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Michael Lin, MD PhD 🧬 Profile picture
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6 Jan, 5 tweets, 2 min read
On-the-ground look at Omicron from the Marin County PH officer.

- Cases peaked 2 wks ago
- 18/19 hospitalizations non-ICU (most don't even need O2, some asymptomatic)
- Older vaccinated well protected

Not sure Omicron truly done here but still...

sfgate.com/coronavirus/ar… Image
As @Merz mentioned Marin is one of the highest-vaxxed counties in CA. However it's not particularly young. The experience is "anecdotal" anyway but the PH officer relates it to past experience in the same location. It may serve as an example of what high vax rates can achieve.
@Merz The observation about low ICU rates is similar to what we've seen in London so far
@Merz Apparently vast majority of at-risk have been immunized by virus or vaccine by now. In the US, this is likely to be true in areas hard-hit by Delta such as FL, or high-vax areas like Marin County, but not those that did better during Delta yet didn't fully vaccinate like MA
More on vaccine efficacy

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More from @michaelzlin

Michael Lin, MD PhD 🧬 Profile picture
7 Jan
Since my analysis concluding 3 shots are required for the broad response needed against Omicron, and that #JnJers will need 2 shots of RNA, others like former Surgeon General @JeromeAdamsMD have reached the same conclusion
16M Americans are stuck in pre-Omicron limbo. We just need to admit J&J was like one shot of RNA, so they were behind 2xRNA-vaxxed and should be allowed to catch up. (And a 2nd J&J is not as good due to immunized clearance of the adenovirus vector)
Most #JnJers understand past mistakes of CDC and FDA on this and other topics have already degraded their credibility. This is why people are turning to writing articles to point out the problem. Credibility on this topic can only go up by addressing it
usatoday.com/story/news/hea…
Read 4 tweets
Michael Lin, MD PhD 🧬 Profile picture
3 Jan
While our attention was diverted by Omicron, FDA approved the viral mutagen molnupiravir (MOV) on the last business day before Christmas. The same time, Merck published that MOV doesn't reduce virus levels in the first 3 days. So patients will be shedding mutated virus for 3 days
I wrote in the Washington Post pointing out that widespread use of the drug increases the risk that we will create new immunoevasive variants. This could come from Delta; it may not be milder like Omicron. Since my piece is no longer browsable, I post it here as a public service
It's not just me. Most scientists or clinicians who know the data are worried. They include @JamesEKHildreth, Defense Health Agency director @peterweina, and former BARDA director @RickABright who were overruled either by FDA or by the prev admin on their MOV concerns
Read 7 tweets
Michael Lin, MD PhD 🧬 Profile picture
1 Jan
For a new year tried out a new mask, the 3M Aura N95 mask. Wow what a night and day difference. Didn't realize a mask could be this comfortable. Most amazing thing: speech comes through clearly.

My colleague @AbraarKaran is correct: CDC should be pushing better masks like these
These are $3 each and worth it. You can buy a 3pack (or 10pack) and rotate between them. On the 3 days off you let the mask air out to evaporate odors and let any viruses in them die off. More info on this thread.
Not only did HHS and CDC failed to push for mass manufacturing of these masks earlier (a problem since the previous administration when @RickABright was overruled on the matter) but CDC continued to push wrong or obsolete ideas about N95s
Read 13 tweets
Michael Lin, MD PhD 🧬 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, MD PhD 🧬 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.
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, MD PhD 🧬 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

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