The "D" in Delta stands for a detour in genomic mutations.
Instead of the prior major variants which had N501Y, and E484K for Beta and Gamma, this one took a different path in its spike RBD and other key spots (sequences at @scrippsresearch's /1
You can see (Delta, in orange) the marked differences from the other variants in multiple locations: receptor binding domain (RBD), N-terminal domain (NTD) and in S2 of the spike protein /2
graphic from @atelentia @Nature…
We don't know much about the functional significance of the mutations in Lambda (C.37), a variant of interest that emerged in South America, that is also on a new path…… by @Ecquis @NatGeo /3
Good discussion @TheEconomist on the evolution of the variants and their different mutations, N501Y, E484K, P681R, in the trimeric spike protein, and binding to our cells /4…
One thing for sure: we need to achieve global containment of #SARSCoV2 as soon as possible to avoid further substantive evolution (a term usually connotating slowness but it's been happening fast). Our upbeat perspective @NatureMedicine w/ @RobertoBurioni…

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More from @EricTopol

8 Jul
Just published @Nature
Delta variant protection by mRNA and AZ vaccines requires 2-doses, little neutralizing antibody (nAb) with 1-dose, and insufficient nAb with prior covid…
A couple of other points from the paper
The mutations unique to Delta (including other B.1.617 lineages, Alpha, Beta, Gamma) include T478K and other regions outside of RBD, highlighted
The large size of fused cells with Delta cf other variants
Read 4 tweets
5 Jul
Call for Full FDA approval of covid vaccines
The stakes could not be higher.
In print, @nytopinion… Image
The @US_FDA is unhappy about this essay. That's good. Maybe they will do something.
Perhaps @DrWoodcockFDA will even make a public statement?
Read 4 tweets
2 Jul
The @US_FDA's overdue full approval of mRNA vaccines is holding us back from getting millions of more people protected, at a time of urgent need, with the Delta variant on the rise. My guest essay @nytopinion… w/ thanks for editing @jopearl
I start off w/ the paradox of FDA's accelerated approval of the Alzheimer's drug despite a 10-0 vote against it by their Advisory Committee, 2 clinical trials that did not show clinical benefit, and for any person w/Alzheimer's even though the trials were for early disease, MCI
Then a brief review of the exceptionally large, completed clinical trials and real world evidence for these vaccines—the 1st ever new vaccines to get Emergency Use Authorization (EUA)—now given to hundreds of millions of people /3
Read 9 tweets
30 Jun
This likely represents the Delta variant inflection point for the US, as cases start to increase in several states (log plot to show trend). Let's hope the rise is limited and without much in the way of hospitalizations and deaths.
A lot more people vaccinated would sure help
Mississippi, the least vaccinated state, starts to show an increase in cases. Had dropped to 3.5/100,000 and now back up to 6/100K. Delta is now approaching dominance there; sequencing is limited.
Sequencing data from Mississippi. There's plenty of Delta (B.1.617.2) there now, but confidence intervals are wide
Read 4 tweets
26 Jun
The US is now over 30% Delta variant for new cases. So how could the 7-day average still be heading down, now at 3.2/100,000? Here compared w/UK trajectory, >93% Delta
There's no question that of the new cases in the US, many are Delta, but sequencing is minimal. The 30%+ is based on a limited sample (wide 95% CI) compared with the UK. Look at the numbers at bottom of US, UK graphs
The 30% Delta is very unevenly distributed. Missouri is >60% and is the hotspot of the US for new cases. Neighboring states Arkansas and Oklahoma are also heating up and have high Delta frequency.
Read 4 tweets
23 Jun
While the Delta variant case frequency for US infections is ~20% overall by @CDCgov, there's marked heterogeneity among states… by @nikasgari and @jburnmurdoch (@FT estimates Delta prevalence much higher 37-42%)
The 3 states--Missouri, Utah, Arkansas--with highest Delta variant prevalence are all increasing in cases, leading the country (still relatively low cases/capita rates), going in the opposite direction as most of the country /2
There are other states with some increase in cases where Delta is out-competing Alpha /3
Read 4 tweets

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