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Monica Gandhi MD, MPH Profile picture
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17 Dec, 6 tweets, 2 min read
These virulence studies showing Omicron may be more mild not only due to increased immunity in population but something to do with its viral pathogenesis are fascinating
And yes @sailorrooscout, I saw your tweet from earlier but not believing our South African colleagues when they tell us something is different about Omicron feels disrespectful to me too. HIV MD/researchers know our S. Africa colleagues working in the field of HIV well
This work by Dr. R Gupta (well known in HIV) done on "3D lung alveolar organoids" (e.g. lung cell simulations). Also found by University of Hong Kong showing Omicron doesn't replicate well in ex vivo human lung tissue (better upper respiratory tract)
med.hku.hk/en/news/press/…
Beyond virulence studies (feel free to ignore), with increasing immunity (vax best way), cases (with Omicron; delta in highly vax'd places) becoming decoupled from hospitalizations/deaths so
time.com/6129225/omicro…
By the way, S Africa data above is the largest dataset of Omicron we have & age-stratified (not just young people as you can see; there are older people in S. Africa). Imperial College model is from 24 people. Look at study sample size, quality of data when making assessments

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More from @MonicaGandhi9

Monica Gandhi MD, MPH Profile picture
15 Dec
My 8 suggested changes for COVID policy 2022:
1) Boosters: risk stratify, do young males need? Space doses
2) Mask mandates based on hospitalization rates like Marin
3) CDC endorse test-to-stay. schools
4) Masks optional schools 8-12 weeks after availability of child vax (11/4)
5)Paxlovid asap
6)Acknowledge natural immunity more like Europe
7)CDC reporting: Better data on severe breakthroughs so can advise boosters, masks, etc.
8) Stop travel bans, harm reduction approach, global equity, acknowledge endemic, prevent illness
nytimes.com/2021/12/11/opi…
Guess not clear. Suggesting off ramps for masks for both adults and kids for top points. I said after AVAILABILITY of child vax; some adults deciding. And yes I recommend for immunocompromised like my dad -fit and filtered masks inside. Everytime I mention masks, both sides yell
Read 8 tweets
Monica Gandhi MD, MPH Profile picture
14 Dec
There seems to be a lament on twitter today that COVID zero could have been possible (although many countries tried so hard & couldn't); it is actually the properties of the virus itself that make that impossible; lucky these amazing vaccines so effective against severe disease
This is a longer discussion on what makes a virus "eradicable" or not
When a virus is recognized to have properties that will make it endemic but have strategies to protect against severe disease (vaccines & therapeutics-Paxlovid- for those who decline), we track cases in health departments, policy formed on hospitalizations
nytimes.com/2021/12/11/opi…
Read 4 tweets
Monica Gandhi MD, MPH Profile picture
11 Dec
1. WHY HOSPITALIZATIONS ARE NOW A BETTER INDICTOR OF COVID'S IMPACT: This is my 50th op-ed on @COVID this year, round number. Suggest with @LeslieBienen and @citizen_oregon how to shift US strategy on restrictions & policies at this stage in pandemic
nytimes.com/2021/12/11/opi…
2. New strategy likely even more important to institute (with our current tools) with the new #Omicron variant which - since likely more transmissible but more mild by accounts to date- can be in people's noses without disease. Public health sworn to protect us against illness
3. The US (and any other country) accepting that a highly transmissible virus with animal reservoirs will be endemic is not "giving up" & cases will still be tracked by health departments, but by focusing on disease, we can work harder to prevent iy
Read 11 tweets
Monica Gandhi MD, MPH Profile picture
11 Dec
Covid Malaise - great article on what it feels like to be in a blue state at this point in the pandemic (@DLeonhardt has written plenty of red states having less vaccine uptake & more COVID hospitalizations since vax available). I call it "twilight zone"
nytimes.com/2021/12/10/bri…
It is important to assess the collateral damage of any interventions we put into place in public health to combat one disease on other conditions and @DLeonhardt does so here, also commenting "And school operations are still not back to normal. Students are sometimes.. Image
"forbidden to sit or talk with one another during lunch — or to eat indoors. Masks make communication harder, especially for students with learning disabilities. Positive Covid tests/worker shortages can cause schools to close temporarily". In blue states, other problems ignored Image
Read 4 tweets
Monica Gandhi MD, MPH Profile picture
10 Dec
Why I don't think variant-specific boosters will be needed on Doctor Radio @DrMarcSiegel
siriusxm.com/clips/clip/e7a…
Why I am excited about upcoming oral treatments for COVID-19 on Doctor Radio @DrMarcSiegel
siriusxm.com/clips/clip/e7a…
And why to remember that protease inhibitors specifically were the turning point for HIV in 1996 & so particularly excited about Paxlovid. Doctor Radio @DrMarcSiegel
siriusxm.com/clips/clip/e7a…
Read 4 tweets
Monica Gandhi MD, MPH Profile picture
7 Dec
Epidemiological update: Omicron continued reporting from EU CDC equivalent as of 6 December. "All [Omicron] cases for which there is available information on severity were either asymptomatic or mild. No deaths". Immune system more than antibodies
ecdc.europa.eu/en/news-events…
Although some references need updating, this explains how the immune system is not just antibodies but cellular memory too
leaps.org/how-long-do-co…
If hybrid immunity strongest type of immunity at all (as shown by the Sigal lab), much better to be vaccinated first & then get benign infection on top than vice versa (not safe). Remains to be seen if boosters stimulate memory/antibodies enough (boosted people have mild Omicron)
Read 4 tweets

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