Thread by @DrTomFrieden

Although deadly new Covid variants could emerge, I'm more optimistic today than at any point since the pandemic began. Here’s why. 1/thread

Despite pandemic fatigue and rough weeks ahead as Omicron crests, we're better defended against Covid than ever. Vaccines and prior infection steadily strengthened our immune defenses. We now have a wall of immunity, though we have lost far, far too many people to get here. 2/

In 2020, failure to follow public health recommendations greatly increased the death toll in the US and elsewhere. In 2021, failure to reach people with vaccination—resistance and partisan opposition in the US and lack of access in many countries—had lethal consequences. 3/

We’ve lost nearly 900,000 people to Covid in the US alone. Most of those deaths could have been prevented. But now, we can have the upper hand over Covid because our defenses are multilayered and strong, starting with immunity. 4/

Based on antibody seroprevalence among people who donated blood, an estimated 94% of Americans had at least some protection against Covid—either through vaccination or prior infection—in November, BEFORE the Omicron wave. bit.ly/3ILxOut 5/

Immunity against severe infection is holding up, especially after boosters. In December, the rate of Covid-associated hospitalization was 16 TIMES higher in unvaccinated adults than among adults who were up-to-date on their vaccination. bit.ly/3o9slFV 6/

10 billion doses of lifesaving vaccines have been administered globally in just over a year. That’s a stunning achievement, although vaccine inequity continues to cost lives and create the conditions for wily variants such as Omicron to emerge. What’s wrong with this picture? 7/

We have new drugs that are highly effective at preventing severe Covid. Lab studies suggest they'll work just as well against Omicron as Delta. Generally, medical treatments don’t have anywhere near the life-saving impact of vaccines, but they help. bit.ly/3GaXRcP 8/

These pills could be a life saver for people at high risk of severe Covid, though we must still overcome supply challenges, pair testing with early treatment, and make sure there’s equitable access for everyone who needs them. 9/

Most people understand that masks work, and that better masks (such as N95s) work better. Masks can stop airborne spread of whatever variant Covid throws at us. We can learn from East Asia, masking if we’re sick or vulnerable to resist not just Covid but flu and more. 10/

Although there have been bumps in the road, testing is more widely available, including rapid antigen tests that can be done at home. When Covid is spreading we can test before gathering indoors with vulnerable people or in large groups, or if we feel sick. 11/

Genomic surveillance is another tool that we’ve sharpened. South Africa set a great example by warning the world about Omicron. Many countries have increased their capacity to do robust sequencing. We can stay ahead of the virus by continuing to be on the lookout. 12/

Genomic surveillance alerted us to a version of Omicron, termed BA.2, that's becoming more common in several countries. This has generated concern, but @UKHSA findings suggest BA.2 doesn’t escape immunity more than the version we've been dealing with. 13/

https://twitter.com/kallmemeg/status/1487157518711222273

All the above are reasons for optimism, but there are wild cards. Protection from Omicron infection may not be strong or long-lasting. And although vaccine protection has held up well against severe disease, we may need additional doses to stay up-to-date. 14/

Long Covid is another question mark. We don’t yet know how often an Omicron infection leads to long Covid, or how best to treat people who are suffering from the condition, although we’re learning more every day and eagerly await NIH study results. nyti.ms/3AEfMaV 15/

A new study suggests that vaccinated people who get infected are much less likely to develop long Covid...another reason to keep your vaccinations up-to-date. go.nature.com/3o8YxJI 16/

The biggest wild card: SARS-CoV-2’s ability to mutate. It’s highly unlikely that Omicron will be the last variant. What’s to say a deadly, highly transmissible, immune-escape variant won’t arise? Frankly, it could. 17/

But even if a worse variant emerges, we’re better prepared than ever: More immunity, more vaccines, more treatments, better masks and more of them, better tests, more understanding of Covid, more sequencing. Covid doesn’t have to dominate: soon we can resume many activities. 18/

Another reason for optimism? We have a unique opportunity to put public health systems in place to find, stop, and prevent health threats when and where they emerge, anywhere in the world. 19/

With partners, @ResolveTSL advocates 7-1-7: Every outbreak detected within 7 days, public health notified and investigation started within 1 day, and all essential control measures established in the next 7 days. preventepidemics.org/7-1-7 20/

The world has a once-in-a-lifetime chance to boost funding for preparedness. @GlobalFund, which is celebrating its 20th anniversary, has made impressive progress against AIDS, TB & malaria and should play a key role in preventing the next pandemic. bit.ly/3ISeD2p 21/

Every country and organization has made mistakes, and challenges remain, but we’ve come a long way. The most important lesson we can learn from Covid is that we’re all in this together. We have a better chance for a safer world than ever in our lifetimes. 22/end

I summarized this thread, and a bit more, here:
tomfriedenpublichealth.net/tom-frieden-bl…