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Eric Feigl-Ding Profile picture
@DrEricDing
Jul 23, 2021 • 30 tweets • 14 min read • Read on X
⚠️ANOTHER EFFICACY DROP—Not good—Israel 🇮🇱 Ministry of Health just released another vaccine efficacy update due to #DeltaVariant—only 39% Pfizer VE for #COVID19 infection, 40.5% for symptomatic, 88% for hospitalization, 91% for ICU/low oxygen/ death. More—waning efficacy too—🧵 ImageImage
2) Gets worse, 🇮🇱 report also reveals waning potency, showing just 16% effectiveness against transmission among those 2nd-shot vaccinated in January, 44% VE if vaccinated in February, 67% VE if 2nd shot in March, 75% if vaccinated in April. Partly also age effect—but still bad. Image
3) I’m trying to find good things in the report—the 88% efficacy against hospitalization and 91% VE for severe #COVID19 death is good. But it is much weaker than the 93% reported 2 weeks ago for hospitalization, and 98% from May.

gov.il/BlobFolder/rep… Image
4) Let’s now look at breakthrough rates by when someone got their vaccination— you clearly clearly see than January vaccinated people currently have the most breakthrough per capita, followed by Feb… and so on. This is partly age (elderly vaxxed first) but possibly also waning. Image
5) This worrisome news is not just my perspective, the Israeli govt is quite worried too. They warn of “decreasing potency” i24news.tv/en/news/corona…
6) but is it just elderly effect in the weaker Jan/Feb potencies? Not sure… if you look at breakthrough rate in age 60+ versus 16-59, the 16-59 have similar if not higher breakthrough rate if comparing Jan vs Jan, Feb vs Feb of same month! That implies waning not just age. ImageImage
7) here was 2 weeks ago… VE was 64% for preventing infection in early June. 94% in May. But now it’s 39-40%. Gee.
8) Let me be clear—vaccines are amazing miracle. But we can’t just rely on just vaccines alone—must do other mitigation to get us out of the pandemic. Epidemiology models show that because #DeltaVariant so contagious, we *must must must* add masks and other NPI measures! ⬇️
9) Boosters—Biden WH Officials Now Expect Vulnerable Americans to Need Booster Shots—The growing consensus that at least some Americans will need a booster is tied in part to research suggesting that Pfizer’s vaccine is less effective after ~6 months. nytimes.com/2021/07/23/us/…
10) “Senior officials now say they expect that people who are 65 and older or who have compromised immune systems will most likely need a third shot from Pfizer or Moderna.”
11) “That is a sharp shift from just a few weeks ago, when the administration said it thought there was not enough evidence to back boosters yet.
12) “On Thursday, a key official at @CDCgov said the agency is exploring options to give patients with compromised immune systems third doses even before regulators broaden the emergency use authorization for coronavirus vaccines, a step that could come soon for Pfizer vaccine.
13) “Dr. Amanda Cohn, the chief medical officer of CDC immunizations division, told an advisory committee to the agency that officials were “actively looking into ways” to provide certain people access to booster shots “earlier than any potential change in regulatory decisions.”
14) there is some debate about the new 🇮🇱 ~40% efficacy data. Some say unvaccinated are tested more—true, but in that case, then we’d find relatively more cases in the unvaccinated, which would make the vaccine efficacy look BETTER, not worse (seen here).
timesofisrael.com/israeli-uk-dat…
