‘Endemic’ Covid?

Is Omicron’s arrival means that Covid is soon going to be endemic?
No, the Omicron’s very existence has in fact underlined concerns about what happens with future Covid mutations. 1/
This is because each successive VOC to emerge through the pandemic – including Alpha, Beta, Delta and now Omicron – has not been a descendant of the previous one, as is typical in flu & seasonal CoVs, allowing immunity to develop. 2/
This pattern means we shouldn’t assume the next variant of interest/concern will emerge from current circulating Omicron viruses – like other variants, it may well have already evolved (or be evolving) somewhere, from a much older ancestor lineage. 3/
This future variant-wherever & whenever it emerges – may be therefore be very different in terms of mutations to Omicron or Delta, meaning it could be just as infectious, since the human population would have lower protection ag transmission, & it could also be more virulent 4/
Pandemics come in waves & at each wave we see people acting foolishly, secure in the belief that the next wave will be very weak if it comes at all.
SARS2 is not going to become a ‘common cold’/ ordinary ‘seasonal’ CoV within the span of the next few months or even years 5/
Excellent reasons to be optimistic that Covid19 disease may become less of a concern. This was mainly to do with vaccines & infection-acquired immunity, rather than the evolution of the virus. 6/
We cannot rely on a virus becoming milder, but have to continue to vaccinate our way out of it.
As long as we fail to share vaccines fairly, new nastier VOC can appear from anywhere, w/ no guarantee that our Omicron immunity will be cross-protective

inews.co.uk/news/politics/…

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More from @vipintukur

Jan 18,
The current events have ‘forced’ me to do a quick, random analysis of global Covid Vaccination (may not be perfect). A short thread….👇 1/
1-Covid vaccines are not providing good protection against infection including ‘symptomatic disease’: the primary endpoint of their efficacy trials

2-They failed to provide reasonable durability of immune response, more so ag the last two global VOC. 2/
3-Though high NAb titers are no guarantee for protection against infection, for a highly immune evading variant like Omicron, one needs several folds(>30-40 folds) higher titers than other variants for protection
Read 14 tweets
Jan 18,
Fourth vaccine shot 'not good enough' against #Omicron in #Israel!

A study conducted at Sheba Medical Center indicates a fourth shot of the Pfizer Covid vaccine provides insufficient protection against the Omicron variant!

timesofisrael.com/liveblog_entry…
The researchers though find an increase in antibodies, higher than after the 3rd dose. However, many were found infected with Omicron who received the 4th dose.
Let’s see how Israel, a hyper-vaxxed country, and India, a country with modest coverage of 2-doses of Covid vaccines performing 👇 ImageImage
Read 4 tweets
Jan 17,
What would be the future scenario w/ #SARS2 variants?

1. Displacement of Delta by Omicron
2. Long-term co-circulation
3. Omicron wave followed by resurgence of Delta & extinction of Omicron
4-Alternate outbreaks of Omicron & Delta
5-An entirely new VOC may displace the two 1/
We know an Omicron infection protects well against reinfection by Delta in previously vaccinated people, but not so well in those that have not been previously vaccinated. In unvaccinated people an Omicron infection only protects well against Omicron reinfection. 2/
This gives advantage Omicron in a highly vaxxed world. But epidemiology of the two VOC in coming weeks should tell us how efficiently Omicron is displacing Delta 3/
Read 12 tweets
Jan 17,
Waning COVID19 Vaccine Effectiveness (VE) for #CoronaVac & #BNT162b2 in #Malaysia

➡️ Observational study: Data on all confirmed COVID cases from 1-30 Sept 2021

⬆️ ‘Early’ group (fully vaccinated in April to June 2021) & the ′late′ group (fully vaccinated in Jul to Aug 21) 1/
➡️ For BNT162b2:

-VE against COVID-19 infections declined from 90.8% in the late group to 79.1% in the early group.

-VE against ICU admission & deaths were comparable between the two different periods. 2/
➡️ For CoronaVac:

-VE against COVID-19 infections waned from 74.4% in the late group to 30.0% in the early group.

-VE also declined significantly against ICU admission, dropping from 56.1% to 29.9%

-For deaths, VE did not wane after 3 to 5 months of full vaccination 3/ Image
Read 4 tweets
Jan 17,
A short thread on sub-lineages of #Omicron & their current epidemiology

Now, we know the Omicron (BA.1) has got 3 sub-lineages: BA.1, BA.2 & BA.3.

1/
-BA.1 is known as Omicron, the parent variant.
-BA.2 is sub-variant that shares many but not all mutations with BA.1. >5000 cases so far
-BA.3 probably antigenically similar to BA.1 as it shares mutations at 417, 446, 484 & other key sites. Only 42 cases are reported so far 2/
-Both BA.1 & BA.2 carry almost all spike RBD mutations 1st noted for Omicron & both furin cleaveage adjacent mutations
-BA.1 & BA.2 have NSP6 deletion seen in other VOC
-BA.2 does not carry spike:69/70del deletion & will thus not be detectable by SGTF (S-gene target failure) 3/
Read 12 tweets
Jan 16,
Extraordinary immune evasion by #Omicron?

Tested #SARSCoV2 positive today. Despite having three doses of Covid vaccine & past infection in Sep'20! And despite possessing anti-spike Abs higher than post-convalescent titer. So, no respect to hybrid immunity too Image
There are a few takeaways:

1-Prevention of Omicron infection is unattainable with current vaccines.
2-Since majority of infections result in mild illness, our focus shouldn’t be infections & symptomatic disease 1/
3-Furthermore, the amount of NAbs titer needed to neutralise Omicron is several folds (>20-30 folds) higher than previous VOC. This is not attainable with the available vaccines & not even with boosters
4-Antibody titres depend on individual’s genetic makeup and sex 2/
Read 4 tweets

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