COVID Update: I’ve been calling around to get a sense of the extent of spread of Omicron in the US.

Will report what I’ve heard and some very strong steps from President Biden to minimize spread. 1/
Two labs, one in the East Coast and one in the West Coast are investigating what earlier in the week was only 6 reported cases.

But as someone says, the absence of proof isn’t the same as proof of absence. So… 2/
The most telling conversation I had was with a state which sequenced every positive case from the last 6 weeks. They found no Omicron cases. 3/
While not definitive this tells me that Omicron is not yet running wild in the US. It is not too late to take action.

Very pleased to see new steps in these key areas… 4/
1- Global vaccination. The US which has already delivered over 200 million vaccines around the globe (& over 90 million to Africa) will send another 200 million in the next hundred days. All free.

$250 million of aid to Africa to conduct vaccinations. 5/
2- More rapid at home testing available in the US. Now for free. 6/
This new testing allows several things:
-keep the country, the economy and people moving without putting them at risk
-reduce spread
-for people who test positive allow them to take therapies early 7/
There are now 8 rapid at home tests approved, up from zero. Thanks to $3 billion investment from Biden Admin and rapid FDA approvals.

There will soon be 4x the number of tests available compared to August. 8/
3- Smarter border and international travel policies.

All foreign nationals to the US must now show proof of vaccination & all travelers must show a negative test within 24 hours. Travel limited from hot spot countries. 9/
4- Emergency response teams

60 teams will be readied around the country to manage potential hot spots. 10/
5- Families and kids

Several hundred family vaccination clinics will open both mobile & in communities.

Relatedly they are looking at school resiliency processes so schools can stay open even when there are positive tests.

Medicaid will pay doctors for vaccine counseling.11/
6- Boosters & seniors

Best advice of scientists is that boosters are best prevention against Omicron.

Pharmacies are expanding hours & walk-ins.
Medicare will do direct outreach to seniors, so will AARP 12/
7- Building the arsenal

-Administration procuring 13 million doses of oral therapeutics
-Partnering on potential adjustments to vaccines if needed so they can be made and introduced in Q1 next year if needed 13/
My overall: they are moving fast.
They are building on prior action.
They are being comprehensive. They are focusing on science. They are preparing for all scenarios.
14/
Meanwhile sadly there are people trying to stand in the way.

Republican leaders have called Omicron a hoax & are prohibiting common sense masking policies while they have challenged the ability of Medicare and OSHA to even keep workplaces & hospitals safe in court.
15/
Republican politicians should support efforts to minimize the pandemic or at a minimum, stay the hell out of the way. /end

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More from @ASlavitt

4 Dec
Here’s the explanation. Omicron will only spread as fast as there are people to infect.

So the Rt or spread will be lower if Omicron can’t outcompete Delta or if it finds large amounts of unvaccinated people, even with prior Delta infections (as it has in S Africa). 10/
It’s possible that this is what’s happening. Omicron could be spreading no faster than Delta but because prior infection slows Delta down but not Omicron, that creates a higher Rt. 11/
This means Omicron, at least in parts of the US with low vaccination rates, will likely be dominant over the next few months even if it is no fastero than Delta.

Again, we all pay for the bad choices any of us make. 12/
Read 11 tweets
4 Dec
COVID Update: The anti-vaccine natural herd immunity-just go get COVID crowd has met their match … with reality. 1/
People are throwing a lot of big numbers around about how fast Omicron spreads.

But it’s impossible to know how fast Omicron spreads. Except in one specific group— the unvaccinated, even those with prior infection.2/
When the 2020 virus became Alpha and Alpha became Delta, prior infection continued to protect against the new variant.

Not so with Omicron. (Study below) 3/

medrxiv.org/content/10.110… Image
Read 19 tweets
30 Nov
NEW: We take a step forward today as an FDA advisory committee approves Merck’s antiviral, the first oral anti-viral to be approved.

It has a low efficacy rate of 30%, but should pave the road for more effective drugs. 1/
The drug isn’t perfect. Its expensive— $700 per treatment (Govt paid), requires it be taken early, and people should talk to their physicians about the side effect profile. 2/
But the principle by which the drug works is promising & calls out for a future of better drugs. One of them is around the corner from Pfizer, with an 89% efficacy rate among unvaccinated people. 3/
Read 9 tweets
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
29 Nov
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?
3/
Read 17 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

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