1) Do vaccines prevent infection? Including delta.
Yes. Unvaccinated 5 times more likely to be infected in LA county study. cdc.gov/mmwr/volumes/7…
2) Do vaccines work as well against delta variant as we hoped?
No. Based on UK studies efficacy is lower against symptomatic infection (see table) but still extremely high against severe disease (>90%).
3) Do vaccines prevent hospitalization and death, including against delta variant.
Yes. Unvaccinated 29 times more likely to be hospitalized due to COVID than vaccinated in LA county study.
4) Why are countries which have high vaccination rates having spike in cases?
Because there are still a number of unvaccinated people even in well vaccinated countries. delta is also vaccine evasive. But deaths this time around are much lower. @FT
5) Do we need to be concerned that vaccine efficacy may be too low in some groups?
Yes. In elderly nursing home residents and immunocompromised. cdc.gov/mmwr/volumes/7… Boosters are recommended.
6) FDA just approved Pfizer. Were the vaccines rushed?
No. Research on the technology used was developed over years. Double blind randomized placebo controlled trials were done and showed high efficacy. We had a huge pandemic so trials enrolled patients very quickly.
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1/ How does monkeypox spread? #MedTwitter
Through close, personal, contact:
•Direct contact with monkeypox rash, scabs, or body fluids
•Touching objects, fabrics (clothing, bedding, towels) used by someone with monkeypox.
•Contact with respiratory secretions
2/ PPE to prevent monkeypox transmission
Healthcare workers: gloves, gowns, mask and eye protection.
N95/respirators for activity that involves aerosol generation
Patients: Keep lesions covered and wear a mask when around others
3/ To control monkeypox we urgently need
a) Testing, testing, testing!!
Early ID means that
⁃isolation can be implemented and further transmission prevented
⁃Ring vaccination of contacts can prevent illness in contacts
3/ if you meet one or more criteria, you should seek out one of the following treatments in order of preference
⁃Paxlovid
⁃Remedesivir IV for 3 days
⁃Monoclonal antibody (Bebtelovimab)
⁃Molnupiravir
COVID cases in India rising rapidly, heralding a probable third wave. While India needs to prepare for the worst, there are hopeful signs that this wave will not be associated with the high death rate of the delta wave
Why?
1/
Two main reasons
- Larger proportion of the population immune through vaccination or past infection
- Omicron does not cause the severe lung inflammation and oxygen need seen with delta
2/
What can an individual do to prepare:
- Get vaccinated, get boosted when eligible
- Mask up
- Avoid crowds whenever possible
3/
What we know and don't know about #Omicron (B 1.1.529)
1/ Reported in S. Africa Nov 24 from a sample from Nov 9. So it has been around for at least 3 weeks, possibly longer.
2/ Classified as Variant of Concern (VOC) on Nov 26
3/ Several mutations on the spike protein
4/ As of Nov 27, found in many other countries including Belgium, Botswana, Germany, Hong Kong, Israel, Italy, UK.
Seems widespread already.
5/ Why is it Omicron a variant of concern ?
First, it has spread rapidly in S. Africa, replacing Delta entirely in some areas. This ability to replace delta is striking because other variants have not been able to do that.
Officials said that "it's clear" that protection from mRNA COVID vaccines decreases over time, and that the US will recommend boosters for all, 8 months after primary vaccination
Let’s look at the evidence for boosters for ALL
Thread
1/
2/ In a NY Health Dept study of 10 million NY residents VE against hospitalization remained >90% in May to July 21 when delta comprised 80% of infections cdc.gov/mmwr/volumes/7…
3/ mRNA vaccines remain effective at preventing hospitalizations at 24 weeks after vaccination