Vaccinations have fallen off a cliff

We are now administering about 500K shots a day -- half of them 2nd shots

At this rate, it'll take about another year to get to 80% fully vaccinated

But we can do better than that if we do a few things

Short thread
If we continue vaccinating 250K new folks/day, yes, it'll take another year to get to 80%

But of course, as we vaccinate,

remaining population gets harder to things will slow further

So what to do?

First, it'll help to get kids 5-11 eligible -- probably fall

But that won't be near enough

So what will help?

1. Continue reaching out to unvaccinated, answering questions, improving access

2. FDA full approval. Yes, this will help a lot

3. Schools & businesses creating virus-free spaces through vaccination requirements

The truth is that we are just beginning our surge with the Delta variant

Cases, hospitalizations, and deaths will rise

Confidence in business, travel, restaurants will fall

And people will pull back economically as hospitals fill up

If we want to put this behind us

And if we don't want to continue to have public health measures (masks, distancing, etc.)

Then work places, schools have to mandate vaccinations

Or we just wait another year until our current approach gets us to the finish line


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More from @ashishkjha

10 Jul
Don't love to see this

Infections up nationally -- about 50% from two weeks ago

This is the Delta variant now widespread

Test positive from 1.7% --> 3.2% nationally

But this is not the whole story

Infections increasing in 22 states
Holding steady in 15
Falling in 13

Here are your three most vaccinated states -- still low, holding steady

Combined, Test + around 0.6%

And your three lowest vaccinated states -- not great

Combined, Test + around 6%

But even in states with moderate degrees of vaccinations, cases are rising
Thankfully, unlikely to see run on hospitals nationally

Because most high risk folks vaccinated

But more infections, hospitalizations unfortunately on the way unless we:

1. Employ public health measures again (masks, distancing etc)

2. Get 60-65% of population vaccinated

Read 4 tweets
8 Jul
As of today,

4 "green" states on @CovidActNow map

3 New England states & South Dakota!

Why green? Because they have very low numbers of infections

How? Largely from population immunity

Lets compare VT and SD -- two states that took different paths to get here

Vermont and South Dakota are actually very similar

Both have slightly older, white, rural populations

Have comparable median incomes

Both have Republican governors

And these days, they look super similar on infections

Here they are over past 2 months

But here's where they diverge

Vermont has vaccinated (1+ shot) nearly 75% of its population

SD? 50%

Vermont has a high degree of immunity through vaccinations

So how does SD have high population immunity?

Prior infections

Here's how pandemic has played out in both states
Read 5 tweets
7 Jul
If you're fully vaccinated, should you wear a mask indoors?

@WHO, LA Health Dept say yes

CDC says no

Who is right?

Well, it turns out, its nuanced

It depends largely on where you live...and your risk tolerance

My latest op-ed in @BostonGlobe…
Think of getting vaccinated like getting a great hockey goalie

Like Gerry Cheevers, who blocked 90% of shots on goal

That's like Pfizer: prevents about 90% of infections against Delta variant

So is that good? Yeah

But 90% isn't 100%.

So question is: 90% of what risk??

If you're in N England, where vaccination rates high, infection rates low

You're unlikely to encounter the virus

But if you do, 90% protection against a small risk is a tiny risk

And you can skip the mask if you want

But if you're in SW Missouri....

Read 7 tweets
28 Jun
Watching Delta variant take off across world

What will it take to control it?

Vaccines & public health measures of course

Here in US, we're abandoning PH measures (masks, distancing)

So vaccines

How much?

My estimate: 60% of Americans fully vaccinated

We're at 46%

So why is 60% a reasonable estimate?

Well, lets begin with R0 of Delta

Best credible estimates suggest its around 5

If you had no public health measures, need 80% population immunity to stop spread of the virus

Immunity comes from two sources:

Prior infections

If 46% have been fully vaccinated,

means 54% not yet fully vaccinated (math!)

But (and this is surprisingly contentious), folks with prior infection obviously have some degree of immunity

Let’s assume they have as much immunity as vaccinated people (I'm not sure they do)

Read 12 tweets
25 Jun
US has done well on vaccinations

Will it be enough to ward off spike from Delta variant?

Let's look to UK for to peek into our future

A month ago, UK had half the cases (per capita) as the US

Delta was starting to take hold in UK

See graph (US in blue, UK in red)

Then, over past month, Delta became dominant in UK

So what happened?

See graph

UK's infections increased nearly 6X in the past month or so

And UK cases now 5X that of the US!!

Ah you say -- that's infections. But surely no impact on hospitalizations!

Actually, hospitalization in the UK are also up

Up nearly 80% from a month ago

With no signs of slowing down

So that's not great

But surely given that UK has vaccinated all of its high risk folks, deaths are falling?

Read 7 tweets
18 Jun
Important study out of UK

Worth your time

Researchers examined brain MRIs of people before and after they got COVID, matched with controls

What did they find?

Substantial loss of grey matter in those who had gotten but recovered from COVID

Loss of grey matter (thickness and volume) suggests damage to areas of the brain

Which areas?

Areas involved in smell/taste, cognitive function, and memory formation

And the kicker?

Most of COVID patients examined had had mild to moderate disease in the past

So what does this mean?

1 Appears to be good evidence that infections lead to neurologic damage in some portion of people

2 severity of neurologic effects not related to severity of initial disease

3 we have to begin to put effort into long-term effects of COVID


Read 4 tweets

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