Mia Malan Profile picture
Nov 29, 2021 15 tweets 10 min read Read on X
[Thread] 1. @ProfAbdoolKarim on the #OmicronVariant globally:

1. Globally #COVID19 case numbers are increasing
2. The WORLD might be entering a 4th #COVID wave
2. Variants have changed the #COVID19 endgame. Each SA #COVID wave = driven by a different variant with different characteristics:

Wave 1: Wuhan variant
Wave 2: Beta variant (more transmissible than Wuhan, immune escape abilities)
Wave 3: Delta (more transmissible than Beta)
3. #COVID19 case surges have been caused by different variants in different countries.
India = #DeltaVariant
Brazil = Gamma variant
SA = #Beta (Wave 2), Delta (Wave 3)
4. SA has seen a rapid rise in #COVID19 cases the past week - from a low transmission rate barely a week or two ago.
5. SA wasn't caught with its pants down:
- In Sept scientists said they expected a new variant for the 4th wave, based on what happened in previous waves (each wave was driven by a new variant)
- But they didn't know exactly when a variant would emerge or what it would look like
6. Because scientists in SA anticipated a new variant, the government invested heavily in the country's genomic surveillance capability so that we're able to pick up new variants as fast as possible. That is why we were able to detect the #OmicronVariant so fast.
7. What characteristics does the #OmicronVariant have?
We don't have clear evidence yet, we can only predict likely scenarios:
- Some mutations = linked to enhanced transmissibility/partial escape of antibodies in other variants
- Some of its mutations we haven't seen before
8. What #OmicronVariant scenarios can we expect?

1. Diagnostics (#COVID19 tests) = work
2. Clinical presentation (who gets sick + how sick): Not enough data yet, but anecdotal patient cases suggest patients = younger (but fewer younger than older people in SA = vaccinated)
9. What #OmicronVariant scenarios can we expect? (continued)?

1. Clinical presentation (who gets sick + how sick): No clear evidence yet, anecdotal cases suggest no big changes in symptoms and disease severity
2. Will antiviral and steroid #COVID19 treatments work? Likely.
10. Will vaccines work @ the #OmicronVariant?
1. Prelim evidence suggest partial immune escape from antibodies (from jabs/natural infection, so slightly less protection)
2. Likely an increased risk of reinfection (if you've had COVID = could be more likely 2 get infected again)
11. Will vaccines work @ the #OmicronVariant (continued)?

1. We don't yet know yet how #JnJ and #Pfizer will respond (the jabs used in SA) - it will take 2-3 weeks to get answers
2. No previous variant has been able to reduce protection by much @ falling seriously ill
12. Will vaccines work @ the #OmicronVariant (continued)?

1. Different vaccines could respond differently, we know that from the past, especially when it pertains to mild infections
2. E.g.:AstraZeneca doesn't protect well @ mild Beta infections, but it protects well @ Delta
13. We have lots of data to show that #COVID jabs = very good to protect us @ falling seriously ill with #COVID. It's hard to reduce the protection of T-cells (the stuff that protect us against serious illness).
14. Why won't #COVID19 travel bans to stop the spread of the #OmicronVariant work?
1. The variant has already been detected in 11+ countries, isolating SA or southern Africa won't help
2. Better measures = screening at border posts, only let the vaccinated travel
15. SA's investment in genomic surveillance (this is what scientists do to pick up new variants) has paid off, because we've identified the #OmicronVariant exceptionally fast. We now need to convert that success to "response success" (what we do to fight the variant).

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More from @miamalan

Jan 17
[Thread] 12 things to know about the the proportion of pregnant women infected with #HIV from SA’s latest antenatal HIV survey. The survey is conducted by the @nicd_sa.

(Analysis of our 95-95-95 goals in my next thread later in Jan).

1/12 Image
2. What is the antenatal #HIV survey?

