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/… Image
South African scientists report that the areas with the greatest % of unvaccinated & the most prior Deltq infection are getting hit hardest.

We have an area like that. It’s called Florida. It’s the South. It’s many red states around the country. 4/
The strategy— most closely associated with Scott Atlas, formerly of the Trump White House—called “natural herd immunity” is prevailing wisdom in areas that voted for Donald Trump or who listen to some of their political leaders. 5/
That strategy was already costly on its face. 65% of Republican adults are vaccinated compared to 90% of Democrats.

And new data shows that has led to a 50% higher death rate in Republican states. 6/
Getting infected and letting COVID run wild isn’t particularly smart for other reasons. I mean other than just that it kills people.

The more spread, the more chances for a virus to mutate. The more mutations, the more chance of a variant of concern. 7/
This strategy of playing with fire by not getting vaccinated & then getting COVID has kept case counts & deaths high.

But now it turns out that the 10s of millions of people who thought they had immunity aren’t immune, many who didn’t really want COVID. That’s bad news. 8/
As usual with this pandemic, what’s bad news for someone is bad news for everyone.

The rate at which COVID is spreading so far in South Africa (Rt) looks to be in the range of 12 to 15, about twice as fast as Delta.

But this may have nothing to do w Omicron at all. 9/
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/
So when Ted Cruz pitches a fit that he will close the government if his anti-vax policies aren’t considered. And when DeSantis says he will pay fines for people don’t vaccinate. And when Red states sue to stop hospitals from requiring vaccinations, well, this is what we get. 13/
Now to be clear, COVID spreads without much help. It doesn’t need all the help it’s being given.

It would do ok on its own, Ted/Scott/Ron. It doesn’t really need your help. 14/
So when people say “hey, you might want to wear a mask” or “consider getting vaccinated” or even “you can’t come into this school/restaurant/office if you’re not vaccinated,” it’s not a police state. It’s called common sense. 15/
We’re also going to see data from South Africa that shows unboosted vaccines are less effective at preventing infections with Omicron than with Delta.

But vaccines, boosters, rapid tests, ventilation, therapeutics, masks are the tools of science there for us. 16/
But these tools of science, which will keep so many alive, have a great flaw.

They do nothing sitting on the shelf. 17/
And the more people who don’t use them, the more vaccines will need to get better & better … to keep up with viruses spread by people who won’t take them. 17/
So for those that do use the tools of science, who mask and vaccinate, the world seems caught in a strange loop.

Things get safer and safer every few days until they seem to take a big step back every few months. That’s the “go for herd immunity” cycle. /end

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More from @ASlavitt

2 Dec
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/
Read 16 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?
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
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

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