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Eric Topol Profile picture
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Jan 28 • 7 tweets • 5 min read
Brief update on Omicron, and its BA.1 and BA.2 lineages (sisters)
1. Origin—the 3 theories for how this hyper-mutated version of the virus evolved
nature.com/articles/d4158… @nature
2. A great annotated graphic by @firefoxx66 of @nextstrain conveying the antigenic distance of Omicron's BA.1 and BA.2 from prior variants
nextstrain.org/ncov/gisaid/gl…
3. The BA.2 variant is spreading widely, throughout many countries in Europe and Asia, out-competing BA.1, indicating higher transmissibility. But the good news from yesterday's @UKHSA: vaccination + boost is holding up quite well; there's no indication of more immune evasion
4. Some countries where BA.2 (light purple) is making or has already made major inroads outcompeting BA.1 (purple) covariants.org
5. And there's a new thread from @trvrb covering these points and many others, with the conclusion that BA.2's impact of extending the length of time (longer tail) for the Omicron wave
6. More on this and it's excellent, by @Dereklowe
science.org/content/blog-p…
7. A new BA.2 dedicated report today from @UKHSA
The secondary attack rate for BA.2 compared with BA.1 is roughly 30% increased, reflecting a transmission edge
assets.publishing.service.gov.uk/government/upl…
And another invaluable @kallmemeg🧵takes you through the rest of it

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More from @EricTopol

Eric Topol Profile picture
Jan 27
Important new @UKHSA report today sheds light on key Omicron concerns
assets.publishing.service.gov.uk/government/upl…
1. BA.2 Vaccine effectiveness holds up very well compared with BA.1 *with booster*
2. The vaccine effectiveness (VE) vs Omicron symptomatic infection vs Omicron falls off 15+ weeks, as was seen with the Israeli data, here more so with Pfizer compared to Moderna
3. But protection (VE) vs Omicron hospitalization remains quite high (Moderna > 90% thru 9 weeks)
Read 5 tweets
Eric Topol Profile picture
Jan 25
ICU admits may be the best proxy for lack of vaccinations. Israel and the US have low rates of vaccination (65, 63%) and have seen rising ICU rates in their Omicron waves (not seen in high vaxx % countries)
@OurWorldInData Image
Clarification: Colors are swapped on the vaccine right-sided panels. Israel has slightly more 2-shot vaccination and >2X boosters
Important graph from @StavKislev that supports my point Image
Read 4 tweets
Eric Topol Profile picture
Jan 24
How to reduce your chance of dying from Covid by 99%?
Get vaccinated and a booster.
One of the most impressive graphs I've seen for the impact of vaccination in the US pandemic
(thanks @redouad @OurWorldinData for re-plotting my makeshift graph from earlier today)
Highlighting the data above are for all ages
Graphs for vaccination vs deaths by age groups (w/o booster partitioned):
Now deaths by age groups: 65+, 50-49, 18-49
For each group, death is reduced by 99% for vaccination plus booster compared with unvaccinated (down to zero for youngest age group)
ourworldindata.org/grapher/united…
Read 5 tweets
Eric Topol Profile picture
Jan 23
What to make of Omicron's BA.1 and (sister) BA.2 lineages?
Both are hyper-mutated with over 50 mutations but many are different, particularly in the spike and ORF1a regions outbreak.info /1
There's not any functional or epidemiological data to show any meaningful differences....yet. But BA.2 has become dominant in Denmark, out-competing BA.1, and its prevalence is rising in India, Singapore, Sweden, the UK and other countries /2 Graph via @Mike_Honey_
The spread of BA.2 supports increased transmissibility (hard to imagine beyond BA.1, O's sister). On Jan 21st, UK designated it as a variant under investigation ft.com/content/34fef1… More to learn, keep 👀, no reason for distress at this point (we already have enough of that)
Read 4 tweets
Eric Topol Profile picture
Jan 22
Debunking the notion that boosters don't reduce Omicron symptomatic infections. Another new study from Qatar shows they are halved medrxiv.org/content/10.110… matched >400,000 people with mRNA vaccines 2 vs 3-dose Image
The booster reduction for Omicron symptomatic infections for 3-dose vs 2-dose was 66% in the @JAMA_current report yesterday
jamanetwork.com/journals/jama/… Image
Booster vaccine effectiveness vs Omicron infections 62% (2 dose 32%) @UKHSA in people without Prior Covid
assets.publishing.service.gov.uk/government/upl…
and higher with Prior Covid, hybrid immunity, as seen in all studies Image
Read 8 tweets
Eric Topol Profile picture
Jan 21
Now there are 3 reports for vaccine effectiveness vs Omicron hospitalization, @UKHSA, @KPSCalResearch and today's @CDCMMWR. They are quite consistent for marked protection of the 3rd shot (booster). My summary table here
Here is today's @CDCMMWR report through January 5th on Omicron, key data summarized in the Table
cdc.gov/mmwr/volumes/7…
Here are the data from the new CDC report for vaccine effectiveness for both Delta and Omicron, 2-dose or 3-dose and vs Emergency Room visits or Hospitalizations
Read 5 tweets

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