A key question US policymakers are asking

Should they follow the EU and put in a travel ban to South Africa?

Is there any benefit of travel bans? Yes here is

Is there any cost of travel bans? Yes there is

So lets talk about what we know

Thread (1 of 4)
First, most of the evidence suggests that travel bans

If put in early, can slow spread of the new variant into a country by a week or two

Not keep it out -- but slow it

Why not keep it out? Because the variant is already in Asia (HK), Europe (Belgium) and other parts of Africa
And it is entirely possible its already here in the US

So travel bans help a little....and buys us a week or two

So what's the cost?

South Africa has done an extraordinary job identifying, sequencing and transparently sharing data on the variant

If we impose a travel ban...
The signal to the next country is

If you identify a variant and share it with the global community

You will be punished with a travel ban

I am not pro or anti travel bans

They can be useful in instances

But we should know that its weak tool for fighting a global pandemic

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More from @ashishkjha

26 Nov
Every few months, we hear about anew variant

Most turn out to not be much

Well, unfortunately, there's a new variant B.1.1.529 that is concerning

What do we know so far? A few things but not a lot

Reminder: when it comes to variants, we focus on three things

Short thread
What are those three to pay attention to?

Is it more transmissible than current strain (Delta)?

Does it cause more severe disease?

And does have it more immune escape (will it render prior infections or vaccines less effective)?

So lets talk quickly about what we know

On transmissibility, data look worrisome

It has taken off quickly in South Africa

This graphs look concerning

But with case numbers in SA low right now, rapid takeover could be driven in part by other factors

So yes, am worried about transmissibility. But not sure

Read 7 tweets
7 Nov
Quick update on state of pandemic in the US

National picture has turned mixed

Bad news: rapid declines in cases has plateaued

Over past 2 weeks, new infections flat at about 75K per day

The good news?

Early in November, we're flat

Could be much worse. Could be 2020

If we compare same two months to last year, we see a very different picture

Last year at this time, infection numbers were taking off!

Doubling every 3 weeks

We were on a steep acceleration

This year, we have the FAR more contagious Delta

Schools are open

And we're flat!
You all know why

Nearly 60% of Americans now fully vaccinated

So as the air gets cold and dry

The virus, spreading more efficiently, keeps running into walls of vaccinated people

And can't accelerate

If you look at the state picture, this becomes clearer
Read 7 tweets
31 Oct
As a dad, I've thought a lot about the vaccines that will get authorized this week

And tried to think through the risk and benefits for my 9-year-old son

Based on data

I wrote out my thinking in a piece in @TIME

Here are some key points


A common misinformation refrain is kids are at lower risk than adults


Not the point

I don't think about my kids risk for COVID compared to my parents risk for COVID

I think about my kids risk for COVID compared to other risks my kids face

And what how to reduce them
The second issue is one of myocarditis or inflammation of the heart muscle

This is a real thing

But vaccine-induced myocarditis is rare and appears based on all the data to be relatively mild

COVID induced myocarditis is more common, and likely worse
Read 5 tweets
26 Oct
FDA expert advisors meeting on kids (5-11) and vaccines

I expect they'll follow the data and authorize vaccines for kids

And soon, I'm getting my 9 year-old vaccinated

Why am I so confident this is the right thing for my kid?

Because of the data

So lets review

First, the vaccine is very effective

In the trial, they reduced infections by 91%

That's during time when Delta variant was widespread

Safety data also compelling

You see standard stuff of course: sore arm, headache, low grade fever after the vaccine

But nothing serious

But lets look at the bigger picture

These vaccines have been given to half of all humanity (3.8 Billion folks)

They are among the most closely studied vaccine in history

15 million kids in the US have already been given the Pfizer vaccine

Side effects happen but are rare

Read 5 tweets
24 Oct
Good morning

Here's a quick update on the state of COVID in the US

5 points:

1. Infections are down 50% from September 1

Last year, infections rose 100% from September 1 to October 31

So we are, at least right now, on a pretty different trajectory

2. Deaths are down about 30% from the peak

This is good but not great

Why not more?

Deaths lag

But also, we are still seeing a lot of infections among vulnerable, high risk people

This is no time to be older, chronically ill and unvaccinated

3. Most new infections are in the northern half the US

And largely in Midwest, Great Plains states

7 states with the highest infection rates (AK, MT, WY, ID, ND, WV, UT)

They also have very low vaccination rates

In New England, cases flat despite weather getting colder

Read 6 tweets
18 Oct
Given the passing of General Powell who was fully vaccinated

A lot of misinformation spreading about breakthrough infections

So let's talk about breakthroughs

What are they about?

When are they a big deal?

Let's put on our public health and clinician hats on this

First, what is a “breakthrough” infection?

Its when someone who is fully vaccinated still gets infected

We know these vaccines prevent infection – but not 100%

So vaccinated people can still get infected

But then, your immune system, trained by vaccines, really kicks in

Within days of infection, a vaccinated person's immune system goes into high gear

Memory B cells make antibodies

T cells arrive to kill infected cells

And for most people, they don’t go on to have severe disease

A few days of symptoms, then they recover


Read 8 tweets

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