Share this page!

Monica Gandhi MD, MPH Profile picture
Twitter logo
28 Nov, 4 tweets, 2 min read
3 characteristics to ask about a variant. Is it more transmissible, more virulent, can it evade vaccines? Delta was 1st, not second two. We don’t know enough about omicron but this is a thread on polyclonal antibodies and B/T cell immunity from vax that makes 3rd more unlikely
And agree with Dr. Katz that the most important thing to understand is the degree of symptoms (illness) from a new variant: preliminary reports on more mild need verification, more study just like the risk stratification by age in COVID so important
linkedin.com/pulse/omicron-…
We know from HIV how incredibly amazing S. Africa scientists, doctors/ epidemiologists are; careful work should be commended, not punished. So far "presents mild disease with symptoms being sore muscles and tiredness" (cough, smell, taste not prominent)
wionews.com/world/covid-om…
More data and clarity to come on omicron but this is not March 2020 - so much more is known about the virus, we have so many more tools, and information is coming out quickly & in real time about the 3 properties we need to understand about a new variant.

• • •

Missing some Tweet in this thread? You can try to force a refresh
　

Keep Current with Monica Gandhi MD, MPH

Monica Gandhi MD, MPH Profile picture

Stay in touch and get notified when new unrolls are available from this author!

Read all threads

This Thread may be Removed Anytime!

PDF

Twitter may remove this content at anytime! Save it as PDF for later use!

Try unrolling a thread yourself!

how to unroll video
  1. Follow @ThreadReaderApp to mention us!

  2. From a Twitter thread mention us with a keyword "unroll"
@threadreaderapp unroll

Practice here first or read more on our help page!

More from @MonicaGandhi9

Monica Gandhi MD, MPH Profile picture
30 Nov
Omicron COVID variant was in Europe before South African detected & flagged for world. Agree with AztraZeneca -no evidence vax doesn't protect from severe disease with variants (AZ less profit oriented); 2) S. Africa scientists that they felt 'punished'
cbsnews.com/news/omicron-v…
This is some of the immunology behind why vaccines likely to still be protective against variants:
And the 2-dose vaccines seem to protect against severe disease per BioNtech; if you want to avoid mild breakthrough, certainly get boosted. With an endemic virus, virus will likely be seen again in future after booster antibodies come down
wsj.com/articles/omicr…
Read 5 tweets
Monica Gandhi MD, MPH Profile picture
26 Nov
NU VARIANT (B.1.1.529) in South Africa & why unlikely to evade vaccine-induced immunity. So, what is this variant? Number 1, we don't know yet if it is more transmissible. Still being studied & described. 59 cases uploaded to database
thenationalnews.com/coronavirus/20…
Okay, so what is a "variant" mean for COVID? Means mutations in spike protein that attaches the virus to the host cell: mutations that differ from the "ancestral strain". This is the bit of the virus that tends to mutate most (like H and N surface proteins of influenza). Also,
of the 8 vaccines approved by the WHO (Novavax will be added soon & will make the 9th), 6 of those 9 involve the spike protein in some way (either code for it with mRNA, DNA; Novavax is protein itself); 3 of the 9 are whole inactivated virions (Covaxin, Sinopharm, Sinovac)
Read 16 tweets
Monica Gandhi MD, MPH Profile picture
24 Nov
DC has dropped its mask mandate. Why I and others think that - with an endemic virus - very justified to do this. Would recommend older people & immunocompromised get boosters & to mask indoors in mixed venues this winter if live in place with cases up
washingtonpost.com/video/national…
Moreover, we are in unique situation in US where 1) highly vax'd places (like Bay Area) still have remaining mask mandates (except Marin, which is going by hospitalization data); 2) we are now finally acknowledging as public health community vax >>masks so let's motivate vax!
Finally, our group seeing 3 patterns worldwide where severe illness low: 1) high natural immunity (tragically gained, India); 2) high vax rate >75%; 3) lots of hybrid immunity (UK opened 7/19 in midst delta surge but with lots of vax). Maybe 3rd shot Covaxin? whole virus?
Read 4 tweets
Monica Gandhi MD, MPH Profile picture
23 Nov
Poll: 74% of Americans Say Lives Have Returned to 'Normal' - very happy to see the confidence many in the US have in the vaccines, despite both 1) misinformation; 2) fearful messaging from some public health officials that they don't work well (they do!)
medscape.com/viewarticle/96…
Mistaken messages on if vaccines reduce transmission (they do) and if vaccines are working during booster conversation (they do) eroded confidence in the vaccines
Cases used to track with hospitalizations but not now after vaccines- so we should now track hospitalizations to track the pandemic, not cases. Places with very high vax (80%), lots of natural immunity (sadly like India), hybrid immunity (UK) doing best
Read 7 tweets
Monica Gandhi MD, MPH Profile picture
17 Nov
SCHOOL CLOSURES: Wow, think we should invest in emotional support for children instead of closing schools again after prolonged schools closures last year (that led to mental/emotional difficulty).
I gave talk in Pediatric Grand Rounds this am at UCSF which made me look more deeply at the history of school closures for infectious diseases in US. School closures were ALWAYS last resort & only happened for raging infections (esp those worse for kids than adults like measles)
In influenza pandemic of 1918 (encourage you to read this article), schools were not closed in NYC (& Chicago/ New Haven) because progressive cities (we really changed!) & out of 1 million children, 750K were not from affluent families; schools place for food, safety, learning
Read 11 tweets
Monica Gandhi MD, MPH Profile picture
16 Nov
Protective immunity after recovery from SARS-CoV-2 infection - an important review in Lancet ID about protection from repeat infection after prior infection vs vaccination. Immunologic review AND review of re-infection studies
thelancet.com/journals/lanin…
#1. Developing illness is what all doctors are sworn to prevent so there is rarely advocacy for natural infection but this is what happens if natural infection occurs. Strongest immunologic evidence for enduring immunity, T cells from Science study here:
science.org/doi/10.1126/sc…
And 2nd amazing paper showing that your B cells will adapt antibodies if they see a variant in the future to the variant in front of them is here (we have discussed this and the above paper in T & B cell threads if you search them)
science.org/doi/epdf/10.11…
Read 5 tweets

Did Thread Reader help you today?

Support us! We are indie developers!

This site is made by just two indie developers on a laptop doing marketing, support and development! Read more about the story.

Become a Premium Member ($3/month or $30/year) and get exclusive features!

Become Premium

Too expensive? Make a small donation by buying us coffee ($5) or help with server cost ($10)

Donate via Paypal

Thank you for your support!

Follow Us on Twitter!

Like this author's thread?

Get emails when @MonicaGandhi9 has new unrolls!

Check out other threads from @MonicaGandhi9!

Read all threads by @MonicaGandhi9

:(