Thread by @ToshiAkima

I had misgivings about this early speculation/hunch that the high Reff/Rt values with superexponential growth might suggest higher viral loads, leading to increased viral load in aerosols and transmissibility. But I might have got it right

https://twitter.com/ToshiAkima/status/1465277667658272773

Now, @Tuliodna is saying quite openly that Omicron is associated with elevated viral loads. This may explain the increased presentation in children (often with a rash not seen with Delta), suggesting MIS-C is probably going to be more common from Omicron cbsnews.com/news/transcrip…

If the viral loads from Omicron do surpass those from Delta, it would confirm that SARS2 is evolving towards becoming more contagious (higher R0), putting it more in line with other airborne viruses like chickenpox or measles

That is to say, an airborne virus like measles likely did not originally have such a high R0, but rather that it EVOLVED to become that way. That means higher viral loads in aerosols. It means we really must do better to undertake aerosol mitigation! Because #COVIDisAirborne

I predict that SARS2 is evolving towards more efficient ACE2 receptor binding and that the vasculopathy—so characteristic of COVID—will likely be exacerbated by this. Add higher viral loads in aerosols at point-of-exposure and it should amplify downstream toxicities

The unfolding scenario is exactly that predicted by virologist @hjelle_brian. The virus is just following the basic evolutionary principle of the survival of the fittest. That is hardly something that should surprise anybody

https://twitter.com/hjelle_brian/status/1469001163412439040?s=20

And I beg to disagree with anyone who says that point-of-transmission viral load and downstream disease severity are not causally related. Anyone who has worked with viral infection, transfection-transduction in a lab knows there is a dose-response curve

https://twitter.com/hjelle_brian/status/1469658408210948097?s=20