15) Thus to rephrase—if unvaccinated are tested more than vaccinated, then we would fine more of the milder / asymptomatic infections in unvaccinated relatively, and that would make the vaccine efficacy look relatively higher, not lower. So that is unlikely to explain the VE dip.
16) another debate is that early vaccinations “reflect time that has passed since vaccination, but also… often people with health conditions and who are more prone to infection, such as the elderly.” We discussed this above—but again age isn’t explaining this—60+ & <60 similar. ImageImage
17) Some others say “oh it’s a smaller dataset than UK”—yeah but it’s still VERY significant. Notice how the 95% confidence intervals’ lower bounds all exclude zero—and by comfortable cushion of certainly. And the 40% VE’s upper bound excludes 88% from 🏴󠁧󠁢󠁥󠁮󠁧󠁿 data. So these are diff. Image
18) also if we look at just the elderly age 60+ (stratification is one form of adjustment in epidemiology), we still see the jump up among the January vaccinated even among these elderly. This implies this is an effect by time (stratified adjusted roughly for age), not just age. Image
19) given the new data—in following the precautionary principle—we need to now urgently reconsider reimposing mask mandates again. @CDCDirector - it is time. Tick tock ⏰
20) Whenever you see vaccine efficacy —keep in mind vaccines are amazing. But data suggest we need to also do both vaccines & public health measures (rather than rely on treatments). Iron lung machines was a good polio treatment, but it could never eradicate polio until vaccines.
21) Welp—there’s discussions among epidemiologists now whether we can hold the #DeltaVariant down. With a R0=6 we can just barely. But with an R0=8 it’s much harder under 60% efficacy and 64% vaxxed. What is the estimated R0 range of Delta? 5-8 ➡️ more contagious than smallpox.
22) large numbers of experts (including @JeromeAdamsMD) now support masks even if vaccinated. @CDCDirector needs to update mask rules ASAP now in light of the new data^
23) #DeltaVariant cases ➡️ hospitalizations. Period. The “link is broken” disinformation machine is running wild that they aren’t correlated anymore. Completely false. Do not fall for that nonsense. Hospitalizations rising in UK and US and Israel.
24) Vaccines are a miracle but we need other mitigation against #DeltaVariant. Iceland is one of the most heavily vaccinated countries in the world… but yet… and yes their ICUs are filling up too.
25) sure looks like we are headed to 3rd shot boosters… both the original vaccine booster as well as a #DeltaVariant tailored booster according to Pfizer. Their internal data also shows waning. finance.yahoo.com/news/pfizer-bi…
26) This is not good. Even under rosy optimistic scenarios, containing #DeltaVariant was already hard. But it’s not easy…. see details 🧵
27) REMINDER— even *mild* COVID still leads to drop in intelligence according to UK 🇬🇧 studies on #COVID19 survivors. The cognitive drop is stronger as it gets more severe, but even significant in the mild cases too! Avoid infection not just hospitalization!
28) Another reminder: mild breakthrough #COVID19 infections can still cause transmission. This is why we mask even if vaccinated! It slows and helps stop the spread. Mask and vaccinate … not just ‘or’.
29) we are mostly pretty certain boosters are coming… the issue is not if but when… and who first.
30) Pfizer reports 12% symptomatic efficacy after 4 months. But it was mostly data from the pre-#DeltaVariant era. Just FYI.

