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Katherine J. Wu, Ph.D.

14 Jan, 9 tweets, 5 min read

(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.

theatlantic.com/science/archiv…

(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.

theatlantic.com/science/archiv…

(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.

theatlantic.com/science/archiv…

(4/9) I had a cycling coach who once told me: Great, you're past the top of the hill. Don't stop pedaling.

We still want to minimize the number of unnecessary infections. The start of a decline does not guarantee a perfect plummet to zero.

theatlantic.com/science/archiv…

(5/9) We also talk about the "peak" as if it's one thing, but the US's peak is a national aggregate. It's also essential to remember that not everywhere will peak at the same time. Later, smaller, regional peaks also merit our attention and concern.

theatlantic.com/science/archiv…

(6/9) No matter where we are, though, the advice is the same: Infection prevention. The healthcare system is overwhelmed ALREADY. We can't afford to make it worse, or prolong the burden.

theatlantic.com/science/archiv…

(7/9) For places pre-peak, there is still time to blunt it. Remember flatten the curve? That's still a thing.

theatlantic.com/science/archiv…

(8/9) The same behaviors that flatten the curve on the left side (the rise) can then speed the downslope on the left (the decline).

The shape of an epidemic curve is not a foregone conclusion. Neither is the number of cases that must fall below it.

theatlantic.com/science/archiv…

@bansallab

(9/9) Big thanks to @bansallab @maiamajumder @yhgrad @svscarpino @JustinLessler @meyerslab @SaadOmer3 @nataliexdean @asosin for chatting with me about this.

theatlantic.com/science/archiv…

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More from @KatherineJWu

Katherine J. Wu, Ph.D.

@KatherineJWu

13 Jan

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

theatlantic.com/science/archiv…

(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."

theatlantic.com/science/archiv…

(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.

theatlantic.com/science/archiv…

Read 14 tweets

Katherine J. Wu, Ph.D.

@KatherineJWu

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?

theatlantic.com/health/archive…

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

theatlantic.com/health/archive…

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?

theatlantic.com/health/archive…

Read 6 tweets

Katherine J. Wu, Ph.D.

@KatherineJWu

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/

theatlantic.com/science/archiv…

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/

theatlantic.com/science/archiv…

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/

theatlantic.com/science/archiv…

Read 4 tweets

Katherine J. Wu, Ph.D.

@KatherineJWu

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/

theatlantic.com/science/archiv…

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

Katherine J. Wu, Ph.D.

@KatherineJWu

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
theatlantic.com/health/archive…

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

theatlantic.com/science/archiv…

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

Katherine J. Wu, Ph.D.

@KatherineJWu

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/

theatlantic.com/science/archiv…

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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