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Dr Satoshi Akima Profile picture
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2 Jan, 10 tweets, 5 min read
Why our big COVID switch is foolish theage.com.au/national/why-o…
Omicron is “a very different disease and infection profile to previous variants”. Yes, in ways which make it more concerning given its higher viral load and tighter ACE2 binding is liable to engender severe disease in some situations eg in children
“So why these dramatic changes in policy? And are they safe?” At no point has “dramatic” evidence emerged that Omicron is Nature's gift of a perfectly safe attenuated live virus vaccine to be spread among the population as a free booster. That didn't work with smallpox either
"Boosters significantly enhance protection from Omicron, but they aren’t perfect". 3rd shots restore vaccine effectiveness. You need 3 shots to be fully vaxxed vs Omicron as per BioNTech CEO Sahin. Why let rip with only 9.26% fully vaxxed? 0-11 yr olds 0% vaxxed
UK reports: while "hospitalisations are increasing with Omicron, they don’t appear to be rising as fast as infections, and the proportion of people in [ICU] is vastly reduced". It's still not enough of an attenuated live vaccine to avert field hospitals
"[W]hat about the apparent shift in attitudes towards antigen tests?" RATs haven't been validated as a test vs Omicron. If you're going to let rip with Omicron as a free booster, you should plan testing capacity, so victims can access #longCOVID care politico.com/news/2021/12/2…
Not only should PCR capacity have been greatly expanded in advance of wilfully seeding Omicron everywhere but mortuary capacity too. Field hospitals needed to be planned with preparation for the defence force to mobilise, as is happening in the UK
A gamble has been made to charge the machine gun positions to bring a swift end to the conflict—assuming that the vulnerable need be sacrificed to a noble cause. Its leaders are hoping that it will be dignified as a historical necessity, 'the price one pays for progress'
ADDIT: the debate between the mildologists and the sceptics has not been settled. Much of the "mild" signal has come from studies in animals like hamsters that don't express ACE2, for which O has a higher binding affinity. Some just assumed it settled
The overconfident assumptions of the mildologists are looking decidedly shaky as they begin to fall ever more curiously silent. But as they say: if you're going to lie—lie big

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More from @ToshiAkima

Dr Satoshi Akima Profile picture
13 Dec 21
I had misgivings about this early speculation/hunch that the high Reff/Rt values with superexponential growth might suggest higher viral loads, leading to increased viral load in aerosols and transmissibility. But I might have got it right
Now, @Tuliodna is saying quite openly that Omicron is associated with elevated viral loads. This may explain the increased presentation in children (often with a rash not seen with Delta), suggesting MIS-C is probably going to be more common from Omicron cbsnews.com/news/transcrip…
If the viral loads from Omicron do surpass those from Delta, it would confirm that SARS2 is evolving towards becoming more contagious (higher R0), putting it more in line with other airborne viruses like chickenpox or measles
Read 7 tweets
Dr Satoshi Akima Profile picture
10 Dec 21
Interpretation: the reason for the exponential surge in Omicron cases is due to breakthrough infections in those with prior vaxx/infection-induced immunity PLUS cases in those without previous immunity. But in breakthrough cases, some protection is retained, reducing severity
It is improbable that Omicron is any less severe in those lacking prior immunity. Just like Delta, Omicron will hunt down these immune naive individuals, producing surges large enough to overwhelm hospitals, then add to the burden by hitting those with prior immunity too
I can easily imagine that the vaccinated/previous infected cases will still progress to respiratory failure a bit more than they used to with Delta. But a significant proportion of them still won't progress and many will be able to be discharged to manage bed pressure
Read 8 tweets
Dr Satoshi Akima Profile picture
29 Nov 21
There’s a lot of #Hopium being shared over #Omicron saying that because info is incomplete that therefore “it’s just a mild cold”, “viruses always become more harmless over time”, “let’s all get infected”. But we know more than many admit
Once again, alarm signals about increased transmissibility (in Delta this mean higher viral loads and increased hospitalisation rates). Lack of perfect evidence of harm is hardly grounds for Faith in #Omicron being the Saviour attenuated live viral vaccine some claim it is
Omicron already exhibits mutations that were predicted to increase infectivity through enhanced binding to ACE2. There are *NO* known genetic features predictive of it turning into a cuddly live attenuated viral vaccine against COVID (the virology equivalent of Santa)
Read 8 tweets
Dr Satoshi Akima Profile picture
28 Nov 21
It takes 3 shots to be fully vaxxed. If you’re double vaxxed, you’re only partially vaxxed. The EU won’t even let you in
If it takes 3 shots to be fully vaxxed, then Australia is only 1.6% fully vaxxed. We've already been overtaken by Canada, who announced their 3rd shot later. To avoid future lockdowns, we've got to get to +50% by winter. Table by @covidbaseau covidbaseau.com/vaccinations/ Image
The evidence is clear. If we get everyone triple jabbed by winter, we have an excellent chance of averting lockdown. Follow the Israeli example. DO IT NOW!—don't start after we end up in another lockdown crisis
Read 12 tweets
Dr Satoshi Akima Profile picture
20 Nov 21
Unsolicited Review: Castle Grade N98 respirator. This gets a recommendation from me. TGA approved making it suitable for HCWs. It is comfortable and reusable. Ideal for Australian HCWs who suffer PPE burns from N95 masks, while upgrading aerosol protection castlegrade.com.au
Initial concerns included that I am not fit-tested by work, but as soon as you put it on you can tell there is reduced air leakage around the mask edges vs. a fit-tested N95. That means ZERO fogging of glasses. The tight seal pushes the air through the front of the respiratory
The acid test is whether I'd wear it working on COVID duties despite not being fit-tested. The answer is YES. There is obvious reduction in air leakage around the mask edges. It would be difficult for work to object to me wearing a TGA approved N98 respiratory instead of an N95
Read 16 tweets
Dr Satoshi Akima Profile picture
20 Nov 21
Another cycling day today. 50km done wearing a KF94 mask all throughout the ride (only removed to drink water). The trick to avoiding having it fog up your glasses is to push it as high on the bridge of your nose as possible.
During my work N95 fit testing, I was instructed to push the N95 mask as high up as possible. A KF94 is smaller so it causes it to sit above your chin, but this encourages exhaled air to be expelled from the bottom—not the top, fogging up the glasses
I was also instructed to carefully mould the nose bridge wire so that it fits the contour of your face. It's best to do this in front of a mirror. This further improves the fit, reducing leaks of air upwards, fogging up your glasses.
Read 6 tweets

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