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More from @DrEricDing

Eric Feigl-Ding Profile picture
Nov 13
⚠️BREAKING—ICU Hospitalized human bird flu case in Canada now officially confirmed as H5N1. Worse, it is the same 2.3.4.4b virus clade (variant group) as the one found in BC🇨🇦 poultry and in Washington state🇺🇸! The hospitalized teenager (with no pre existing conditions) had no animal contact, does not live on farm, had “deterioration quite rapid” and now critical in ICU with ARDS. Canada officials says infectious period is 2 days **prior to symptoms** (ie asymptomatic transmission) and infectious up to 10 days.Image
2) Public Health Agency of Canada's National Microbiology Laboratory (NML) in Winnipeg confirmed that the individual has avian influenza H5N1
canada.ca/en/public-heal…
3) details…

⚠️BAD UPDATE—BIRD FLU HOSPITALIZATION IN CANADIAN TEEN

Summary 🧵 of the live press conference with Canada’s British Columbia health officer.

📌The teen is in intensive care.
📌Condition is ARDS
📌Teen was healthy prior; no underlying conditions

bsky.app/profile/dreric…
Read 4 tweets
Eric Feigl-Ding Profile picture
Nov 13
Trump’s incoming SECRETARY OF DEFENSE who doesn’t wash his hands and doesn’t believe in germs. Image
2) Trump’s new SECDEF is also in favor of committing war crimes. businessinsider.com/pete-hegseth-a…
3) Trump’s SECDEF pick is a wild character. And loves hawking merch.
Read 4 tweets
Eric Feigl-Ding Profile picture
Nov 9
My god—Google Search for “what is a tariff” sudden spikes the DAY AFTER ELECTION DAY. 🤦🏻‍♂️ Image
2) many folks simply don’t understand what a tariff is — unless you explain it several times to them with analogies. Even then, it’s hard for many to grasp. Eg 👇
3) Ah shit… it’s now gotten worse. Why do so many people do their hw late??,
Read 6 tweets
Eric Feigl-Ding Profile picture
Nov 6
📍HARRIS IS STILL AHEAD IN PA—in terms of votes yet to be counted. She’s still +2 of what is needed to win PA, given the outstanding votes still remaining in PA cities, according to @CBSNews @NorahODonnell Image
Image
Image
Harris has enough remaining in PA Philly suburbs to still win. Image
3) folks. The NYT needle is not reliable.
Read 5 tweets
Eric Feigl-Ding Profile picture
Oct 31
Plastic cookware should not be used. Period. Especially BLACK PLASTIC cookware, that often mixes in toxic recycled electronic waste materials. DISPOSE OF ALL PLASTIC COOKWARE, especially if black colored plastic ones. Pass it on to your family.

Gift🎁🔗
theatlantic.com/health/archive…Image
2) Because optical sensors in recycling facilities can’t detect them, black-colored plastics are largely rejected from domestic-waste streams, resulting in a shortage of black base material for recycled plastic. So the demand for black plastic appears to be met “in no insignificant part” via recycled e-waste, according to Turner’s research. TV and computer casings, like the majority of the world’s plastic waste, tend to be recycled in informal waste economies with few regulations and end up remolded into consumer products, including ones, such as spatulas and slotted spoons, that come into contact with food.
3) You simply do not want flame retardants anywhere near your stir-fry. Flame retardants are typically not bound to the polymers to which they are added, making them a particular flight risk: They dislodge easily and make their way into the surrounding environment. And, indeed, another paper from 2018 found that flame retardants in black kitchen utensils readily migrate into hot cooking oil. The health concerns associated with those chemicals are well established: Some flame retardants are endocrine disruptors, which can interfere with the body’s hormonal system, and scientific literature suggests that they may be associated with a range of ailments, including thyroid disease, diabetes, and cancer. People with the highest blood levels of PBDEs, a class of flame retardants found in black plastic, had about a 300 percent increase in their risk of dying from cancer compared with people who had the lowest levels, according to a study released this year. In a separate study, published in a peer-reviewed journal this month, researchers from the advocacy group Toxic-Free Future and from Vrije Universiteit Amsterdam found that, out of all of the consumer products they tested, kitchen utensils had some of the highest levels of flame retardants.
Read 4 tweets
Eric Feigl-Ding Profile picture
Oct 29
⚠️MASK MANDATE RETURNING TO ALL NIH PATIENT CLINICS—Effective November 4, 2024, masking will be required in all patient care & waiting rooms. Furthermore, testing for COVID, flu A, flu B, and RSV will be required for all inpatients & rooming-in visitors.
cc.nih.gov/patient-servic…Image
Image
2) This means wearing a mask will be REQUIRED in all patient care areas, including waiting rooms. ➡️This change is due to an anticipated increase in COVID-19 and other respiratory virus activity in the community. 😷
3) I think people should stock up on COVID tests again. The Cheapest COVID test on the U.S. market is now as low as $1.50 with special promo code “COV20”… expiring Jan or March 2025.

store.pharmalynk.com/products/advin…Image
Read 6 tweets

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