I keep looking at New York State as the indicator for what's to come in the US. For new cases/capita, it's leading the US. If it were a country, it would now be the 2nd highest in the world after Ireland. In contrast to the CDC, the state has a lot of solid new data to review /1
Hospitalizations are rising, sharply
The level of patients requiring ICU beds is nearly as high as the monster 3rd wave (well below the 1st wave) /2
newsnodes.com/us_state/NY
coronavirus.health.ny.gov/daily-hospital…
NYS "fully vaxx" rate is 72% and also has better than US avg for older age groups.
There's some reduction of vaccine effectiveness vs hospitalization recently, but the overwhelming proportion of patients admitted are among the unvaccinated /3
Here are the case data by vaccinated status, which shows more VE attrition than hospitalization (as expected). And the shift from Delta to Omicron dominance that just took place recently/4
I can't find any VE data for💉💉waned, 3rd shots. Putting that aside, these findings are v concerning. Omicron's impact isn't yet baked in for severe disease, but already signs of VE reduction.
NYS has a much better immunity wall than much of the US, but less than many countries

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More from @EricTopol

22 Dec 21
Paxlovid just cleared by FDA!
Will be available in days
Just not enough of it to go around and that needs to be fixed ASAP
This is big, folks 👋👍👍
For more than a year we've been talking about Global Vaccine equity.
Now it'll also be Global Pill Equity.
Unless something is done to get production revved up, as discussed here
theguardian.com/commentisfree/…
Read 4 tweets
22 Dec 21
Omicron resulting in less severe illness
The latest roundup of data from this preprint with South Africa data and from Denmark ft.com/content/19065f… by @mroliverbarnes @jburnmurdoch @rmilneNordic
1. Less hospital admission in South Africa
2. Also 3X less likely in Denmark, but with a skew towards younger people testing positive
Also of note is the higher vaccinated proportion with Omicron in Denmark than was the case with Delta and prior variants
Read 7 tweets
20 Dec 21
Last week @CDCgov reported Omicron was 2.9% (that has now been revised)
*Today it is 73%*
Dominant across the US (with heterogeneity)
This is a doubling growth rate of 2 days or less
Replicates what has been seen in South Africa, UK, Denmark
Last week's 2.9% of cases being Omicron has been revised upward to 12.6%
12.6% -->73% of new cases are now Omicron
That's what you call exponential growth, folks
Yes, you read it right, a whopping 73%
Read 5 tweets
10 Dec 21
First data on booster vaccine effectiveness vs Omicron (581 cases): drop in protection vs symptomatic infection by 2 doses (AZ ->0, Pfizer-> <40%) restored to ~75% with 3rd shot Pfizer
assets.publishing.service.gov.uk/government/upl… @UKHSA

khub.net/documents/1359…
The 95% CI presented here with relatively small number of Omicron cases overlap vs Delta, but certainly suggest less protection after 3rd dose.
For Omicron, essentially no protective effect of 2 AZ doses, 3rd goes to 71% (42,86); 2 Pfizer doses to 34%, 3rd doses to 76% (56,83)
Much more new beyond 1st look at Omicron vaccine effectiveness, summarized in a terrific thread by @kallmemeg
— ~7% cases Omicron reinfections (0.4% Delta)
— 3.2X adjusted odds of household transmission (vs Delta)
— big growth advantage👇
Read 4 tweets
9 Dec 21
The overwhelming evidence for 3rd shot boosters *before* Omicron, reinforced by new data for benefit vs Omicron
1. The randomized trial of 3 shots vs 2 shots + placebo, 95% efficacy for preventing symptomatic infections across all age 16+ groups (N=10,125)
cdc.gov/vaccines/acip/…
2. Reduction in death by 90% for age 50+, 3 shots vs 2, among >840,000 people
nejm.org/doi/full/10.10… @NEJM
3. Marked reduction of hospitalizations and deaths in over 728,321 people with 3 shots vs matched 728,321 people with 2 shots, across all age groups
thelancet.com/action/showPdf…
Read 5 tweets
7 Dec 21
Great credit to this team for quickly getting us Omicron lab neutralization data. The bright side is that there is incomplete immune escape from vaccination👍
For people who had Prior Covid plus vaccination, the preserved Omicron neutralization level (FRNT) likely reflects solid protection. Not seen with 2 doses of Pfizer vaccine, but would expect that a 3rd shot, with its marked effect on raising nAbs, would simulate that
Here are some relevant data for the small sample. The 6 vaccinated individuals range from 10-39 days post-vaxx.

Take home point is how powerful hybrid immunity (vaccine + prior Covid) vs all variants that we've seen now, including Omicron
Read 4 tweets

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