It can be positive, which means those with advantageous mutations get selected over others, leading to an increase in its population. Example is delta variant in the case of SARS-CoV-2 virus.
Negative selection pressure is 👇
2/
Negative selection pressure also occurs in evolution, it is basically the force that gets rid of the “seconds” or “imperfect products” or those who have genetic changes that are deemed unfit for long term survival of the species.
3/
When this pressure is excessive, species become extinct.
If on the other hand this force (negative selection pressure) is too weak, that also is not good for the species; as “less fit” variants take over - and survival isn’t optimal.
In other words, both these forces exist.
4/
The problem with predicting the future in the case of this virus are several.
1. Unlike most common cold viruses that might have taken hundreds or thousands of years to reach their present level, this one has had only 2 years experience with having man as a host.
5/
2. This virus achieves its needs (i.e. to produce most copies & move to the next host) in the first 4 days of illness.
In other words, it doesn’t matter for this virus even if the person dies after that, as it has already moved on to other people (of whom there are plenty)
6/
In other words, the death of the host doesn’t matter for the evolution of THIS virus.
(For other viruses that directly and invariably kill the host, that might be an issue, because they might literally run into a dead end)
7/
3. The cause of death in the case of COVID-19 is not exactly the direct action of the virus, rather the anomalous immune response launched by a small subset of people, for reasons that aren’t known fully yet.
8/
That is, we still do not know why some people get just an asymptomatic infection, while others develop dreadful lung damage.
4. This virus also is hugely different from “common cold viruses”- it affects multiple systems in its hosts, including blood vessels & other organs.
9/
Hence, while it is comforting to engage in wishful thinking, & assume we know its trajectory, we must be mindful of the fact that many big predictions have so far been wrong about this virus.
What will make a massive difference however is an effective antiviral drug.
10/10
• • •
Missing some Tweet in this thread? You can try to
force a refresh
It is 9 months since vaccines were rolled out in the US.
61% have received at least 1 dose.
54% are fully vaccinated.
The ratio between cases and deaths should have increased by now.
(Fewer deaths per case = bigger ratio)
Thread 👇
One possibility is that there are still many people who are not vaccinated, and these figures represent infection & death among the unvaccinated subgroup.
And if the unvaccinated are predominantly over 65, it would mean more deaths. See NYT article👇
The above article states that in 11 states, at least 20% of older adults have not received even one dose.
The most logical explanation for the above graph is the combination of factors (older age group + being unvaccinated) existing in a large number of people.
3/
Breakthrough infection rate is not provided for type of vaccine. Only overall number is given (13%, 81/614)
Antibody levels are seen to drop with time as expected.
Peak antibody levels are lower & the decline faster for covaxin, but this does not imply lower protection.
2/
The reason why a lower antibody level does not mean lower protection is that there are multiple components in the immune system that provide protection. Not all of them are measurable.
Besides, the study does not provide data that lower antibody level led to more infections.
3/
Multiple issues with the widely quoted NEJM Israel study on boosters
Long thread👇
1. Authors report a lofty reduction in infections & severe cases by a factor of 11.3 & 19.5 in the primary analysis, where rates are compared between boosted & non boosted groups.
2. In secondary analysis, this factor is down to 5.4. Secondary analysis compares rates within the SAME group, by timeframe. This is more believable not only because comparison is within the same group, but also because we know higher antibody levels reduce infection rates.
2/
Note: secondary analysis is available ONLY for infections, not severe cases.
In other words, we do not yet know if this 5.4-fold reduction in ‘infection’ will translate to reduction in hospitalisation/death later.
3. No mention of number of people who were hospitalised.
3/
Detailed graphical representation of the story of the US elementary school teacher who infected 12 of her masked students by reading aloud without mask.
Lessons:
1. Multiple factors have to be in place to prevent outbreaks
Large cohort of 673,676 vaccinated, 62883 past infection, & 42,099 vacc + past infection. The groups were matched to exclude confounding.
They looked at remote & recent past infection separately. Those who were infected in 2021 had greater protection than 1 year ago.
2/
The vaccinated group had a 27-fold greater risk of SYMPTOMATIC breakthrough infection compared to natural infection. The risk was 13-fold for ALL breakthrough infections.
A single dose of vaccine further increased the level of protection for those who had past infection.
3/
Audit of 281 COVID-19 deaths in Ernakulam showed that 98.2% of the deaths occurred among those who had not been (fully) vaccinated. i.e. only 1.8% of deaths were fully vaccinated.