Share this page!

Michael Lin, PhD-MD 🧬 Profile picture
Twitter logo
29 Dec 21, 29 tweets, 11 min read
Reordered the COVID19 meta-thread by date.

2020.03: Introducing the #coronadeck, explaining what we knew about SARSCoV2 based on its 80% identity to SARSCoV1. Discussed evidence for masks. This was back when CDC and WHO were saying they were ineffective.
2020.04: On why SARSCoV2 disease should have been called simply SARS2 or vSARS or even simply SARS, rather than the meaningless COVID-19.
2020.04: Wherein I appeared on CBC to advocate for mask wearing, because studies show it works to prevent viral infections. On the other side was a doctor following public health talking points, that masks were ineffective.
2020.04: Remember the obsession with antibody tests and seroprevalence in April 2020, driven by this unfounded idea some large % of people got COVID without any symptoms? I didn't want to say it, but it was a dumb press fad.
2020.05: Pointing out the illogical incongruity of the CDC telling us the only thing we can do to prevent a respiratory illness is to wash our hands
2020.07: Proposing that preadolescent children should be considered separately from adolescents, and hypothesizing that they may have milder disease because of stronger innate immunity.
2020.08: On how finding live SARSCoV2 in aerosols makes airborne spread undeniable, but actually studies showing infection from distances >>6ft were already know in 2020.03, even while CDC and WHO denied aerosol spread
2020.09: Announcing the first SARSCoV2 protease inhibitor with a alkylated proline P2 group for preorganization, designed by my lab by modifying the HCV protease inhibitor boceprevir. A very similar design was later seen in Pfizer's PF-07321332 = Paxlovid.
2021.03: Pointing out that local public health officials were cherry-picking numbers, choosing anecdotal non-statistics over less favorable real statistics to argue that Moderna, Pfizer, and J&J vaccines were all the same.
2021.04: Proposing that antibodies raised to adenovirus proteins may cross-react with PF4 to cause VITT (vaccine-induced thrombocytopenic thrombosis) with a home-made graphic of vaccine types
2021.06: Proposed that the concept of easy preventions called for JnJers to get a RNA booster
2021.06: Pointed out that RNA-vaccinated people were getting and transmitting Delta, knowable only by Singapore’s excellent tracing. This was the same week CDC removed masking recommendations for vaccinated people.
2021.07: Pointed out that breakthroughs were expected even at peak vaccine effectiveness from the trial results, that <100% VE is one reason it's important to get everyone eligible vaccinated, and that pretending VE was 100% just leads to disappointment.
2021.08: Wherein I used an IKEA TÄRENDÖ table to illustrate that you need multiple mitigations to effectively prevent infection by COVID19.
2021.08: Started a long thread on efficacy against Delta for Moderna, Pfizer, and J&J, creating the first public estimates of VE for J&J at ~50%, much worse than Pfizer and Moderna
2021.09: On how J&J's booster study was too small and noisy to be conclusive, esp how they extracted the tiny US dataset out of an already small worldwide dataset so they could quote a higher VE although it had even less statistical confidence.
2021.09: On why vaccines will break transmission chains mostly by preventing infection in the first place, not transmission onward once infected, hence boosters are useful
2021.09: Explaining how a vaccinated immune system is able to adapt to a new strain better than a naive immune system, due to having reserves of minor-league memory B cells ready to be called up.
2021.10: On how 2 FDA officials tried to suppress robust epidemiological findings by tossing them into a data blender, so they could oppose boosters that Israel had already showed we needed. Just embarrassing (yet they still have supporters as of 2021.12).
2021.10: First analysis of the NIH-sponsored mix-and-match booster study (2xModerna or 2xPfizer or 1xJJ boosted with 1xModerna or 1xPfizer or 1xJJ).
2021.10: Another analysis of mix & match boosters, figuring out which combos protect well against Delta. Result: everything except Pfizer+JJ and JJ+JJ. Ironically, JJ+JJ was the first combination approved for #JnJers, because FDA acts on company requests.
2021.10: Celebrating mix and match boosters for everyone but especially #JnJers who have been left behind and ignored (still are actually). Also, recounting the history and consequences of denialism around J&J’s poorer efficacy.
2021.11: Explaining how Pfizer's protease inhibitor Paxlovid, revealed in April 2021, used the same idea we revealed in 2020.09 (above, 1 year ago): that SARSCoV2 inhibitors can be derived from the HCV protease inhibitor boceprevir.
2021.11: On how molnupiravir will inevitably create viable mutated viruses, and how just 1 lucky mutant with improved fitness can then escape and be the next immunoevasive variant.
2021.12: Presenting the mix-and-match booster study again with better visuals by reordering figure panels, and reiterating #JnJers should get Pfizer or Moderna boosters. This was before Omicron serology studies.
2021.12: On how 3 strong immunization events broaden antibody responses to SARSCoV2, so that immunization with original spike can produce antibodies that neutralize Omicron. Discusses implications for #JnJers, who can only get 2 shots officially.
2021.12: On how the Omicron wave has a lower hosp/case ratio than prior waves in SA, and how that will generalize to Western countries who have the same % immunity, and on hints of milder intrinsic severity too.
2021.12: On how ICL's low-power low-confidence failure to find diffs between Omicron and Delta hospitalizations was misinterpreted as evidence of equal severity, often in response to the above thread. ICL later found that Omicron is indeed less severe.
2021.12: On how molnupiravir’s risks of creating immunoevasive variants of SARSCoV2 should be publicly discussed by doctors and policymakers, and how many well known people share my concern.

• • •

Missing some Tweet in this thread? You can try to force a refresh
　

Keep Current with Michael Lin, PhD-MD 🧬

Michael Lin, PhD-MD 🧬 Profile picture

Stay in touch and get notified when new unrolls are available from this author!

