Andy Slavitt 🇺🇦 Profile picture
Dec 9, 2021 25 tweets 4 min read Read on X
COVID Update: 2 weeks ago we said we would know a lot more about Omicron in 2 weeks.

I’ve rounded up the best scientific opinions to share a consensus. 1/
The bottom line-up front: We should expect a significant wave of COVID this weekend: likely a Delta + Omicron wave. 2/
The consensus view of Omicron is that it is NOT innately more contagious, but that it IS spreading much faster. 3/
What is wrapped up in that enigma is that the R0, the reproductive rate that Omicron spreads in the wild is likely no greater than Delta.

Delta is a 6 or 7 R0 and Omicron may be a bit lower or only slightly higher. But…. 4/
The virus spreads based on not just the rate COVIS spreads in the wild but what portion of the people are succeptable to spread.

Delta spread is limited by the people who are vaccinated & who have prior infections. Omicron, for reasons I will lay out, has a more open field. 5/
As a result, the rate Delta actually spreads (Re) is about 1
& the rate Omicron spreads is closer to 2.5.

So it should feel like Omicron is growing about 2.5x as fast as Delta. Most of what we see is from the S African outbreak & more recently from the U.K. 6/
The reason Omicron is able to spread with little in its way stems from the fact that Omicron comes from a different lineage than Delta. Therefore prior infection from Delta does a poor job protecting against spread & infection if there is no vaccination. 7/
How do vaccines themselves perform?

Good and bad.

Limited data from Pfizer shows that with a 3rd dose, the vaccine will continue to do a very good job—particularly at preventing severe illness.

Even with that third dose/booster, it appears to have some fall off from Delta.8/
Without a booster, vaccines aren’t expected to do a great job preventing the virus from spreading, although still provide strong protection against severe illness. 9/
This is relieving news for people who have gotten or will get boosted.

For people who are vaccinated but not boosted there is real risk of breakthrough infection.

But anyone who has been vaccinated is far better off than those who haven’t. Prior infection isn’t a help. 10/
The other question we began wrestling with— and are still wrestling with— is whether the COVID that people get w Omicron is more or less severe. 11/
Depending who you ask, Omicron is either more, less, or equally severe.

Now that that’s cleared up, there is an interesting & important theory of the case. 12/
The perspective I find most compelling is that Omicron is not likely to be more or less severe than Delta but that we may be seeing the effects of memory B cell and T cell accumulated immunity. 13/
This would be similar to what’s happening as we look at how fast the virus spreads. What we’re seeing is clouded by the impact of prior infection, not the innate properties of the virus itself. 14/
If it turns out that Omicron is less lethal because more people have cellular protection that’s an overall good thing for the population— it means we are making progress towards making the virus less lethal. But…
15/
It would be even better if Omicron were less lethal than Delta innately. We still have many people— like those under 5– with no protection and those with compromised immune systems.
16/
So what happens when Omicron begins to grow in the US? What would an even more rapidly growing virus (250% faster than Delta) that is less lethal look like?

It can be damaging. Even a small percentage of a big number is a big number. 17/
If Omicron were the only challenge of the winter, it would be easier to manage. But Omicron will arrive when Delta is raging. And if Delta spreads as fast or faster than Omicron innately, then scientists tell me we are likely to get stuck with both. 18/
Both.

That means two viruses circulating, 2 types of immunity required to thwart infection. 2 cycles of spread.

We have had 2 strains of the flu before. 2 flu vaccines combined.

One solution. 19/
A third shot on top of 2 prior shots works well against Delta and appears to make a big difference with Omicron. 20/
Rapid tests. Therapeutics. Ventilation. n-95 masks.

All help on top of vaccines. 21/
And this is how the winter of 2021-2022 is different from last winter.

As bad a storm as comes, we have the tools to stay safe. If we use them. /end
And if you want to hear the podcast with @ScottGottliebMD on the topic on @inthebubblepod, listen here.

podcasts.apple.com/us/podcast/in-…
Tweet 3 should say “this winter” not “this weekend.”

