COVID UPDATE: The latest on Omicron from a few brief conversations with scientists plus 24 hours of development.

A little of what’s known & what’s speculated. 1/
For a summary as of yesterday, here is my thread. Please note that while the first case was detected in Botswana— but unlike the thread says— it is still not clear where the first case originated. 2/
South Africa has become a hot spot but cases are popping up now in Belgium, the UK, and Hong Kong. It’s a safe bet that there are cases now throughout the world. 3/
Countries including the US have banned travel from the region of southern Africa.

A far better response would be the mass shipment of hundreds of millions of vaccines to the area. 4/
Scientists are indeed quite focused and concerned about Omicron. It appears to have the properties that would both evade an immune response (at least to some degree) and spread faster than Delta. 5/
What is interesting is that unlike the Alpha and Delta discoveries, this has been discovered with a very small number of cases due in large part to excellent work by S African scientists. 6/
What it also means is that much of the analysis we are reading about is based on sophisticated modeling.

Some of the mutations we’ve seen before & know how they create problems. Many we haven’t seen before. 7/
There are questions about the rate of spread with some modeling showing the virus could spread at 5x the rate of the 2020 version of COVID. That is being studied and will be borne out more clearly in the next few weeks & as Omicron is exposed to areas where Delta is stronger.8/
It appears that PCR tests are able to detect Omicron directly. If this holds it creates a powerful tracking & surveillance tool.

As data emerges, this is something to be mindful of. 9/
What about our tools?
-Rapid tests
-Masks, ventilation 10/
We don’t yet know how well our current vaccines perform against Omicron. We should have analysis within 2 weeks. 11/
Scientists from Moderna and Pfizer have begun to work to test the Omicron virus against the vaccine in a lab. Moderna has indicated they are also testing a larger boost, an Omicron specific boost, and a boost that would work against multiple-variants. 11/
Ideally, the next boost we have to combat Omicron should combine a vaccine that works against multiple variants/known mutations and the flu presuming it can be safely administered— something they express confidence in. 12/
The mRNA platform allows for rapid development. Unless there are surprises, this means weeks to create, months to produce. 13/
Studies on monoclonal antibodies also suggest that Omicron will cause challenges for the existing monoclonals. I’m uncertain how long it would take to adjust to new strains. I have been told it is a rapid process but don’t have that confirmed so can’t throw out a date.14/
Omicron is airborne. Well fitting masks, ventilation, avoiding crowds— particularly large, unmasked crowds— is a fail safe— in the event of rapid spread.

Testing people on arrival (at home tests appear to still work— to be confirmed over time) & quarantining is sensible. 15/
Assume that no one thing does the trick to protect you but the magic is in the combination.

There is no answer yet for people worrying & wondering about holiday plans other than to use precautions, particularly among & around older & immunocompromised people. 16/
When we worry almost entirely about how this will effect us if it gets here, we make the same mistake that got us here. Over and over.

If we don’t worry about everyone, all over the world, we are more likely to live in this cycle. 17/
Even as we learn more, know that we have tools & will have better ones to combat Omicron.

We need to not only use them but make sure they are able to be used by people everywhere. /end

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More from @ASlavitt

28 Nov
COVID Update: Many things reported as known about Omicron that are still questions or at best hunches. From my communications w scientists/officials today.

Here are key questions & my shot at current state answers. 1/
Is Omicron able to evade the current vaccine?

Unknown. The profile and amount of mutations leads to the assumption that it likely does at least in part. That is not the real world but first looks at early real world data seem to support that it does evade to some extent. 2/
What we will look for is reduction of prevention of severe disease and moderate. The early pieces of data show more decline in moderate or mild disease. Some but less in severe.

It appears certain that being vaccinated improves your odds even if there is some degradation. 3/
Read 15 tweets
26 Nov
COVID Update: A new variant in southern Africa has emerged & is grabbing global concern.

What do we know about it? Should we be worried? 1/
In situations like this, it is useful to separate into what is known with good certainty, what is unknown, and what is being speculated.

Then I will address the “what if…” question. 2/

B.1.1.529 (it will be given a Greek alphabet name today) originated in South Africa and Botswana and cases have been recorded among travelers in Belgium, Hong Kong, and Israel. 3/
Read 22 tweets
14 Nov
COVID Update: The US Court of Appeals is preventing the Biden Admin from implementing common sense requirements that the workplace & workers be kept safe from COVID. 1/
Parroting the over-wrought language of a Trump fundraising letter, the 5th circuit, the most conservative appeals court in the country, refers to the requirement that people either get tested or vaccinated as a “sledgehammer” that will “decimate their workforces.”

Oh my. 2/
Trying to remember, have we seen workplaces “decimated” and “sledgehammered” by asking people to take a once/week test to see if they may have have COVID?

Or have we seen workplaces and people who work there decimated by something else…COVID-19 itself. 3/
Read 15 tweets
11 Nov
Here’s a lawsuit that has nothing to do with the law or health or common sense.

I used to run Medicare & the vaccine program so I have a point of view.

“States sue to block vaccine mandates for health care workers from Medicare.” 1/…
Medicare has the unquestioned right to determine which care providers are in the program very simply because Medicare pays the bills.

Just like the DoD can make the rules for which defense contractors they contract with. 2/
To do this, Medicare has conditions of participation for hospitals and nursing homes to provide care to beneficiaries.

If you can’t keep beneficiaries safe or provide quality care then Medicare won’t want beneficiaries risking their lives. 3/
Read 8 tweets
10 Nov
COVID Update: One too many smart people has told me or said on TV this week that the pandemic is over.

I offer this thread as a single, uniform response to everyone. 1/
It is still here.

There are still 1200 people dying every day. That’s a rate of 440,000 deaths/year.

40,000 from accidents
70,000 from opioids

I have a work colleague in the hospital right now who got COVID last week. It’s serious & we don’t know the outcome. 2/
I don’t know the amount of vaccinations we need to have it end here, but we’re not there.

Russia has 1/3 of the country vaccinated. And it’s not pretty.

Denmark has 70% and it’s not enough. 3/
Read 15 tweets
1 Nov
COVID Update: My remarks this morning in New York at mayoral press conference on vaccine mandates. 1/
“The proof is in Halloween.

If you walked around city yesterday you saw families in costume, restaurants filled, stores open, a parade like you only find in NY, adults in elaborate costumes (at least I think they were costumes). 2/
What I saw was New York City. A city able to return to normal, to life, to joy— secure in their belief that they were protected from the virus because whenever they entered somewhere people were vaccinated. The word that kept coming to mind was: freedom. 3/
Read 9 tweets

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