COVID UPDATE: What’s changed and what’s stated the same since I wrote the tweet that said vaccinated people have far greater things to worry about then the Delta variant?

And what would I say now? 1/
Let’s look at what’s changed?

We have significant growth in cases. So far those are largely among unvaccinated people. And serious cases are almost entirely among unvaccinated people. 2/
There are areas of the country where there are low vaccination levels that are experiencing the largest growth in cases? Hospitalizations are following.

While we can’t say for sure, the death rates look to be dramatically lower given vaccination protection in the elderly. 3/
Still there are 100 million people estimated to have no immune protection either from a vax or prior infection & we know Delta is twice as contagious.

Delta appears likely to quickly rip through communities largely impacting the unvaccinated. 4/
How many of the unvaccinated will be infected? Not 100 million.

There was an odd effect in India the first to experience Delta. It ripped through quickly and died just as quickly. 5/
We should watch carefully what happens in the UK— where there are vaccination levels close to the US and vaccinated people are so far well protected.

Two doses of the mRNA produces plenty of antibodies & T-cell & B-cell memory. 6/
As awful as Delta is to unvaccinated people, in a weird way, it has helped vaccinated people by out-competing variants thatevade the vaccine. Delta attaches much more easily to cells but it is easier for the vaccine.

So far more contagious has meant easier for the vaccine. 7/
Vaccinated people should view Delta as a slight difference as well. UK studies which are the closest thing we have suggest instead of 95% protection against infection, it may be closer to 88%. 8/
A good way to think about that is it’s 10% less protective.

Here’s a decent analogy. A vaccine is like an umbrella. It keeps us from getting wet. Not perfectly. But mostly. 9/
With Delta, the rain is the slanty kind that makes you 10% more likely to get wet.

Still, bring a little wet is ok. Easy to dry off in this analogy. What you don’t want to be is soaked (or being hospitalized would be the analogy). And the umbrella prevents that. 10/
So what does it mean to be close to 10% more exposed. Should it mean you wear a mask for example?

Well you could always add a rain jacket if it’s really pouring. In other words if indoors around a lot of unvaccinated people for a long while, it could help. 11/
My friend the scientist @EricTopol says it this way: just because the vaccines are great doesn’t mean you need to constantly stress test them.

Plenty of vaccinated people live in areas w lots of unvaccinated people & with case spread. Wearing a mask can’t hurt. 12/
What is not the case is that evidence of breakthrough cases are concerning. They are news because they are surprising to people but in many cases they are found in routine testing without symptoms. 13/
So if you’re in the Olympic village or on a sports team or traveling, you could find you’re testing positive as your immune system fires off. 14/
And that will happen 10% more now. As will mild breakthrough cases. And presumably hospitalizations & deaths.

So instead of 99.3% of people who die being unvaccinated, it could well be 98.5%. 15/
Your chances of being vaccinated & getting sick with COVID are still very very low. Not zero & slightly higher.

Worth taking precautions in areas with COVID & with unvaxxed people in the community. But remarkably low risk. 16/
OK. Maybe vaccinated people are safe but is it possible with Delta that you could be infected, not know it, and pass it along to someone who does get sick?

Not great data on this with Delta but scientists consider that a very infrequent scenario. 17/
So what do I think of my tweet weeks back where I say Delta is very low risk for vaccinated people and the most important thing they can do is begin to get their lives back? 18/
On the one hand, science supports the ability of vaccinated people to get back the most important things in their lives. If Delta is a risk, it is a very low one.


Still most vaccinated people I know don’t feel like things can feel normal while cases are growing, even if it’s largely among unvaxxed people.

And of course, many people can’t get immune protection right now— kids & people who are immunosuppressed. 20/
Psychologically for those who have it, the feeling of safety after a year of fear is a vital psychological respite. So is hugging our family & returning some of the normal rhythms of life. Delta shouldn’t keep people from any of it. 21/
But there’s also no doubt that the unwillingness of so many to get vaccinated & Delta combined should make us all more cautious.

And getting back to life can be done while wearing the occasional mask & balanced with plenty of empathy & concern for others. /end

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More from @ASlavitt

16 Jul
COVID Update: In most countries, the greatest threat are variants & the lack of vaccines.

In the US it’s different. Very different. 1/
Vaccines are broadly available in the US. To understand the significance of this, you need to talk to people in other countries.

I’ve spent much of the week talking to officials & media in Australia. Oh how they wish they were in the US. 2/
Australia didn’t buy enough vaccines and the one they bought has run into problems. They are low vaccinated & not likely to get vaccines until September. Cases are rising & they’re on lockdown.

Rough winter for them. (They believe winter is in July for some reason). 3/
Read 10 tweets
10 Jul
COVID Update July 10, 2021: 2021 will be the year of the Unvaccinated Pandemic.

Vaccinated or not, there are implications for all of us. 1/
The most tragic toll will be in the countries that have not done mass vaccinations yet.

India, Australia, Bangladesh, E Asia, Africa— places that dodged COVID in 2020 and either couldn’t afford or didn’t make an effort to procure vaccines will pay the highest toll. 2/
In the US, we were racing against Alpha & largely beat it. But imagine if we had not. A new study from Yale points to 100s of thousands of lives saved & millions of hospitalizations by having vaccines beat alpha. 3/…
Read 25 tweets
9 Jul
NEW: The CDC issues guidance on masking in K-12 schools for the Fall.

Vaccinated children do not need to wear masks; unvaccinated kids should per the guidance.

I know this raises questions & is a hot topic so I will hit a few points. 1/
It helps to begin with what CDC guidance is and what it isn’t. It provides the best recommendation based on the science but allows states, schools & individuals in some cases to weigh other factors. 2/
For example, CDC doesn’t set out to address the question of how to tell who’s vaccinated & who isn’t. Or other factors like school ventilation & desk configuration— all of which the speak about as “layers” of protection. 3/
Read 8 tweets
9 Jul
COVID Update: I deeply regret that we live in a world where I have to respond to Marjorie Taylor Greene.

But alas… 1/
Greene is now comparing Biden’s vaccination program to her new favorite topic: yes, Naziism.

The latest chapter in her Holocaust education fetish is not encouraging.

Cc: @HolocaustMuseum 2/
No one is in danger of asking Greene to teach a history class (or a public health class) (with the exception of Texas) anytime soon.

But she did learn one lesson well from the Nazis: dangerous propoganda. 3/
Read 11 tweets
8 Jul
NEWS: Pfizer to submit application for COVID specific booster to FDA. More here shortly.

Follow here if interested.
Having had a few conversations with the company and others about this, here is what I know. 2/
The first question is whether a booster will be needed and Pfizer believes that there is a significant boast in immunity if a third shot is given after 6 months.

This may be particularly useful among older people who are immunity wane faster. 3/
Read 13 tweets
6 Jul
COVID Update: A strategy I deploy & recommend when there’s a new study, particularly with explosive headlines about COVID.

It’s the same strategy I deployed last year when reading about how promising the vaccine trials were.

Wait it out a bit. 1/
We are all subject to that sinking feeling of seeing the headline:

“Study shows variant gains strength”
“Do the vaccines work against Lambda?”
“Breakthrough cases increase.”

Makes your ❤️ drop. None of us wants to relive the last year & that often flashes through our minds. 2/
There’s no doubt that these can be upsetting to see. In our minds, we want to compartmentalize COVID as either a threat or not a threat & it’s confusing to feel in between. 3/
Read 16 tweets

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