Thread by @MonicaGandhi9

Good summary from WaPo on day's issues 1) waiting on CDC data on vax'd and viral load (we will likely need culture for deeper dive); 2) masks @CarlosdelRio7 "putting toothpaste back in tube"; 3) plummeting UK cases: delta-driven natural immunity+ vax
washingtonpost.com/politics/2021/…

In terms of UK cases falling despite easing lockdowns, not surprising. Delta is a hurricane- if finds vaccinated's nose, will boost immune response if asymptomatic; finds unvax'd adults FAST & tragically causes deaths or natural immunity if non-severe
cnbc.com/2021/07/28/uk-…

Of note,- I'm sure CDC has data on viral loads with delta & will tell us. Delta has higher viral load, different beast than alpha. But is a PCR-determined viral load in a vax'd person with immunity (Abs/T cells in nose) as infectious as in unvax'd? Do we need culture to tell??

@sailorrooscout, thoughts? Remember how we diagnose measles is now is via PCR RNA; but before PCR and even now, gold standard of infectiousness is culture. Was that why Indian study showing same CT values in vax'd rejected in peer review? Wanted culture?
cdc.gov/measles/lab-to…

We know T cells get into nasal mucosa, not only from many many studies in general literature but from those in this pandemic. Here is general
atsjournals.org/doi/full/10.11…

And here is study that shows 1 dose of vax after natural COVID hones T cells to nasopharynx. We know mild symptomatic delta breakthroughs have T cells as don't have severe disease. Do those T cells hurt virus in nose so loads up but less infectious?biorxiv.org/content/10.110…

Well, here is the data CDC was referring to- in Provincetown outbreak, news says that the viral load among vaccinated by CT value I assume is same as in unvaccinated making delta different than alpha and hypertransmitting, justifying mask recs. Hate delta
newsbreak.com/news/232525896…

Culture data would tell us how infectious but true that this outbreak occurred among mostly vaccinated individuals (some unvaccinated) so seems likely that vaccinated people with delta different than other prior versions & this high viral load means transmissible even from vax'd

Now, there were some unvaccinated people in group in Provincetown so since there was obviously an outbreak investigation (data is not here, this is news report), want to know culture data of subset please so we can determine infectiousness; still low rates of severe disease

However, is time of infectiousness shorter because you fight virus in nose? Is the virus as infectious? Intense exposure as lots of inside close activity in Provincetown. Antibodies wane with time. T cells stay strong so more mild breakthroughs, not severe. lots of work to do

Finally, isn't this outbreak a success story of the vaccines? 882 infections, 3 hospitalizations in vaccinated (4 in unvaccinated); no deaths; all did well. That is a low rate of severe disease. Isn't this the promise of vaccines?

Isn't that your T cells to a T? And no, don't think a variant can evade our vaccines because of T cells and how there are so many that line up across spike protein to fight viral infection (so that 10-13 mutations of variants can't faze 80-100 T cells)

https://twitter.com/MonicaGandhi9/status/1373506320154849282

If you have just changed a severe infection like this awful COVID to mild infection or hopefully asymptomatic, you have just "defanged" the virus, "uncoupled" hospitalizations from cases. I know we hate delta & yes, we don't want mild breakthroughs so mask but this is vax success

This is helpful to explain- T cells seem to be doing their job here.
theatlantic.com/science/archiv…