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Michael Lin, MD PhD 🧬 Profile picture
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Jan 29 • 8 tweets • 3 min read
What's the diff between a chief librarian and a CDC director?

When a chief librarian leads his staff from a 1000mi away, it's a scandal.

When the CDC director does it during the deadliest pandemic ever, it's somehow not.

Yes, literally phoning it in.

seattletimes.com/entertainment/…
Well the director does fly in a few times a month. Is that enough time to see everything interesting from 10k staffers? Also doubt much reform/reorg is going to happen remotely

google.com/amp/s/time.com… Image
I expected the WH would had made willingness to move to Atlanta a precondition of appointment for the CDC director during our biggest loss of life ever, when access to info and good communication is more important than ever.
So, if a county head librarian is "at center of remote-work controversy"... well maybe there's somebody else we should be discussing as well.

publicola.com/2022/01/27/sea…
The WH should know a physically absent CDC director is a leak in the CDC credibility balloon.

For the aware, it's already reason to doubt that the director's word is really backed up by CDC staff. For everyone else, they are certain to lose some faith when they find out.
Re the Time magazine statement that Walensky "seems to have overcome the challenges" of connecting with staff remotely... how do we know? Where's the evidence? How about we do a controlled trial and put a CDC director at, you know, the CDC, and survey the staff which is better?
Besides not getting the job she deserved, this was another reason for Nancy Messonnier @DrNancyM_CDC to leave. If she had stayed, everyone would be seeking her directions. She'd have all the work without authority or credit. Pointless being XO when the captain is not on board.
So let's sum up this sorry situation, which is more sorry than I would have thought possible 1 year ago:
HHS Secretary: lawyer who has never said a thing about COVID
FDA Commissioner: there isn't one
CDC Director: working from home via Zoom

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More from @michaelzlin

Michael Lin, MD PhD 🧬 Profile picture
Jan 31
🙄 Count on some "researchers" to claim the obvious answer isn't the answer.

Did we want a vax to the original strain? We did?

Is SARSCoV2 now mostly Omicron? It is?

Okay then...
Chances are nonzero that the next variant will come from the currently most widespread and most contagious variant, i.e. Omicron. Good to be prepared.
Basically in this epidemic, if the question is "should we .... just in case?" the answer is yes. Just do it.
Read 4 tweets
Michael Lin, MD PhD 🧬 Profile picture
Jan 25
If you haven't heard, FDA approved molnupiravir for COVID19. I've been concerned it could create highly mutated SARSCoV2 and make new enhanced viruses more likely. Today a new study supports the idea that letting viruses sample multiple mutations is risky.
It's already known that molnupiravir doesn't kill off all mutant viruses after 5 days, but does introduce mutations into the viral genome. That is after all its only mechanism of action. Some of the mutated viable viruses may then hop to other people.
The pro-MOV argument is that MOV drops levels of viable virus more than it increases mutations in the remaining viruses, which might mean fewer later mutational templates. For several reasons, these arguments are not convincing, which means we're making an unusually dangerous bet
Read 18 tweets
Michael Lin, MD PhD 🧬 Profile picture
Jan 24
New CDC studies have good news for the boosted, I mean up-to-date, bad news for double-jabbed only

The good news: Protection from Omicron ER visits is 82% for the up-to-date

The bad news: Protection down to measly 38% for non-boosted 6mo after dose 2

cdc.gov/mmwr/volumes/7…
First a quick detour: We're now calling people who are adhering to the most recent recommendation up-to-date on their shots. I think this is a good thing. Unlike "fully vaxxed" it is language that can be continually used even as guidance changes.
usnews.com/news/health-ne…
Now back to the studies. The first one, linked in the top post, looked at ER/urgent-care visits, and at hospitalizations. Hospitalization protection against Omicron is also poor after two doses and waning. It's also restored to excellent levels by a third dose.
Read 20 tweets
Michael Lin, MD PhD 🧬 Profile picture
Jan 13
Two years too late. Okay, it was the former guy then, so just 1 year too late for this administration.

I recommended household distribution of small packs of masks in March 2020.

Image
Korea and Taiwan did that for their citizens. Taiwan gave out a few free medical masks per week per person. Korea allowed purchases but limited per person and price-controlled.
nytimes.com/2020/04/01/opi…
In the US, pushback to medical masks for all was based on the myth that there were not enough to go around. But this was simply not true. There were 100s of millions of masks, but HHS took them all for the hospitals. Hence a prevention opportunity was lost
Read 6 tweets
Michael Lin, MD PhD 🧬 Profile picture
Jan 11
Making a new COVID-19 metathread for 2022.

Previous 2020-2021 COVID-19 metathread is below

2022.01.01. Recommending the 3M Aura as a speakable, breathable, comfortable, affordable N95 mask.
2022.01.04. Reiterating my concerns that molnupiravir's low efficacy is not worth the risk of creating highly mutated viruses, with similar opinions from Danish MDs and an admission from a Danish official that its approval skipped normal requirements.
Read 6 tweets
Michael Lin, MD PhD 🧬 Profile picture
Jan 11
Some Omicron trends that we can now definitively see:
• Case hospitalization and fatality rates (CHR, CFR) in SA, Denmark, UK, Australia, US
• A guess at true infection hospitalization and fatality rates (IHR, IFR)
• Omicron peaking in many regions of the US
This follows a previous thread where we inferred from early SA data that the CHR was lower for Omicron than earlier waves due to prior immunity and lower virulence, and it would be similar in the West. (But still bad news due to very high case # s)
The SA data as of 2021/12/28 showed Omicron CHR and CFR at ~50% and ~15% of the 2021/01 peak.

The CHR is clearly ~50% of the year-ago peak. Deaths however are still creeping up and CFR now 20% of year-ago. Others observed older people got Omicron later in SA; may relate to that.
Read 25 tweets

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