Since SARS-CoV-2 has had months to break thru delta and hasn't landed any serious punches with other variants, delta still dominantes...
AND delta cases ARE dropping worldwide, at however frustrating a pace...
I think we need to envision a world some months from now where delta has dropped from the horizon, a victim of its own success. The failure of current non-deltas to break thru the delta wall bodes well, but depends upon...
Our ability in the US to maintain a serious immune wall against the virus.
There will be some who will enjoy considerable protection against infection bc they live in "immunologically gated communities", safe from the COVID world...
But if no "new delta" with spectacular transmission characteristics, or ability to defy the immunity delta left behind emerges (so far no dice) delta could leave us in a viral trough for many months.
This won't grant us complete impunity, mind you, but it won't be pandemic...
Like you, I wish I could predict a viral trough so I could perhaps travel or eat out. But I don't know the pace, or just how thoroughly our friend delta will abandon us.
But you should indeed anticipate marked improvement in coming months IMO. END

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More from @hjelle_brian

2 Oct
We know of a lost tribe of hominids called Denisovans cuz and enterprising postdoc in Germany sequenced the pinky fingertip genes from a girl's bone they found in Denisova cave, Siberia...
A few percent of genes from moderns from Micronesia are Denisovan in origin.
Thru fossils, we now know a bit of what Denisovans looked like. They were BIG...
These were a hulking species- what we always imagined Neanderthal to be.
But Neanderthal and Denisovans aren't alone...
Read 4 tweets
1 Oct
To understand the world of RNA viruses is to enter a totally different world.
The first thing to know, is that they exist as a swarm, not as a single entity...
The "sequence" of an RNA virus is a bit of an invention, since there is no guarantee that any member of a swarm actually has that sequence.
It is more of a consensus.
If you average out everyone in the swarm, it would look like this sequence.
A bit frustrating, no?...
The RNA virus world is a world of constant trial and error- the idea, that if you crank out enough mutants and variants, eventually you'll stumble upon that killer app that conquers your host. But RNA viruses, like the rest of us, also live on the margins of survival...
Read 6 tweets
1 Oct
I understand the doom and gloom but there is light at the end of the COVID tunnel and it's not always an oncoming train.
Thread...
First, delta is waning and there is as of yet no viable replacement. We're far from out of the woods but the trend is positive. If/when delta declines, replacements look to be less daunting, less successful...
The vaccine penetration continues to leave the US with wealthy vaxed populations that will likely remain increasingly low risk. Esp to extent that we MASK. Of COURSE we need to go beyond saving rich white people, but there are safe areas that are growing...
Read 7 tweets
30 Sep
Told yall that innate immunity matters. OAS1 a classic ISG- interferon induced gene, protecting those with the right polymorphism.

science.org/doi/10.1126/sc…
Interferon a crucial component of antiviral innate immunity and SARS2 is both extremely sensitive and extremely proficient at blocking its production. It sets up a program of antiviral defenses...
That can do things like detect, degrade or edit its RNA. OAS1is downstream of IFN but still works.
Read 5 tweets
27 Sep
"Age of viability" thing for a fetus is slippery thing. You can, in rare circumstance, "rescue"fetus of 22, 23, 24 wks- condemning them usually to months in NICU, gasping for air on vent, deficient in surfactant and 1000 other things- and immunocompromised.childrensmn.org/2020/12/23/bab…
Nurses and techs who perhaps should have honed their skills on rodents will be challenged cannulating their tiny blue veins, among many other insults that make preterm baby's first months an endless trial of hurt and deprivation.
And so many are just immunologically unprepared. An RSV infection, usually a cold or asymptomatic to older kids or adults, can kill a preterm baby. Their brains struggle for proper development, as does their immune system, which is immature and on its own. Mom can't help.
Read 4 tweets
25 Sep
In 1950, Australia tried the bold experiment that gave rise to one of our most enduring myths in virology: that viruses become less lethal upon adaptation to a new host.
The science was brilliant, but that conclusion, misguided.
Thread...
Australia was plagued by an out of control proliferation of (exotic) rabbits, and they had a shiny bioweapon to try out: myxomavirus, a smallpox like thing, that kills that kind of rabbit with "near 100%" lethality. Win win. All Oz hadda do was unleash it...
And unleash it they did, then grin with satisfaction as dead rabbits appeared everywhere. Wow! Biowarfare WORKS!
But then the "problems" emerged...
Read 6 tweets

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