Read all threads

This Thread may be Removed Anytime!

PDF

Twitter may remove this content at anytime! Save it as PDF for later use!

Try unrolling a thread yourself!

how to unroll video
  1. Follow @ThreadReaderApp to mention us!

  2. From a Twitter thread mention us with a keyword "unroll"
@threadreaderapp unroll

Practice here first or read more on our help page!

More from @michaelzlin

Michael Lin, PhD-MD 🧬 Profile picture
31 Dec 21
Going to wrap up 2021 with an optimistic thread.

If we can avoid creating worse variants with molnupiravir, COVID19 can finally become like the flu in 2022.

1/n
The SA experience, mirrored in Western countries so far, suggests Omicron IFR is an order of magnitude lower than previous variants. This is due to preexisting immunity and lower virulence of Omicron.

2/n
 nytimes.com/2021/12/30/wor…
Specifically, deaths per counted case in SA are 16% of the Delta wave so far, but cases are almost certainly undercounted several-fold.

3/n
Read 24 tweets
Michael Lin, PhD-MD 🧬 Profile picture
31 Dec 21
More evidence a booster helps prevent you from catching Omicron. We knew that already from Pfizer but this study looks at risks within households, which is useful info as it provides an absolute rather than relative risk in a common situation
The chart ET posted is confusing, as it normalizes to the "fully vaxxed" state. Leaving aside the heterogeneity of this population (vaxxed at different times, and includes some unknown % with the less effective 1-shot J&J), normalizing to unvaxxed would be better. So I redid it. Image
As you can see the relative protection from intra-household infection for a boosted person is 48% for Omicron and 84% for Delta vs unvaxxed. 48% is lower than the 70% Pfizer measured, but that's expected for the higher-exposure household setting compared to community transmission
Read 8 tweets
Michael Lin, PhD-MD 🧬 Profile picture
30 Dec 21
Thanks Dr. Hildreth for speaking out on the dangers of molnupiravir to "the health of the world". We need more people with foresight and integrity like you and @RickABright speaking up
Drs. Hildreth and Bright were inspirations for my essay on the risk of molnupiravir creating immunoevasive strains.
Peter Weina @peterweina, director of the Defense Health Agency, also voted against molnupiravir at the 11/30 AMDAC meeting out of concern for generating new variants. The meeting has been poorly covered in most articles, but here's a good one below

amp.dailycaller.com/2021/12/23/mer…
Read 5 tweets
Michael Lin, PhD-MD 🧬 Profile picture
27 Dec 21
ICYMI, on 12/23, the last news day before a long holiday break, FDA approved the viral mutagen molnupiravir as an at-home COVID19 drug. It sounds worrisome because it is. I wrote in the @washingtonpost that immunoevasive variants could arise from its use.
washingtonpost.com/outlook/2021/1…
If molnupiravir gives rise to enhanced mutants of SARSCoV2, it will prolong the pandemic and cause countless deaths and needless suffering. Yet it's only 30% effective in preventing hospitalization, similar to generic antidepressant and far worse than the 89% of other antivirals.
FDA knew of the concerns about mutant viruses escaping from patients taking MOV. This was discussed at the AMDAC FDA advisors meeting 1 month ago and contributed to the 10 no votes. It was revealed Merck didn't know what mutations occur in patients and when viruses are cleared.
Read 32 tweets
Michael Lin, PhD-MD 🧬 Profile picture
23 Dec 21
Would you prefer (1) we get back to normal activities sometime, or (2) we make new vaccine-evading coronaviruses continuously, suffer widespread breakthrough waves, and wear masks forever?

If you chose #1, then know this: Merck's molnupiravir should not be approved.
Molnupiravir is, to put it in clear terms, a potentially dangerous and virus-enhancing drug. It is not an effective antiviral medication outside of the confined conditions of cell culture and hamster cages. I'll explain below.
Well known independent voices have brought this up, such as @CT_Bergstrom (renowned skeptic of bad research) @WmHaseltine (HIV pioneer) and @JamesEKHildreth (FDA advisor). Others such as @chasewnelson have done more in-depth analysis. I'm here to try to explain the issue simply.
Read 135 tweets
Michael Lin, PhD-MD 🧬 Profile picture
22 Dec 21
I've been meaning to reveal some exciting results from my lab's SARSCoV2 protease inhibitor research. With FDA approval of Pfizer's Paxlovid today, it's a good time to finally share our good news as well.

We've developed not 1 but 2 inhibitors with activity superior to Paxlovid.
This work began in March 2020 when we hypothesized the HCV protease inhibitor boceprevir could serve as a template for the creation of orally dosable SARSCoV2 protease inhibitors. We announced initial results from this work in September 2020.
Our initial drug, ML1000, described in 2020 September, preceded Pfizer's PF-07321332 (Paxlovid) announced in 2021 April and approved today. Other groups have also made drugs with boceprevir parts, but our drug is the closest in structure to PF-07321332
Read 5 tweets

Did Thread Reader help you today?

Support us! We are indie developers!

This site is made by just two indie developers on a laptop doing marketing, support and development! Read more about the story.

Become a Premium Member ($3/month or $30/year) and get exclusive features!

Become Premium

Too expensive? Make a small donation by buying us coffee ($5) or help with server cost ($10)

Donate via Paypal

Or Donate anonymously using crypto!

Ethereum

0xfe58350B80634f60Fa6Dc149a72b4DFbc17D341E copy

Bitcoin

3ATGMxNzCUFzxpMCHL5sWSt4DVtS8UqXpi copy

Thank you for your support!

Follow Us on Twitter!

Like this author's thread?

Get emails when @michaelzlin has new unrolls!

Check out other threads from @michaelzlin!

Read all threads by @michaelzlin

:(