Tuesday COVID meeting updates this week (been holding these ever since the onset of the pandemic)
#1
In a series of 70 consecutive COVID deaths reported at a large Kerala hospital, 69 were unvaccinated, one had received 1 dose vaccine.
That was 98.6% unvaccinated, May-Sept
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This data is powerful evidence that vaccination has made a significant reduction in the severe outcomes of delta.
Remember, these are vaccines based on the old Wuhan strain of the SARS-CoV-2 virus.
Yet they are protective against delta variant.
This is hard evidence.
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This is real-world evidence that vaccine protection (against severe disease, mainly cell mediated immunity) kicks in with the first dose itself.
In fact we know from lab studies that T cells arrive by day 10 after the first dose.
Let me explain the immunology.
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After the initial “excitement” (introduction of components of virus by vaccination), a few of these T cells retire and become memory cells that live in the tissues and elsewhere.
Retirement also occurs in B cells (antibody factory), where a few live ~forever as memory cells.
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These memory cells of B & T cell genre sniff out the earliest presence of the virus if & when an infection occurs. They make sure that a strong, systematic, prompt response is mounted.
That is how organ damage is prevented. It doesn’t matter what variant it is, see the data.
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Many people panic when they hear words like “neutralising titer drops by 40 fold” etc. That is why we must look at the big picture.
Let’s not forget the same “drop of neutralising titre” was the worry of the world ever since delta arrived.
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We doctors are carefully monitoring the situation to look for any changes in trends.
So far there is no cause for any alarm with vaccines failing.
(Asymptomatic breakthrough infections are expected within a few months after vaccine, that is not the same as severe disease)
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Please note the diagram only presents an outline, not the whole thing.
Neutralising antibodies form only a tiny fraction of our TOTAL antibody response. Most antibodies are produced AFTER the attack occurs, helping eliminate virus.
(Labs measure Ab’s ALREADY in circulation)
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In other words, neutralising antibodies aren’t everything.
And, importantly, a “loss of neutralisation” (‼️🔴alarmist language that lab researchers love to use while describing their work to a clueless public) doesn’t mean “we have lost against the virus”.
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A high % vaccination coverage does not stop waves. The pandemic has a cyclical pattern. The sooner we acknowledge that, the more realistic our approach will be. Vaccination will help reduce risk of severe disease & death by a big margin, and also lower the risk of infection.
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In any country there will be large numbers of people who are not previously exposed to virus or vaccine. They will be more represented in future waves, along with some reinfections and breakthrough infections.
Reinfections are almost invariably mild or asymptomatic.
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Theoretical prediction of the effect omicron mutations on monoclonal antibodies by @jbloom_lab
Authors believe that this combination of mutations located on the RBD could potentially reduce the effect of monoclonal antibodies targeting that area of the virus.
This study is based on the apparent individual & additive effect of mutations based on a computer model of the RBD.
They did a computational method called “deep mutational scanning” which is used to study multiple mutations at once.
It is however not a biophysical model.
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Authors conclude
“Sites 484, 446 & 417 are the biggest drivers of this antigenic change, although other mutations also contribute. Mutations at sites 346, 378, 444 & 504 could make it worse”
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