Why was I thinking about the weekend on a Wednesday? That never happens.
Errant tweet. Should say “winter” not “weekend.”

Now back to the thread.

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More from @ASlavitt

Feb 8, 2023
On the latest @inthebubblepod, I talk with @SykesCharlie, founder and editor of @BulwarkOnline, about the emergence of Ron DeSantis as the presumptive leader of the far right wing of the Republican Party. Here are my takeaways in a 🧵
Listen here: link.chtbl.com/InTheBubble?si… 1/
“Ron DeSantis ​​is taking the politics of being a bully to a different level,” Sykes tells me. “He’s decided he's going to move as hard and demagogically to the right as he can. He’s learned something from Donald Trump: you don’t need to be a nice guy.” 2/
Sykes says DeSantis is exploiting the culture wars in order to tap into Republicans’ grievances, and that the GOP sees the Florida governor as a “younger, smarter” but equally combative replacement for Trump. But DeSantis stands out from other conservatives for a reason. 3/
Read 7 tweets
Nov 25, 2022
Some thoughts on using Twitter:
With Musk inviting back people who use the platform to threaten rape, to lie at scale & become whatever else his whims decide, here are some actions worth considering …
-Mute all advertisers in your feed. I’m not going to be a revenue source & don’t want those who advertise here to be encouraged.
-If you have a lot of followers or post a lot, consider moving the bulk of your content elsewhere. Post looks promising. (I’m @ASlavitt there.)
-I’m also on Mastadon to check it out & until Post is done with its waitlist & will eventually pick one.
-I continue to occasionally check the news feed here & promote things on Twitter minimally & will cross-post for a short time as people decide what they want to do.
Read 4 tweets
Oct 13, 2022
COVID Update: It’s time for one as we look ahead to the winter.

The real question is whether we will have another 2021 with a lot of disruption— on a more modest wave— or nothing at all.

There is early data to help answer this question. 1/
Currently there are lots of Omicron sub-variants co-circulating around the globe.

Household names like:
BA.4.6
BQ1.1
XBB

While it’s all a little hard to follow, there’s something interesting about the nature of these variants. 2/
Variants:
1- These are all variants of Omicron. This is good. Better than dealing with a Delta variant emerging. Makes progression more closely resemble the flu.
2- Each are growing in different parts of the world without 1 being dominant. We could have a mix this winter.3/
Read 14 tweets
Sep 6, 2022
NEW: COVID vaccines will now be recommended annually, with the flu shot.

I spoke to the White House yesterday about the plan. 1/
Rather than an ad hoc schedule which confuses many as to when to get vaccinated, the thinking is that an annual shot will result in many more people getting vaccinated.

They point to 2/3 of adults who take the flu vaccine vs 1/3 of adults over 50 who have been taking COVID. 2/
We have infrastructure, outreach, and habits that can be capitalized to get people their flu and COVID vaccines together.

This is the prime benefit.

But of course it comes with some questions they are preparing to address. 3/
Read 8 tweets
Aug 19, 2022
COVID Update: When will we have new boosters and when should we take them.

I’ve asked 5 of our top scientists & policy leaders and here are answers and other COVID news (good and bad). (1)
The new boosters are bivalent vaccines. Ancestral strain plus Omicron. The idea is broad protection from a virus that is strayed quite a lot. (2)
Pfizer’s vaccine will be ready first— the first week to 10 days of September is the best estimate.

Moderna will follow the first week in October. (3)
Read 14 tweets
Aug 15, 2022
Over time, the climate legislation which Congress passed has the potential to become one of the most popular pieces of legislation ever passed.

Rivaling Social Security and Medicare.

The reasons include __things, many of which don’t meet the eye. 1/
1- The first reason is simple. As younger generations grow older, they will mark the shift in the slowing of carbon emissions to this bill.

Floods, fires, heat waves, and rising sea levels won’t abate. We are not cooling. 2/
2- The changes to people’s lives to improve the climate will not require the sacrifice the GOP has long stated.

Heat pumps at home, a renewable grid & electric cars require no sacrifice to people’s lives.

Yes people can still eat hamburgers. 3/
Read 12 tweets

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