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Céline Gounder, MD, ScM, FIDSA Profile picture
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29 Nov, 4 tweets, 1 min read
1/ Variants have hitched a ride on super-spreading events before, causing much worry:
science.org/content/articl…

This time of year is a super-spreading event around the world.
2/ In South Africa (where I worked on & off from the late 90s to 2012), students are celebrating the end of the term & passing final exams.

Migrant workers are heading back from the mines & cities back home to rural areas.
3/ In the US, we've just kicked off our winter holiday season.

And remember, Chinese New Year fell just as the SARS-CoV-2 virus was taking off.
4/ The spike in Omicron cases *could* be due to super-spreading.

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Céline Gounder, MD, ScM, FIDSA Profile picture
29 Nov
1/ With the emergence of the Omicron variant, my stance on boosters is shifting.

If Omicron is truly immune-evading, we can likely overcome that immune evasion with boosters (similar to what was seen with Beta).
2/ Boosters would buy us time to develop 2nd generation COVID vaccines specific for Omicron.

But risks remain:
- FALSE SENSE OF SECURITY: your risk of SARS-CoV-2 infection is proportional to levels of transmission in the community, no matter how many boosters you get

➡️
3/
Other risks:
- COMPLACENCY: we need a multi-pronged approach; vaccinations alone will not control SARS-CoV-2, at least not in the short term

➡️
Read 10 tweets
Céline Gounder, MD, ScM, FIDSA Profile picture
26 Nov
1/ FAQs I'm getting re: Omicron variant:

Q: Is Omicron more infectious than Delta?
A: We don't know yet. Possibly. Or it could be "hitching a ride" with lax behavior or super spreading.
2/

Q: Does Omicron have a shorter incubation period than Delta?
A: We don't know yet.

Q: Will neutralizing antibodies elicited by the vaccines protect against Omicron?
A: We don't know yet. We may have that data in ~2 weeks.
3/

Q: Is Omicron more virulent than Delta or other variants?
A: We don't know yet. This will likely take months to parse out.

Q: Can we develop mRNA vaccines against Omicron? How long that would take?
A: Yes. Starting now, developed by spring 2022, manufactured by summer 2022.
Read 10 tweets
Céline Gounder, MD, ScM, FIDSA Profile picture
24 Nov
1/ Thanksgiving🦃COVID safety tips:

What about kids who aren't yet vaccinated?
- Kids 5+ years of age: go to vaccines.gov for an appointment
- Rapid test at least every other day over the holidays

with @MSNBC's @ChrisJansing
2/ My 2-year-old niece isn't yet eligible for COVID vaccination.

My sister has been rapid testing her every few days because my niece, like most 2-year-olds, has a runny nose much of the time now.
3/ This weekend, my niece's rapid test came back positive.

My mom cancelled her trip to spend Thanksgiving with my sister and her family.

Rapid COVID antigen tests work! They're keeping us safe this holiday.
Read 7 tweets
Céline Gounder, MD, ScM, FIDSA Profile picture
24 Nov
1/ Have we vaccinated enough people to transition from PANDEMIC to ENDEMIC transmission of SARS-CoV-2?

No, not nearly enough.

nytimes.com/live/2021/11/2… with @nytimes' @MaggieAstor Image
2/ There's a lot of confusion about what we mean by PANDEMIC vs EPIDEMIC vs ENDEMIC.

Note that ENDEMIC doesn't mean the virus has gone away.
3/ A good way to think about the difference is the shape of the case curve.

Once almost everyone is immune, then most susceptible people in the population fall into a couple categories:
- newly born
- migrating into the population
- waning immunity (esp elderly) Image
Read 4 tweets
Céline Gounder, MD, ScM, FIDSA Profile picture
23 Nov
1/ The new COVID antiviral medications won't be game-changing

UNLESS

we game-change the health system.

statnews.com/2021/11/23/cov… with @statnews' @levfacher
2/ Even if fully vaccinated & boosted, immunocompromised & other vulnerable people remain at risk for SARS-CoV-2 infection & severe COVID.

We should scale up access to monoclonal antibodies for highly immunocompromised people as PRE-EXPOSURE prophylaxis.
3/ And we should scale up access to COVID antiviral medications for highly immunocompromised people & residents of long-term care facilities and other congregate settings as POST-EXPOSURE prophylaxis.
Read 5 tweets
Céline Gounder, MD, ScM, FIDSA Profile picture
23 Nov
1/ Where are we at in vaccinating the world?

politico.com/news/2021/11/2… by @politico's @ErinBanco

Many will have to wait until late 2022.
2/ The rest of the world remains an afterthought.

A new variant emerging elsewhere in the world could put our pandemic recovery in jeopardy, as did the rise of the Delta variant this spring.
3/ Our pandemic response continues to be driven by political considerations.
Read 5 tweets

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