If you are attending a large New Year celebration with strangers, please know that in many areas of the country you are contributing to the collapse of the health care system.
This applies regardless of your vaccination status.
I know this sounds dramatic- please read on.
1/
I am not chicken little when it comes to COVID
I have been a proponent of pulling back restrictions and mask requirements for the vaccinated
But the goal of public health measures is to protect hospital capacity
I’ve followed the data closely the entire time and I am floored by it.
3/
Omicron is less severe but will lead to hospitalization: in England, hospitalizations have almost doubled in the last 10 days despite an 82% vaccination rate and are going up quickly.
4/
The perfect storm of Omicron in Indiana: 1.An astoundingly fast spreading virus that will hospitalize some unvaccinated people
2.A hospital system already at the point of bursting
3.A population with a very low vaccination rate
5/
And it sucks, but vaccinated people will become infected more than with delta (but less than the unvax)
They won’t generally get very sick, but they will be more a part of the chain of transmission than before
6/
And with the amount of COVID in the community, a New Year’s Eve party at a bar or public place where you pay a certain amount and get all you can drink and kiss someone at midnight will most certainly have Omicron there
And many will be infected regardless of vaccine status.
7/
This sucks
It is not the holiday season any of us had wanted
But all the indications are that this fire will ignite fast and burn itself out quickly
And while the Omicron conflagration is burning, we have real risk of a humanitarian disaster with sickness and it scares me
8/
Because hospitals without capacity means a heart attack or stroke or car accident becomes something different than usual- because there is no place or people to help
And right now we to need to protect the helpers
9/
For those of you getting together with small groups of family, please use a home test if you can afford to immediately before the gathering and cancel if positive
Omicron strikes quick and even if you are all vaccinated, reducing the chain of transmission is important
9/
Once hospitalizations go back to something that resemble normal, I will stop the shouting
But for now to protect hospitals we need to limit interactions with other humans
Hopefully not for long, but now is more important than ever
10/
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mRNA injected into deltoid cells lasts about 72 hours and do not travel to distant sites in the body.
I get asked about this all of the time, so I went to find the primary science on this.
A couple of quick tweets
1/
The first paper I can find on this was in @ScienceMagazine in 1990 and showed the half-life of RNA in muscle cells to be less than 24 hours- RNA encoding the luciferase protein was injected into mouse quads and luciferase was undetectable at 60 hours. pubmed.ncbi.nlm.nih.gov/1690918/
2/
In 2007, a study agreed:
Luciferase-encoding mRNA injected into human ear dermis peaked transcription at 17h and was undetectable at 3 days (panel d).
They also looked for luciferase expression at distal sites in the ear and saw none (panel e).
Earlier this summer I was adamant that school would be reasonable without masks, even for the ages for which vaccines are not available.
I have changed my tune. A quick 🧵as to why.
1/
Most data suggest that the SARS-CoV-2 virus affects kids in a generally quite benign way.
I know people get frustrated when COVID is compared to the flu, but for kids the data suggest the comparison is reasonable. And this accounts for "long COVID" and MIS-C.
2/
So when I suggest that masks should be mandatory in school for kids, I am not worried about the health of my unvaccinated 6 and 11 year olds.
I am worried about it causing widespread community transmission and overwhelming hospitals.
This week our manuscript on the role of in-person school on community spread of SARS-CoV-2 in Indiana was published online in Clinical Infectious Diseases.
I’m going to target this thread to a wide audience, so my description of our work may leave some wanting more detail. The detail is in the online version and the supplement. Happy to answer any questions on the work as they come up.