Thread by @ASlavitt

COVID Update: The good case for what’s happening with Omicron is getting signs of scientific support. 1/

What could be good about a new variant that blankets the population and has mutations that make it far easier to spread & harder for many vaccines to keep up with? 2/

Certainly it’s rapid spread will stress already stressed Hospital systems. That’s NOT good.

Very encouraging to see President Biden will announce today the military personnel & FEMA will be deployed to help. 3/

The first piece of good news stems from separate studies in the U.K. and Hong Kong which shows something quite surprising about the Omicron variant.

It doesn’t appear to attach very well in the lungs. This from @GuptaR_lab. 5/

What it shows is that compared to the 2020 or “wild type” COVID or delta, omicron does not multiply efficiently in the lungs. 6/

Recall that the virus multiplies for survival & spreads in 2 different ways: between people & within the human body.

Omicron spreads between people incredibly easily.

But for it to do most of its damage, it needs to escape the nose & travel to the lungs & beyond.7/

And at least according to these studies & models that are emerging, that’s where the virus’s mutations actually make it less efficient. This could account for why there are reports of “milder” cases. 8/

It is certainly also possible that vaccination rates are responsible. Both SA and the UK report that the lion’s share of hospitalizations are from unvaccinated people. 9/

It is certainly the case that vaccinated & boosted people produce a strong antibody response to protect against Omicron even without accounting for severity concerns caused by slower spread to the lungs. 10/

While we are far short of a definitive peer reviewed study, these studies give the power of belief to anecdotal observed evidence.

Right now best to say that there’s a case that this is what’s happening— that lower omicron hospitalizations may be linked here. 11/

The other positive thing we are observing— and don’t entirely understand— is that cases in Gauteng, SA & possibly London are showing signs of peaking & declining. 12/

Delta tended to peak after 2 months, but with much more rapid spread scientists are predicting an even quicker peak & decline.

Hear 11 scientists make their predictions for 2022 here— where this view is the consensus. 13/

podcasts.apple.com/us/podcast/in-…

This may be happening even more quickly than just the math alone would project.

Could be something we don’t understand about omicron, about testing, or about how many mold@& untested cases there are. 14/

If a lot fewer people show symptoms & a lot fewer get tested (or only test using at home tests but never go to the hospital), the virus runs out of room more rapidly. 15/

Whether a wave peaks in the US as quickly with our age & vaccination levels, we don’t know.

What we do know is that 3 doses@of an mRNA vaccine gives us great protection against symptoms. The more boosted? The quicker it leaves. 16/

These positive signs— lower potential severity & a quick spread— are mere possibilities not probabilities in my view at this time. And it’s nice to have even possibilities like this.

It implies a good scenario but another question. 17/

The good scenario of course would be a population vaccinated or with prior omicron infection & a much less concerning strength dominant.

But the question in this scenario is whether omicron wipes out delta, keeps it at bay & whether it provides any cross-immunity to it. 18/

In other words, if omicron were to come & go quickly, it might not eliminate delta as alpha & wild type were eliminated before it by succeeding variants. And if omicron infection doesn’t protect against delta, then delta could do what it has been— feasting on the unvaxxed.19/

If omicron is much tamer than delta, at least as it regards lower respiratory spread, in an odd way, you might root for it to stick around longer to wipe out delta. 20/

2022 could be shaped by these questions in part.

But in any event, there is a strong combination to respond to any scenario: broad booster availability, the announcement from Biden today of 500
million free at home tests & a very promising oral antiviral. 21/

We have invested in first class science & research. We just have to convince people to use it. It is the key no matter if the news is good or bad.

(Still let’s aim for good.) /end