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Dr. Abraar Karan Profile picture
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25 Jul, 4 tweets, 4 min read
#COVID19 outbreak from #Gamma variant in Gold Miners in French Guiana

24/44 infected (54.6%), and 21 symptomatic

25/44 were fully vaccinated (Pfizer)--> and 15 of those 25 were infected (60%)

but

NO clinically severe #COVID19 requiring hospitalization

wwwnc.cdc.gov/eid/article/27…
2/ Gamma variant (P1) has been shown to escape from neutralizing antibodies, but the immune system is made up of more than just humoral immunity

Studies from other variants have shown retained activity of T cell immune response

sciencedirect.com/science/articl…
3/ While the attack rate here is high among even fully vaccinated w/ mRNA vaccines, our number one goal is to prevent severe disease, hospitalizations, deaths.

With that said, as variants continue to emerge, we must monitor very closely.

Also, no mask use was reported here.
Cc @V2019N @InfectiousDz @EricTopol @parsonnt @MonicaGandhi9 @carlzimmer @CarlosdelRio7 @PaulSaxMD @BogochIsaac

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More from @AbraarKaran

Dr. Abraar Karan Profile picture
24 Jul
🧵🧵
1/ The moment we begin to reframe unvaccinated people as people vulnerable to malicious misinformation, & still deserving of protection from a deadly virus, the sooner we will figure out ways to bridge this gap.

Shaming them isn’t going to work. It will further the divide.
2/ People seem to argue that because they could understand how to see through misinformation (& get vaxx’d), that there is no excuse for others to also not have come to the level of understanding that they have

This thinking quickly turns into blame/anger, but it doesn’t help
3/ When we tried to use blame/shame this year, we lost access to those who were on the fence.

In some cases, this meant losing access to contact tracing when people were hesitant to reveal they had tested positive.

bostonglobe.com/2020/11/30/opi…
Read 6 tweets
Dr. Abraar Karan Profile picture
22 Jul
Very concerning. Especially with millions still unvaccinated, and rates of vaccinations slowing.

And do not say this is 'their fault'; people are literally being fed anti-vaxx BS daily in this country.

These are patients, these are people; they don't deserve to be sick.
2/ Our oath as doctors is to protect our patients; our oath as public health leaders is to protect the health of our communities-- it is NOT good enough to say that it's the public's fault for not being vaccinated at this point.

That's not how public health works.
3/ This is a constant battle between information and misinformation. People have a right to be hesitant to new medical interventions. Our job is to dispel myths and lessen fears; to bring public health to communities, not wait for them to come to us. Esp not during a crisis.
Read 6 tweets
Dr. Abraar Karan Profile picture
17 Jul
Our op-ed summarizing the findings of our recent study in CID @IDSAInfo from @BrighamWomens looking at risk of #SARSCoV2 transmission from index cases to their hospital roommates. ~40% secondary attack rate; and beds are 7 feet apart w/ curtain in between

medpagetoday.com/opinion/second…
2/ We felt that short-range aerosol transmission most likely explains our key finding. Better ventilation & #betterMasks are essential in addition to vaccine rollout.

Cc @kprather88 @j_g_allen @linseymarr @DFisman @carlzimmer @jljcolorado @RanuDhillon @sri_srikrishna @zeynep
3/ Important to note that over several months, the incidence of roommate transmission was exceptionally low- 0.1%; the key takeaway is that IF you end up roomed w/ someone that has a #covid19 infection w/ a low CT value (high viral load, infectious)- very high risk of spread.
Read 4 tweets
Dr. Abraar Karan Profile picture
17 Jul
The rapid spread of new variants is a *symptom* of a deeper issue. We can continue to try & protect ourselves against variants--talking third doses in rich countries--OR, we can address one of the biggest underlying drivers: most of the world having little access to vaccines.
2/ I'm frankly disappointed- because 'global solidarity' has once again proven to be all talk.

Go to any global vaccine tracker website right now and look at the countries that are at the bottom. Are you surprised? I am not.
3/ We have to acknowledge that our global power structures are ones that even before #covid19 existed to propagate inequities; they exist to extract resources from impoverished places; they exist at the expense of entire populations who are now facing dangerous variants w/o vaxx
Read 6 tweets
Dr. Abraar Karan Profile picture
15 Jul
Los Angeles County to mandate indoor masking in public spaces, regardless of vaccination status

Only 52% of residents in the county are fully vaccinated

261% increase in new daily #covid19 cases compared to two weeks ago, driven by Delta variant

latimes.com/california/sto…
2/ 1,537 additional new cases reported Thursday

Indoor shared spaces, esp crowded ones w/ poor ventilation, are highest risk for transmission

Public health is local first; measures must be taken at the local level to stay ahead of larger surges
3/ Vaccinated individuals have a significantly lower chance of severe disease, hospitalization, or death.

They also have a lower risk of transmitting too. Get vaccinated.

But bigger point here is the large # of *unvaccinated*/partially vax- in LA County, over 5 million people
Read 6 tweets
Dr. Abraar Karan Profile picture
12 Jul
Another new study worth looking into-- Delta variant #covid19 outbreak in a London nursing home.

Many residents/staff were <14 days since receiving dose 2 of Astra Zeneca vaccine; secondary attack rate among partially vaxx residents was 81.3% (13/16)

eurosurveillance.org/content/10.280… Image
2/ Table 1 has a break down by demographics and vaccination status

Unique situation here as most residents/staff were getting dose 2 right when the index case was diagnosed with #covid19
3/ Reassuring- hospitalization uncommon; no deaths here. And this was among a care home population where we know #covid19 has caused immense suffering/death this past year.

Index case here was described as getting dose 1 in January, but unclear whether they ever got dose 2.
Read 6 tweets

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