I've gotten a couple of Qs about the increasing deaths in #Israel w/ #Omicron & reports that the majority of their deaths are in vaccinated folks. Anti-vax antennae are activated. What's happening?
TL/DR: Vaccines work and be careful with headlines.
Let's break it down
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1st point: Vaccination in Israel is not as great among the developed world as it seems. This was a surprise to me. The constant barrage of vaccine headlines make it seem they lead the world. They do not.
66% of the population is fully vaccinated. Pretty close to the US 64.4% 2/
In that context, it's not surprising that their death rate per million is in line with the US. And-just like in the US-you see a dramatic rise with #Omicron ripping through the population.
So what about this part about the majority of deaths are vaccinated people? 3/
2nd point: You have to account for seeing a skewed view of the world.
Say someone visits the US for the 1st time & lands in #Boston on ⚾️ opening day.
They'd see mostly #RedSox gear & maybe a couple weirdos in #Yankees caps.
Conclusion: The majority of 🇺🇸's = RedSox fans
4/
And (sadly) we know this to not be true. You have to look at the # of RedSox fans relative to ALL baseball fans. What seems like a lot is actually a little.
Similarly, looking at Israeli patients dying from COVID you see a much higher percent are unvaxed or partially vaxed 5/
BT deaths do occur, but luckily, they are rare:
- 88% of Israeli's >60 fully vaxed & a super small % who die from COVID
- 12% are uvaxed & die at a much higher rate
It's a lie to say the 88% is less protected b/c they may be higher in number
This graph tells the real story. 6/
In sum:
- The vaccines work
- Israel, the US, and nearly every other country needs to increase rates of vaccination and boosting
- Don't mistake a skewed picture with reality
- #GoSox
I took a few days to collect my thoughts on the #Omicron variant based on the early reports.
There are 3 things that concern me so far in S. Africa: 1) Explosive growth rate in infections 2) Increased rate of re-infections 3) Higher numbers of younger people hospitalized
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#1: This is a graph shows 7d average cases by week with different variants overlayed on each other. Whereas the #Delta (blue) wave looks like a steep mountain, Omicron (black) looks like a rocket taking off straight up. It’s unprecedented and nauseating. 2/
#2 Partly driving cases is higher reinfection rates w/ Omicron. So far 3x higher than Delta! Until now we’ve thought of natural immunity as decent (though vax-immunity is better). But Omicron is eating natural immunity’s lunch money.
I’m getting more worried about the elderly & immunocompromised patients as the #DeltaVariant spreads. Some concerning stats:
- 75% of patients hospitalized with breakthrough infections are 65 & older
- 44% are immunocompromised despite making up only 2.7% of the population.
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The data is even more concerning for severely immunocompromised patients (like organ transplant recipients). They have an 82x higher risk of breakthrough infections. See below from @costisifri.
Studies looking at giving a 3rd dose of #mRNA vaccine to immunocompromised patients who fail to mount an antibody response are promising. This one showed that 33-50% of these participants developed an antibody response after the additional dose.
Cases from the #DeltaVariant are increasing in every state. So should you start wearing a mask indoors again if you're fully vaccinated? I have, and for most people I think the answer is yes. But this is especially true for folks who live in areas with low vaccination rates. 🧵
Delta is no joke. Compared to the original strain, 1000x more of it sits in your nose/throat and it peaks earlier. It's hard to believe. It is one of the most infectious respiratory viruses we have ever seen. Period. virological.org/t/viral-infect…
With something so infectious your risk of infection goes up with any higher risk activity you do. But at each level of risk, your chances of getting infected are higher if you are unvaccinated. If you are in a community with low vaccination rates, this risk is even more amplified
I’ve debated all day whether to post this, but the world deserves to know that 9 years ago to this day my first child, Julian, was stillborn. While @k_scottbell and I knew him through his kicks and tumbles, he was born at full term and never took a breath. We don’t know why.
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There are no words to describe losing a child, so I won’t try. The emotional shock and depression was profound and it’s hard to even access that emotional space this far out. But it taught me how to set my priorities, and I’m a better parent, husband, and physician because of it.
I’m forever grateful for the staff at @MtAuburnHosp, where Julian was born. They advised us to create an identity for him. We swaddled him, kissed him and took pictures. We held him in our arms until the warmth passed on from his mother began to fade. These are precious memories.
After a MICU stretch I finally saw #TotallyUnderControl. One line that stuck with me is there are times when politicians need to get out of the way. @alexgibneyfilm shows that a key failure of the WH was the inability to cede control and let the experts manage the pandemic.
The film does a very good job of taking the frustrations voiced by so many people and bringing them into a laser focus on the root causes. It should serve as a record of how our response went wrong and how to avoid the same mistakes for the next pandemic.
The film highlights the importance of public servants. People like @RickABright & @DrNancyM_CDC should be commended for the stand they took. At their personal/professional expense, they put the needs of the country first to tell the truth & speak out. They are heroes in my book.
Yes. #RunningwhileBlack should not be a death sentence. Maybe it’s a good moment to share some insight into being black and male. I haven’t run alone for years out of this concern; but there are other things black men do to decrease their chances of being killed 1/
One night I was on call in the ICU and had to come in for a dire emergency. I hopped in my car and started to floor it. But then realized I was a black man, alone in a speeding car, late at night. It’s a setup for badness. I slowed down for my safety. 2/
Also speaking of cars, this is a “don’t shoot me” sticker. Every car I’ve ever owned has had some sort of sticker like this. It’s not a desire to advertise my cred, but an effort to assign me #human value when it may not be assumed if I’m pulled over. 3/