With early data rolling in, here’s where we currently stand with Omicron

First, we have plenty of evidence that Omicron will spread easily, quickly, and far

We should expect, globally, relatively large waves of infections

How will people fare?

Depends on who you are

I think of 3 groups of people

Immunologically naïve

Somewhat protected

Highly protected

Depending on which group you are in

Your risk of infection varies

As does your risk of bad outcomes

So let's talk about each of them

Group 1 Immunologically naïve:

Who are they?

Unvaccinated and not recently infected

How will they fare?

They are likely to get infected with Omicron at very, very high rates

Many of them will get sick. I hope...but doubt... that the virus will be mild for them

Group 2 Somewhat protected

Who are they?

Folks with 1-2 shots of a vaccine OR a recent infection

How will they fare?

Large numbers will see breakthrough infections

Severe illness should largely be preventable

High risk folks in this group still at risk of bad outcomes

Group 3 Highly protected

Who are they?

Folks boosted or have hybrid immunity (infection + 2 shots)

How will they fare?

Relatively high degree of protection against infection but probably some breakthroughs

Severe illness very rare

Will look like “mild” disease

So when you hear Omicron no big deal

Because "this is a mild disease"

Understand that for some, that is true

But not for all

That's why critical to get 1st/2nd shots for as many unvaccinated as quickly as possible

And 3rd shots for everyone else


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More from @ashishkjha

30 Nov
While everyone is focused on #Omicron

Let's not forget Delta, our current scourge

And over past 5 days, we've seen a 25% drop in cases (see graph)

Good news, right?


Its what we see during every holiday: drops in cases due to drops in testing

And its a problem

Some of the drop off is lack of reporting

But a lot of it is sick people not getting tested

That's a problem because...with less testing

more infected people are spreading to others

And what we've seen?

Bigger the drop during the holiday

Bigger the bounce that follows

Which gets us to this Thanksgiving

We've seen a 25% drop in cases over Thanksgiving holiday

That's big -- much bigger than last Thanksgiving

Which means we should expect a sharp jump in reported infections later this week

Some of those will be reporting catchup


Read 4 tweets
26 Nov
A key question US policymakers are asking

Should they follow the EU and put in a travel ban to South Africa?

Is there any benefit of travel bans? Yes here is

Is there any cost of travel bans? Yes there is

So lets talk about what we know

Thread (1 of 4)
First, most of the evidence suggests that travel bans

If put in early, can slow spread of the new variant into a country by a week or two

Not keep it out -- but slow it

Why not keep it out? Because the variant is already in Asia (HK), Europe (Belgium) and other parts of Africa
And it is entirely possible its already here in the US

So travel bans help a little....and buys us a week or two

So what's the cost?

South Africa has done an extraordinary job identifying, sequencing and transparently sharing data on the variant

If we impose a travel ban...
Read 4 tweets
26 Nov
Every few months, we hear about anew variant

Most turn out to not be much

Well, unfortunately, there's a new variant B.1.1.529 that is concerning

What do we know so far? A few things but not a lot

Reminder: when it comes to variants, we focus on three things

Short thread
What are those three to pay attention to?

Is it more transmissible than current strain (Delta)?

Does it cause more severe disease?

And does have it more immune escape (will it render prior infections or vaccines less effective)?

So lets talk quickly about what we know

On transmissibility, data look worrisome

It has taken off quickly in South Africa

This graphs look concerning

But with case numbers in SA low right now, rapid takeover could be driven in part by other factors

So yes, am worried about transmissibility. But not sure

Read 7 tweets
7 Nov
Quick update on state of pandemic in the US

National picture has turned mixed

Bad news: rapid declines in cases has plateaued

Over past 2 weeks, new infections flat at about 75K per day

The good news?

Early in November, we're flat

Could be much worse. Could be 2020

If we compare same two months to last year, we see a very different picture

Last year at this time, infection numbers were taking off!

Doubling every 3 weeks

We were on a steep acceleration

This year, we have the FAR more contagious Delta

Schools are open

And we're flat!
You all know why

Nearly 60% of Americans now fully vaccinated

So as the air gets cold and dry

The virus, spreading more efficiently, keeps running into walls of vaccinated people

And can't accelerate

If you look at the state picture, this becomes clearer
Read 7 tweets
31 Oct
As a dad, I've thought a lot about the vaccines that will get authorized this week

And tried to think through the risk and benefits for my 9-year-old son

Based on data

I wrote out my thinking in a piece in @TIME

Here are some key points


A common misinformation refrain is kids are at lower risk than adults


Not the point

I don't think about my kids risk for COVID compared to my parents risk for COVID

I think about my kids risk for COVID compared to other risks my kids face

And what how to reduce them
The second issue is one of myocarditis or inflammation of the heart muscle

This is a real thing

But vaccine-induced myocarditis is rare and appears based on all the data to be relatively mild

COVID induced myocarditis is more common, and likely worse
Read 5 tweets
26 Oct
FDA expert advisors meeting on kids (5-11) and vaccines

I expect they'll follow the data and authorize vaccines for kids

And soon, I'm getting my 9 year-old vaccinated

Why am I so confident this is the right thing for my kid?

Because of the data

So lets review

First, the vaccine is very effective

In the trial, they reduced infections by 91%

That's during time when Delta variant was widespread

Safety data also compelling

You see standard stuff of course: sore arm, headache, low grade fever after the vaccine

But nothing serious

But lets look at the bigger picture

These vaccines have been given to half of all humanity (3.8 Billion folks)

They are among the most closely studied vaccine in history

15 million kids in the US have already been given the Pfizer vaccine

Side effects happen but are rare

Read 5 tweets

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