend @PCH_SF acknowledged in this piece. Know it feels disappointing: delta so fit, not expected sfgate.com/coronavirus/ar…
But thought you'd be interested in this from Israel on what they are calling "soft suppression" with the delta variant: not closing society as only high amounts of severe disease can do that (45 in hospital across whole country of 9 million) but doing 2 reuters.com/world/middle-e…
things: 1) keeping masks indoors for all, also normalize mask wearing for unvax'd (have pockets of communities not yet interested in vax); 2) tracking severe disease as main metric: tests are flawed (PCR without CT & cases not main metric with vax) jpost.com/israel-news/fo…
I know many would like to put back masks for the vaccinated; every county's jurisdiction. But I encourage you to try to understand why @CDCgov released masks for vax'd which was around effectiveness of vaccines (even with delta)/reduced transmission after washingtonpost.com/outlook/2021/0…
I know vax'd talk to each other; unvax'd talk to each other and we are not conversing but their reasoning was helping unvax'd become convinced to vaccinate. This seems even more important to me today - to use science to convince those still on the fence to please get the vaccine
After CDC said masks not needed for vax'd in May, uptick in vax. So, masking after vax should done based on your personal risk tolerance/immunocompromise/elderly, but consider psychology of messaging in this delicate period cnn.com/2021/05/27/hea…
I know I have a mixed twitter following which earns me ire, but the reason I was so impressed by the @CDCgov guidance on schools last Friday and the follow-up @CAPublicHealth statement was how in-person learning with mitigation was stressed so much because so important for kids
@CAPublicHealth opted for universal masking in schools in order to forgo distancing so that children could get back to school. I saw @sfchronicle editorial board saying this am that they did an "about face" on this but they did not, actually. @CAPublicHealth (@TAragonMD)
said they would clarify their messaging so doesn't fall on districts to interpret and enforce, which they will. With delta, mitigation indicated at first, they chose masks will clarify for districts a likely metric-based approach of when mitigations ease nytimes.com/2021/06/08/opi…
Nice explanation of why symptoms define real vax "breakthrough" @KatherineJWu: "Bungling messaging around shots’ astounding success has made it hard to convey the truly minimal risk that the vaccinated face & the enormous gamble taken by those" not vax'd theatlantic.com/science/archiv…
Good to check in with CDC breakthrough data in light of delta to see if same; hasn't budged:
Of >157 million people fully vax'd,
0.002% hospitalized with COVID-19
0.0004% deaths from COVID-19 (4 in 1 million) cdc.gov/vaccines/covid…
This Israeli study gives risk factors for a severe breakthrough infection among vaccinated- small number (152) because vax so effective but high rate of immunocompromise or severe other medical conditions. Good demographic for 3rd dose jpost.com/health-science…
You know what just hit me when I read about 100% of the patients in LA County public system in hospital with COVID being unvax'd or see this in SF much smaller numbers (unvax'd in hospital) or see data from around country that 99% of those in hospital are unvax'd?
The vaccines are extraordinarily effective (even against the delta variant) since the PHE England data said Pfizer 96% preventative against hospitalizations. And it reminds me of this yellow line from the clinical trials that show such high protection against hospitalization
Efficacy is the term for outcomes in clinical trial; effectiveness is what you see in "real life". And effectiveness mirroring efficacy (even with delta variant) is unusual for a drug or vax. CDC publicly-available data doesn't show increase in hospitalizations in kids
Thread on MOLNUPIRAVIR. First, what is this medication? First we should remember, there is not a highly effective outpatient oral treatment for COVID yet. There are tantalizing glimpses into other meds but they are still in clinical trials. So, let's explore this one.
Molnupiravir was not developed for SARS-CoV-2- originally thought of as a broad-spectrum antiviral because it is a "nucleoside analogs". We use those a lot in HIV but they basically inhibit the virus from replicating because this compound interrupts the process of copying
Remdesivir is a nucleoside analog that we use for inpatient treatment because it is intravenous. But what if there was an outpatient oral treatment that you could give to someone like Tamiflu (or in the case of HIV treaters, we give this type of med in combo with others)