1. It measures the % of HIV+ pregnant women between the ages of 15 + 49.
2. Only women using state pregnancy clinics take part.
3. The survey has been conducted each year between 1990-2015, then in 2017, 2019 +2022. Image
3. How many pregnant women between 15-49’s blood was tested for #HIV? 37 828 out of 40 542 collected samples.
- 37 7171 = Black African women
- 37 541 didn’t live with the dad of their child
- 35,635 of dads were 5 years+ older than moms (this makes them more likely to get HIV) Image
Read 12 tweets
Jan 10, 2023
JUST IN [Thread]:
1.@healthza's Lesley Broomberg:
An extra #COVID19 booster jab for people of 18+ in SA will become available towards the end of JANUARY
- People of 50+ qualify for a 5th dose
- People of 18+ qualify for a 4th dose
2. Lesley Broomberg: Can you mix and match with additional boosters? Yes. You can choose whether you want a #JnJ or #Pfizer booster.
3. Lesley Broomberg:
Will teens of 12-17 qualify for boosters? Not at this stage. Why not? The #VMAC = not recommended booster doses for 12-17, based on an understanding that the protection provided by 2 #Pfizer doses = adequate, as 12-17 = @ low risk of severe #COVID19 illness
Read 5 tweets
Jan 10, 2023
[Thread] #JoePhaahla:
- Genomic surveillance Network reported the detection of the new subvariant XBB.1.5 in SA of a sample of a patient tested on 22 Dec
- Details of the patient = not known, it was a random sample taken for testing
- XBB.1.5 = also common in US
2. XBB.1.5 = common in US
#JoePhaahla:
- 97%+ of #COVID19 cases worldwide = still #Omicron
- XBB.1.5 cases = no major change in hospitalisations or deaths
- Immunity of SAs (vax and natural immunity) = still strong, so that is why we haven't seen much change in terms of hospital admissions/deaths
Read 5 tweets
Dec 13, 2022
🧵1. SA's @aspenpharma will be making 4 jabs (fill + finish) — pneumococcal, rotavirus, meningococcal, hexavalent — from 2023.

How will they finance this?
With a $30 million grant from @CEPIvaccines + @gatesfoundation.

Which APIs will Aspen use?
India's Serum Institute's
2. Why is it NB that an African company makes these jabs?

#Africa imports almost all its jabs. #COVID19 showed us this results in Africa being last in line to get vaccines during pandemics. The grant to Aspen is 1 of the 1st steps to change that.
3. What's the goal?

By 2040, the African Union wants #Africa to make 60% of the jabs the continent uses.

Why?
So that Africa is better equipped 2 respond 2 outbreaks (by developing the ability to make jabs + have technology in place to also make new jabs during pandemics).
Read 6 tweets
Dec 2, 2022
🧵1. BREAKING: @SAHPRA1 has confirmed the registration of the #HIV prevention jab, #CABLA in South Africa. On Thursday, #ViiVHealthcare issued their statement. ImageImage
2. Who can use the jab? @SAHPRA1 didn't specify restrictions for use in their statement, only that it is "a highly effective option for people at substantial risk of #HIV infection." Image
3. How does the jab work? It uses an #ARV called cabotegravir that prevents #HIV from replicating and entering someone’s cells. It’s taken every two months. Read my latest story for more. bit.ly/3ER7ejq
Read 5 tweets
Dec 1, 2022
🧵1. @SAHPRA1 says it’s “days away” from announcing a decision on the registration of the #HIV prevention jab, #CABLA. The shot virtually wipes out your chances of contracting HIV through sex + needs to be taken every 2 months. bit.ly/3ER7ejq#WAD2022
2. How does the jab work? A bit like contraception, says @LindaGailBekker. “U take contraception before sex 2 prevent pregnancy. Similarly, u take the jab before being exposed 2 #HIV 2 prevent infection.” Listen 2 Linda-Gail on @bhekisisa’s #HealthBeat. bit.ly/3FjBlS8
3. What makes #CABLA work? An antiretroviral drug called cabotegravir. Some people with #HIV use it for treatment, along with other #ARVs. The drug prevents #HIV from entering your cells. bit.ly/3ER7ejq
Read 8 tweets

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