Breakthrough coronavirus cases are disappointing ― but most of them are also evidence that the shots are working. huffpost.com/entry/breakthr… via @HuffPostLife
Think this is responsible reporting by the @HuffPostLife about breakthrough infections with delta as the promise of these amazing vaccines was in the yellow column, in preventing severe disease & death, which is what the vaccines are doing. Never before in history have we swabbed
noses for asymptomatic infection; vaccine trials always designed on preventing disease. No vaccine for common cold because that is not the disease vaccines needed for - vaccines needed for severe disease, so designed that way. COVID vax in that way work stupendously well
3 types of breakthroughs.
1) Asymptomatic breakthroughs are because we are still testing immune individuals, which is not recommended by CDC
When media report on asymptomatic breakthroughs, outbreak investigation should report on viral loads in the tests if PCR is the test being done, otherwise, can't tell meaning of that positive test (low viral load, no symptoms =vax success; fought it off!)
washingtonpost.com/outlook/2021/0…
2) Mild breakthroughs happening more with delta than we saw with alpha. Vaccines (T cell immunity longer lasting) designed to prevent severe disease as outlined here, but expectations may have been set differently. 4 other cold coronaviruses
Vax still "defanging" COVID (hospitalizations still decoupling from cases) in light of delta variant. @TracyBethHoeg presented data yesterday yesterday updated from our data in @WSJ last week that hospitalizations in children from @CDC still remaining low
wsj.com/articles/delta…
Pres Biden yesterday said children <12 vax trials ready by fall & he is urging FDA to approve the >12 vax asap to help increase uptake. Most urgent need is to vaccinate remaining eligible unvaccinated which is main focus of COVID-19 task force. Vax still doing what designed to do
I know this seems like it never ends & I am so sorry; this is a very wily virus & not tamping down transmission worldwide and allowing ongoing preventable deaths without #globalvaxequity is a tragedy & moral failing. "Vaccinate, vaccinate, vaccinate"
apple.news/A-1CAiRd9Tc2zm…

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More from @MonicaGandhi9

17 Jul
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…
Read 9 tweets
16 Jul
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
Read 8 tweets
15 Jul
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…
Read 4 tweets
15 Jul
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…
Read 7 tweets
15 Jul
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…
Read 4 tweets
14 Jul
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
Read 4 tweets

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