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/…
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

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More from @ASlavitt

23 Dec
COVID Update: The marvels of science are slowly but surely taming this virus.

Vaccines are helping mute the effects of Omicron. And now Paxlovid, approved by FDA under EUA, ushers in a new era of the pandemic. Patience & caution still required. 1/
For almost everyone, vaccines make dying from COVID extremely unlikely. Delta increased the need for a booster. Omicron increases it further if you want to avoid even a mild infection.

But the main point is vaccinate the globe & the country & fewer will lose their lives. 2/
Still, in the US at least, this leaves 130 million people who aren’t vaccinated, the majority of whom are eligible.

This isn’t a failure of science. The vaccine is very well tolerated & production scales nicely. But it is a vulnerability nonetheless. 3/
Read 19 tweets
18 Dec
COVID Update: A setback is a setback. And we’ve had 3 setbacks with vaccine testing this week.

But all of those setbacks remind me of how blessed we have been so far by science and the people who monitor safety.

One setback, announced yesterday, is the change of position from the CDC on Johnson & Johnson’s vaccine. 2/
J&J’s vaccine was flagged and pulled from the market temporarily in the Spring when reports of several blood clotting issues arose.

Many criticized the decision for causing doubt & disruption of vaccines at a critical moment after it was ultimately put back on the market. 3/
Read 23 tweets
16 Dec
COVID Update: Three groups of Americans will face Omicron in 3 very different ways.

Those who can
Those who can’t
And the biggest group— those who can but haven’t

17% of Americans have gotten boosted, a dangerously low number with a virus which doesn’t respect prior infection or those with 1 or 2 doses. 2/
23% of Americans either aren’t eligible for boosters (17%) or eligible for the vaccine (6%).

That’s 75 million Americans who are basically counting on the rest of us to stay safe through no choice of their own. 3/
Read 12 tweets
16 Dec
COVID Update: Omicron will peak in the US in the third wave in January according to a consensus of 10 scientists we interviewed. 1/
So far Omicron is doubling every 2-4 days, extraordinarily fast. People with prior infections or have been vaccinated but not boosted are right in the path of the spread.

This makes the spread 2-3x as fast as Delta. 2/
Even with a limited understanding of the severity of Omicron, it feels like this implies some concerning news and some better news (it’s all relative at this point😕). 3/
Read 21 tweets
13 Dec
COVID Update: Vaccine boosters appear to double the effectiveness of vaccines against Omicron.

But with only 14% of the country boosted, we should brace for a tough winter. 1/
Studies in the UK and SA are coming back with a consistent finding.

Prior Delta immunity is not preventing Omicron. Re infection rates are at least triple Delta.
2 Pfizer vaccines (presume same for Moderna) have a 30-40% efficacy against Omicron. 2/
Some good news. In both cases (prior immunity & 2 vaccines), studies are showing T cell response (our line of defense that prevents more severe illness in the lungs) continues to work against Omicron. 3/
Read 20 tweets
12 Dec
COVID Update: At a time when most scientists are concluding an additional mRNA vaccines is needed, a Republican senator wants to go the other direction.

His idea? Prior infection should count as immunity. 1/
Roger Marshall from Kansas thinks the country should officially recognize prior COVID infection as the equivalent of being vaccinated when considering a vaccine requirement.

He’s not alone but he’s wrong in so many ways. 2/
Roger also recently said this:

“The people that have thus far not gotten the vaccine are not going to do it until this White House acknowledges natural immunity.”

He’s calling for a sort of protest? Wut? 3/
Read 21 tweets

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