COVID Update: An internal document from CDC shows Delta is a whole “new war.”

First real estimates of spread & breakthrough cases. And a clear sense of why CDC policies are changing.

More here soon. 1/
Point 1: Vaccines work. They dramatically reduce the risk of cases (8x) & even more so serious cases (25x). But they don’t work perfectly.

With 165 million fully vaccinated people, they estimate 7,000 breakthroughs/day. 2/
A thorough discussion of breakthrough cases & vaccine efficacy is here in this discussion with what Pfizer sees in the data. Worth listening to to understand. 3/
Point 2: Delta vaccine effectiveness is reduced vs. Alpha. This could be because of waning effectiveness or the increased viral load or both.

Thankfully hospitalizations are only minimally impacted. 4/
With only slight movements in hospitalization risk, with more and more people vaccinated, the percentage of people who are hospitalized with COVID who are fully vaccinated will climb. In some studies it is approaching 10%. That is to be expected. Absolute numbers are key. 5/
Point 3: The document calls out who is most at risk and points to some data showing the risks are higher among the elderly & among immunocompromised people.

In nursing homes:

Protection against infection looks like 65-75%. Hospitalization 85%. 6/
Point 4: They have compared Delta to other infectious diseases including 2020 COVID.

Delta spreads as fast as chicken pox (but is more lethal). The 2020 version was significantly less transmissible (more like SARS or Ebola—but far less deadly).

Delta is a new disease. 7/
Point 5: Delta has much higher viral loads & potentially sheds longer. If so this could mean longer isolation periods. 8/
Point 6: Reinfection risk may be higher if infection occurred more than 6 months ago. Strikes a blow against herd immunity theorists who tell people to get infected. 9/
Point 7: Breakthrough cases of Delta appear as transmissible as those of unvaccinated people.

Another blow against blanket immunity if future variants look like this one.

Let me tick through some implications. 11/
IMPLICATION 1: The vaccine is our best tool. It’s efficacy is lower but it has a dramatic & lifesaving impact.

If vaccination rates don’t increase meaningfully, COVID waves will likely continue. 12/
IMPLICATION 2: Around only vaccinated people you are safer but not perfectly safe. Vaccinated people could shed the virus to the same degree as unvaccinated people if they’re infected & pre-symptomatic.

Also, if you’re sick, you gotta stay home. 13/
IMPLICATION 3: We will need to shore up nursing home safety with preventative measures until a booster is approved. 14/
IMPLICATION 4: Employers should follow the lead of the federal government & require vaccines or a negative test result 2x week.

In some job types where there is a lot of public interaction, like health care settings, vaccines should be required. 15/
IMPLICATION 5: Points 6 & 7 would make herd or blanket immunity more elusive. It would require almost full vaccination levels. 16/
IMPLICATION 6: Unlike 2020, given the vaccines, death rates will be dramatically lower. Lots of cases, fewer deaths.

But, while Delta is out there, expect deaths to climb some on an absolute basis for the low point they have been at. 17/
We don’t know how long Delta lasts— some data suggests we will see peaks soon & big declines. But that’s not certain. In the meantime, more caution is warranted than before. 18/
Seeing that before the school year begins would be very encouraging as would progress in vaccinations for under 12, boosters, anti-virals & additional tools in our arsenal.

Much more info on these areas on the podcast @inthebubblepod with Bourla & Topol. /end

• • •

Missing some Tweet in this thread? You can try to force a refresh

Keep Current with Andy Slavitt 🇺🇸💉

Andy Slavitt 🇺🇸💉 Profile picture

Stay in touch and get notified when new unrolls are available from this author!

Read all threads

This Thread may be Removed Anytime!


Twitter may remove this content at anytime! Save it as PDF for later use!

Try unrolling a thread yourself!

how to unroll video
  1. Follow @ThreadReaderApp to mention us!

  2. From a Twitter thread mention us with a keyword "unroll"
@threadreaderapp unroll

Practice here first or read more on our help page!

More from @ASlavitt

29 Jul
COVID Update: What did President Biden announce today and why.

The story. Follow if interested here. 1/
President Biden’s announcement today that federal workforces and on-site contractors must demonstrate that they are not infectious is as much about ensuring safe workplaces as it is driving up vaccinations. 2/
The federal workforce, over 2 million civilians, serves the public. And his commitment to keep them safe while they do that is one of his commitments as a leader. 3/
Read 19 tweets
28 Jul
As of this week, the dam is beginning to break publicly so I will comment. Google just announced a vaccination requirement, the VA has, CA has, NY has and others are on the path.

Including Biden publicly commenting that this is being considered 4 all federal ees & contractors.2/
Let me step back cover something:

First, what are we talking about here?

We’re talking about safe workplaces.

What we’re not talking about?

Violating anybody’s individual liberties. 3/
No one is requiring anyone to get vaccinated. What these leaders are doing is requiring people to demonstrate they are not contagious.

Either by getting vaccinated or by showing a negative test result several times/week. 4/
Read 11 tweets
27 Jul
COVID UPDATE: CDC is revising its mask guidance today.

Been gathering info before the announcement and will cover below. Follow if interested?
The new guidance will recommend that vaccinated people in higher risk areas wear masks in higher risk areas. 2/
As with almost every change in guidance, some people will think this is too slow to come; some will think it’s too fast a change & backtracking.

While criticism will be constant (& the lifeblood of Twitter), none of that is the way I think about it. 3/
Read 12 tweets
26 Jul
COVID Update: Is there evidence of the vaccine’s immunity waning? What does new data showing lower efficacy in Israel mean? 1/
Several weeks ago reports started coming out of Israel, the first country to drive widespread vaccination, that the vaccines were showing lower efficacy against moderate symptomatic COVID. (Against severe COVID, the vaccine is still highly protective with a slight dropoff.) 2/
A more recent study made public late last week showed lower efficacy still among the same group at 39% and severe COVID at closer to 90%, also a drop, though more modest. 3/
Read 21 tweets
23 Jul
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/
Read 22 tweets
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

Did Thread Reader help you today?

Support us! We are indie developers!

This site is made by just two indie developers on a laptop doing marketing, support and development! Read more about the story.

Become a Premium Member ($3/month or $30/year) and get exclusive features!

Become Premium

Too expensive? Make a small donation by buying us coffee ($5) or help with server cost ($10)

Donate via Paypal Become our Patreon

Thank you for your support!

Follow Us on Twitter!