(1/14) I wrote about the trap of "mildness" and how it's hamstringing our approach to tempering the Omicron wave.

(2/14) There is now decent data to show that, on average, Omicron infections are indeed less severe than cases caused by Delta. But all too often, we conflate "less severe disease" with "an inherently milder virus."

(3/14) Infection disease is always an interaction between pathogen and host. I think the *majority* of the reduction in case severity is actually about us: we're mounting a better defense. That's blunting the carnage. Credit where credit is due.

(4/14) Yes, there is also data to support the idea that Omicron is, particle for particle, a bit less toothsome than Delta. But Delta was a monster. That's a pretty low bar to set. And Omicron is clearly capable of causing immense damage.

(5/14) Even if the average Omicron case is less severe, that does not mean its *extremes* are less severe. At its worst, this variant is still terrible. And no one has zero risk of such an outcome.

(6/14) When we dismiss Omicron as mild, we don't just conflate the contributions of host and pathogen. We take an individual experience and project it onto communities. That erases the suffering of people who experience Omicron differently.

(7/14) Let's also keep in mind who's more likely to have a worse time with Omicron: people who carry risk factors. These are people we need to protect, and yet we do them a disservice when we paint with a broad "mild" brush...

(8/14) ...It says their experiences matter less, because they're suffering from a virus that most others easily survive.

(9/14) Even if Omicron has the potential to be less severe for single people, it's clearly severe on societal scales. The variant is everywhere. It's pervasive. It's finding the vulnerable. It's fracturing our infrastructure through sheer numbers alone.

(10/14) We forget the societal tolls because "mildness" is inherently individualistic, a frame of mind that Americans, especially, tend to prioritize.

(11/14) Saying "mild" is, in some ways, implying that the virus has done its job for us. It's tamed itself. We can check out. We can exempt ourselves from harm reduction. Pandemics don't work like that.

(12/14) Omicron is not mild. Its toll is not mild. But if pick our relationship to this variant apart again, we can remember that our experience of it is also up to us. More vaccinated populations will have, on average, less severe disease.

(13/14) We can soften Omicron's blow just by better armoring ourselves. It's something we should prioritize, instead of looking at the virus and thinking 'phew.'

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More from @KatherineJWu

14 Jan
(1/9) There are a lot of headlines out there right now about the United States being at or quite near (maybe even just past?) the peak of the Omicron wave.

I wrote about what's potentially past the peak.

(2/9) Obviously, no one *knows* what is beyond the peak, but we can be fairly certain what the downslope won't be: super simple, easy, and quick. Curves aren't always symmetrical. A fast, sharp upswing doesn't always mean a fast, sharp downswing.

(3/9) Biology, behavior, and geography will dictate what's next. We could see something jagged, something sawtoothed, especially if we don't take care to keep the peak as low as we can, and if we let up on mitigation on the way down.

Read 9 tweets
18 Dec 21
1/5 with such expansive booster recommendations, the phrase "fully vaccinated" is only getting murkier, and a lot of experts are pushing for the CDC to change it.

but is it even the right way to be looking at our COVID-19 vaccines?

2/5 the term implies a kind of finality - something we can't really have when we're still figuring out the ideal regimen, and what vaccines are supposed to accomplish, and how often we'll need to update them

3/5 we could change the definition now as a kick in the pants for people to get boosted. but what does that do for the unvaccinated? and what happens if we need to change it again? and are we really sure that boosters are third primary doses?

Read 6 tweets
20 Oct 21
hi there! are you mourning the loss of your antibodies, months out from getting your COVID vaccine? don't be—your absolute numbers might be down, but the average *quality* of the antibodies you have now is much higher than it was before. 1/

that's the silver lining of "waning"—which, honestly, I prefer to see as a refinement, a sort of weeding out of mediocrity, rather than some mass culling of protection. 2/

all this centers on the immune system's ability to evolve over time. months after vaccination, your cells are still learning about the virus, and sharpening their SARS-CoV-2-sniping skills. it's actually kind of amazing, and yes, VERY Squid Game. 3/

Read 4 tweets
3 Sep 21
I wrote about how vaccine effectiveness is (surprise!) a very, very complex thing.

This is a dive into some of the science behind recent reports of post-vaccination infections and sicknesses, and why the numbers seem to so often conflict. 1/

The key is that vaccine "protection" can take many forms, depending on what our goals are. Some forms of protection are easier to achieve than others. Vaccine effectiveness is not a monolith, which means certain safeguards can hold while others slightly falter. 2/
And when certain types of vaccine protection do seem to wane, there can be a multitude of explanations. Disentangling them can help us deal with them. Remember that infection is a push and pull between pathogen and host; a change in either one can tip the balance between them. 3/
Read 8 tweets
16 Aug 21
I know a lot of people are frustrated and angry right now. But it doesn't help anyone if we mock, ridicule, slander, or portray the unvaccinated as our "enemies," or being on the virus's "side."

Being unvaccinated is not a monolith... 1/4
And the ways in which we describe vaccines and vaccination really, really matter.

People sometimes try to say that they're referring only to people who are "willfully" unvaccinated. But that's an oversimplification... 2/4

Fear, lack of access, lack of education, exposure to misinformation, etc. often co-occur. And even those who have been acting in misguided ways deserve our compassion.

In a pandemic, you also can't will the virus to infect only the people you're angry at. 3/4
Read 4 tweets
13 Aug 21
There's really nothing else out there *quite* like a vaccine: something that protects everyone's health *by* protecting individual health.

I wrote about how many of the vaccine analogies we default to struggle to capture public health. 1/

Finding a perfect analogy is tough. You'd ideally want a tangible tool that can benefit health on multiple scales; something that varies in performance, according to local conditions; something that addresses a threat that is infectious. 2/
Don't get me wrong, I love a lot of the analogies we've all used, and I think they still have their place. But they might be subtly signaling to a frustrated and confused public that vaccination is merely a personal decision, with penned-in consequences. 3/
Read 7 tweets

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