Thread by @MonicaGandhi9

In places of low vaxn (23% in S Africa), hospitalizations rise with increasing cases with new variant; does not mean it is more virulent; means it is a COVID variant. Now 8 cases at least in US but likely much more (5 in NY, verified community spread)
cnb.cx/3lpjnTE

Yesterday, WHO & S. Africa reported 90% of those in hospital were unvaccinated (meaning vaccines work); there is nothing nothing more important than getting vaccines out to the world (S. Africa 23% vax'd; surrounding countries less)

Watch carefully- current disconnect in trends in S. Africa, comparing cases and deaths. We expect lag but the increasing cases with omicron not showing the same patterns as with delta so may be clue of lower virulence. More data needed
ourworldindata.org/explorers/coro…

Dr. Karim (we know well from HIV!) discusses how much testing ramped up in S Africa after identification of Omicron last week but seek & you will find - Omicron probably there & many other places before so if deaths not rising, good sign; watch hospitals
bbc.co.uk/programmes/p0b…

In terms of more re-infections, antibodies decline with time from original infection (which occurred in 2020) (or original vaccine in early 2021) so can get more mild re-infections while you wait for your B cells to make more Abs & T cells protect from severe disease

So, a mild re-infection on top of former infection or vax (there were a lot of mild breakthroughs with delta) will give "hybrid immunity" but is prior infection or vax protecting from severe disease? Seems so and consistent with T/B cells, keep watching

https://twitter.com/MonicaGandhi9/status/1454085053458223106

In highly vaccinated countries like Europe & in the US (at least across many states), if we start using hospitalizations (have to be COVID hospitalizations though, for and not with) as our main metric for "success" (and restrictions like Marin County), good shift in strategy

As administration ramps up testing, limitations of our current tests will come up (PCR too sensitive; low viral load unclear significance; antigen tests false positives); seek & you will find virus in nose; looking at illness in high vax states (CA data here) of clinical import

US strategy: if start using hospitalizations as our main metric in high vax places, must give data
1) On status of vax, unvax'd, prior infected
2) On symptoms since we do COVID swabs on all for infection control- there with or for COVID? If latter, how ill
theatlantic.com/health/archive…

I wrote this to CDC in delta (since places with high vax had hospitalizations "decoupled" from cases, but suggest each municipality in US in context of vax report data out on hospitalizations by vax/unvax (or prior infection), symptoms/no symptoms (with universal screening)

Finally, please remember what happened in the US with delta; places with high vax (Bay Area) had low rates of child illness even though 5-11 vaccine not out because adult vax protect kids; in S. Africa with 25% vax, kids not protected by adult vaccines; #globalvaxequity