#Immunology General concepts:
1. A virus rampantly spreading will tend to mutate, and
2. 'natural selection' principles select the most transmissible strains that'll predominate.
3. Under a vaccinated population environment, the selection is towards a vaccine resistant strains!
The predominate strain will then be more transmissible, and develop vaccine resistance properties.
@pfizer and other vaccine scientists need to continue to sequence and test for the evolution of SARS-CoV-2 against transmissibility and vaccine resistance properties
@CDCDirector
Staying ahead of this is vital.
Our ability to preempt such vaccine resistant viral strain emergence by modifying the mRNA coded in our current vaccine is crucial if we hope to avoid another more severe pandemic.
@EricTopol @PeterHotez @CDCgov
medrxiv.org/content/10.110…
As long as this virus is given the rich medium to rampantly spread and multiply, it WILL mutate & naturally select for the most transmissible strain AND mutate to defy the host's defenses. So eventually the vaccinated folks will encounter 'selected' strains that'll propagate!
The attached article is a window of what may come and what we must understand to model viral vaccine resistance and prepare a winning approach.
The unvaccinated are such rich medium for this variant which takes 3.71 days, vs alpha strain 5.61, to reach titers 1,260X that of alpha
What will it take for you to get vaccinated?

It's novel, it's mutating and, as a result you're seeing perhaps from six months ago, you're seeing a very different strain or variant which might be more severe, so it’s important for people to get vaccinated right now.
The #DeltaVariant is so 'sticky' and comes at you with 1,260 times the viral load than the Alpha variant.
That means it enters your nose or airway (or even eyes) and hits you very hard
The vaccinated are protected against hospitalization
The unvaccinated are not
#GetVaccinated

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More from @MdFacep

Jan 9
If yet another mutation or variant of concern surges that more completely evades the antibodies people have built up, “we start all over,” ---Dr. Gregory Poland, head of the Mayo Clinic's Vaccine Research Group 1/4/2022

I stress that mutations happen during rampant surge
Omicron has an enhanced and focused affinity for the upper airways, replicating 70X more than delta and not invading the lower airway.
The resultant edema, inflammation, increased secretions are presenting as bronchiolitis, RAD, bronchospasms, and croup depending on the age group
It is predicted that the next variant of concern WILL arise before June of 2022.

The unprecedented explosive surge of new cases is the perfect petri dish for Omicron's next variant.

I keep citing basic principles in virology and immunology that so many clinicians forgot
Read 11 tweets
Jan 9
A week of attending duties and monitoring the trends across The US- Here is what I observed:

US has 93-97% Omicron now
Some states went this week from 10% to 66%
All should be at 97% by next week.
Hospitalizations rising.. For and with about 55% & 45%
The Booster raises your protection of reinfection & hospitalization close to 90% in > older than 65.

The problem is anything less than 3 dose (boosted) reinfection is very likely & hospitalization is about 5-10% of infected depends on risk status

US has only 36% boosted people
That means Omicron has about 256 Million people who aren't 3 dose, or boosted to go through.

I expect those vaxxed X2 w/prior infection to have less severe illness, and if not high risk, not be admitted

those less than 2 dose and PI, are most vulnerable

Get the booster!
Read 5 tweets
Jan 8
Stop calling Omicron "mild".
It is NOT. In fact it is a major public threat and here is why: Allow me please,

Omicron is more infectious than Delta by a factor of 2.7-3.7.

If you are recovered from previous infection, chance of reinfection w/ Omicron is 5.4 times that of Delta
Researchers at UKHSA and NHS estimate the growth and immune escape of the Omicron variant in England.

They used data from for all PCR-confirmed SARS-CoV-2 cases in England who had taken a COVID test between November 29th and December 11th 2021.

They tested for Omicron..
They separated all non-Omicron case.

They use S-Gene Target Failure or genotyping as Omicron ID signals.

They found the proportion of Omicron among all COVID cases was doubling every 2 days up to December 11th.

Positive patients reported disease severity (how bad they felt)
Read 11 tweets
Mar 23, 2020
1/The absolute key to beating this pandemic is testing to identify any and all positive patients, isolating them until they test negative. This will temporize the pandemic allowing us time to develop therapeutic drugs, study therapeutics in clinical trials, and develop a vaccine
2/Lessons from Singapore and Wuhan,China should serve as lessons for us here. Containment is always the primary objective. Let us not give up on containment.
Mitigation is not appropriate for #coronavirus. That maybe okay for the flu, but not #COVIDー19
3/ We must test, test, and test some more. We must identify all positives and isolate them until they test negative. We must use technology and track all their potential exposed contacts and test/quarantine them. Social distancing, lockdown, and testing will contain this disease.
Read 4 tweets

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