COVID Update: What should we consider doing differently with Omicron? 1/
1. Plan ahead.

Political leaders, business leaders & the rest of us should consider acting in some areas even before the facts are known for certain.

So what should be assumed about Omicron? 2/
2. Operate with informed but conservative assumptions until we know more.

Making assumptions is always hazardous. So what assumptions should we make until we learn more?
Starting assumptions:

-prior COVID exposure will not protect well against Omicron
-the vaccines still work but to a lesser degree than on Delta
-vaccines will work better at protecting against severe disease than moderate
-Omicron spreads as or more rapidly than Delta 4/
More educated guesses to make near term decisions by.

-Assume Omicron may outcompete Delta & if there is no cross-immunity, it can spread even where it doesn’t
-Monoclonals will need to be retargeted
-PCR, antigen tests & the new Pfizer drug therapy continue to work 5/
3. Push boosters aggressively.

A number of scientists say that boosters are likely to provide additional protection against Omicron. Even before we know how much benefit, we should act now to boost everyone possible. 6/
4. Unvaccinated should use this as a chance to reconsider.

Already skeptical people may turn more skeptical. But they shouldn’t. Against an even more rapidly spreading virus, if your risk of hospitalization were cut by even 50-75%, you should do it.

But it is critical that vaccination isn’t talked about as the only answer even if it’s an important one.

One reason why people are skeptical is prior talk from many (including me at times) that vaccines are a panacea. It’s enough that it’s a great tool. But we need others. 8/
5. Speaking of others— Rapidly scale up purchase & production of at-home antigen tests & Pfizer & Merck anti-virals.

Six months from now if every American had access to instant tests & a Rx for a highly effective therapy, it would ease concerns a great deal. 9/
These therapies require very quick response so frequent and much cheaper testing is needed. And while new boosters are tested we are likely to need many more therapies. 10/
6. Start treating COVID as a global problem not a personal threat.

Shower resources on hot spot countries including vaccines & boosters, tests & therapies. Until it matters “there” as much as it matters “here”, our chances of beating this are low. 11/
The US is now sending an average of over 3 million vaccines overseas every day. The G20 needs to reciprocate & act to help get these vaccines in arms whenever needed. 12/
7. Portable ventilators, ventilated spaces & high quality well-fitting masks are our FRIENDS, not an assault on our freedoms.

Let’s stop fighting our friends and enabling our foe. 13/
8/ Those who went to great lengths to prevent schools & localities from requiring masks should reverse course.

With rapidly spreading viruses what starts in a school or bar quickly lands in a nursing home. 14/
9/ Contingency planning.

The mRNA platform give us the capacity to adjust the vaccines to fit mutations. In the case that the virus’s mutations require changes to the vaccine, we can & should have those ready. 15/
10/ “This is a source of concern, but not panic.”

The president said this in his remarks today. And that’s right. We have tools, we have preparation, & we are not going back to Square 1. 16/
These assumptions may not be the right ones. We should systematically & scientifically answer these questions as we have enough data.

But things which cause little disruption & have the potential to save lives if things get worse are steps we should never regret.

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More from @ASlavitt

30 Nov
COVID Update: Given the events of the last few days, I got a rundown of what the US has been doing in Africa over the last few months. 1/
So far the US has sent 93 million vaccines to Africa, 13 million to Southern Africa, and 8 million to South Africa. More is available to S Africa when they need.

(The US has sent 275 million free doses outside the country total & are at a clip of 3 million/day.) 2/
US agencies providing support in Africa include PEPFAR, NIH, CDC, and USAID. 3/
Read 4 tweets
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
27 Nov
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/
Read 19 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

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