Roller coasters give us fewer twists & turns than we’ve had in the last 2 years. 1/
Coming to grips with each new reality of the virus itself as we experience it— contagiousness, illness, symptomatic spread— is hard enough.

Yet each time we do, it seems to make new versions with different features an ever harder adjustment. 2/
We have seen a string of new news over 2 years that still manages to surprise as much as the first wave itself. It’s deadliness has been replaced by its fitness as perhaps its most enduring feature. 3/
More troubling has been the selectivity— first the elderly, then frontline workers, multi-generational families, prisons & then with better science, the harder to protect with vaccines. People who have already had traumatic illness like organ failure or cancer. 4/
The selectivity has meant the healthy, young & comfortable afford to view the virus as not a real threat to them.

Like with HIV decades ago, the safe risk becoming the indifferent even as millions around the world still die each year. And the safe control the resources. 5/
There are also the unbelieving. Unbelieving in the virus, in vaccines, in scientists. They are exposed and vulnerable in greater numbers.

The greatest factor is not just politics but age. But where you live, your culture & who your governor is does play a role. 6/
There are far fewer villains in this epic than we often like to think. Yes, there is the liar-in-chief, his band of anti-science advisors. His Brazilian look alike & those who knowingly peddle lies— which we charitably call misinformation.

But they are not the main event.7/
There are some guilty of neglect as people died, some of error, a few of cruelty. But we have only been capable of reacting badly not acting badly.

This war has been person vs nature and we’ve only conjured it up to be person vs person out of habit, frustration & fracture. 8/
We are used to enemies we can name & therefore hope to defeat & control. It is too discomfiting to face one hard to predict from season to season.

Easiest to rage against the unvaccinated, the vaccinated, those that called it wrong or see it differently. 9/
Our deprivations & disruptions have been real. A lost loved one, a missed friend, cancelled joys, school or work, conveniences, predictability, the ground under our feet, the things we thought could be taken for grated. Lost. 10/
What has been revealed about ourselves & society & our lack of a united human purpose may be only confirming but it’s reality painful.

How & who we vaccinate, how much we are willing to sacrifice, how easy it has been to forget. The higher the cost the slower the empathy.11/
Among all the American values, we have often chosen vacant individualism over the power of the whole & turned common sense into controversy.

A vaccine credential, an N-95 & a reliable regular test could get us far if we had the will. 12/
Many have spent their energy fighting the people who are fighting instead of simply fighting the virus. 100 state laws from state legislatures now protect the virus.

But for too many the enemy needs a face not a spike protein. 13/
Even the world’s best leaders have no magical answers. But they have shown us real ones— honesty, humility, the willingness to make tough unpopular decisions.

And in the US, they don’t point to a constitution that doesn’t exist but to lives that can be saved. 14/
We must remember we have had profound successes. A rapid safe vaccine. A rapidly expandable one. Impressive new surveillance & coming drugs. Science has been a better foe to the virus & will eventually win.

And people have come through in ways that defy the narrative. 15/
85% of adults in the US have had a vaccine & we’re just a year in. One year ago only 40% said they would be sure to get it.

And they have been rewarded. With life almost assuredly. With hope. But also no doubt with some confusion & disappointment at times. 16/
A vaccine that teaches our cells immunity wins the war. But a virus that has evolved to act faster than our T-cells can respond has won many battles.

Delta then omicron can make us sick & contagious without a recent booster. That’s a fact. 17/
Our bodies are forced to accept this compromise since we cannot have antibodies constantly swimming through us. We can only respond after the virus— newly more infectious & defiant of the vaccines— has already acted. 18/
Perhaps the biggest nausea-inducing twist of the roller coaster is the inability to see around the next bend & know when the ride will slow or end.

Will the virus stalk us in our our bodies & keep us sick? Will it evolve again just as we think we understand it? 19/
We hate the uncertainty for the same reason we hate a faceless enemy. Our ability to control this ride as much as we try is its worse feature. 20/
All pandemics end. This one might end with an ongoing death toll & a nasty long term illness & even occasional waves.

Or it may be better. Either way it will seem neater in hindsight when the end date right there in Wikipedia. 21/
Rather than prognosticate or blame or cower, the virus has also taught us we can prevail one by one, person by person.

A great nurse, a scientific advancement, support & love from a friend. Or even better a stranger. 22/
I wish everyone an easing of any pain, a restoration of any hope lost, and whatever it takes to stay as steady in the saddle through whatever twists are out there.

No matter what there will be joy in the new year. /end

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More from @ASlavitt

30 Dec 21
COVID Update: Tens of millions could get COVID in the US this winter omicron wave.

What are the chances of getting infected during this wave? How much different from “normal” pandemic times?

Let me try some basic math. This isn’t big math with log scales but the kind where the numbers are round enough because there are enough assumptions to make precision feel false. 2/
There are 250,000 recorded daily infections now. Actual estimates are that it’s actually about 4x higher counting for rising test positivity, test shortages & at home tests. IHME projects well over 1 million/day. 2/…
Read 18 tweets
26 Dec 21
COVID Update: I’ve interviewed well over 100 experts now. With omicron, the graphs & opinions are many but the truths are muddled.

There are plenty of contradictions including 8 important ones. In that muddy world, 2022 will be shaped by differing circumstances & 3 attitudes. 1/
1. Some of the scientists I respect the most, like @DrTomFrieden & @Farzad_MD are expressing doubts that with omicron, efforts to prevent contagion are realistic.

Yet, there are many of us who have worked hard to avoid COVID & don’t want to stop now. 2/
2. Omicron, either because of our T cell response, vaccination rates, inherent challenges in spreading to the lungs, or some combination is less likely to put any one of us in the hospital.

Yet hospitals will be swamped because enough people will still get sick. 3/
Read 25 tweets
23 Dec 21
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
21 Dec 21
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/
Read 21 tweets
18 Dec 21
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 21
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

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