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Eric Feigl-Ding Profile picture
@DrEricDing
Feb 9, 2022 • 20 tweets • 16 min read • Read on X
⚠️SUB-VARIANT SURGING—Omicron 2.0 is rising—the #BA2 sublineage of #Omicron has *tripled* in one week, dislodging the old Omicron from total dominance—BA2 now at 3.6% and climbing fast. Expect to be dominant by March. Omicron reinfections are possible. 🧵 covid.cdc.gov/covid-data-tra… ImageImage
2) Omicron subvariant #BA2 now seems to be surging nationwide (pink), especially in the coastal regions of the Us the fastest. This means it’s not a fluke increase. US’s #BA2 trend will follow Europe’s rise for sure. Image
3) I’ve been worried about #BA2 for a while. In 3rd week of January, it was rising in Denmark— it’s now near total dominant in Denmark.
4) Multiple studies show the #BA2 subvariant is much faster transmission than old Omicron. Some say 30% some say ~90-120%, and some say 150% (1.5 time more).
5) Who said #BA2 is 1.5 times more contagious? Denmark’s CDC @SSI_dk said so—and they warned it was extending Denmark’s Omicron wave much longer. Same thing is going to happen in the US which is much much less vaccinated.
6) other tricky thing is that #Omicron #Ba2’s PCR looks like almost any other non-BA1 Omicron because the SGTF shortcut PCR won’t work on BA2. Thus it’s hard to tell apart BA2 from Delta variant without genome 🧬 sequencing.
7) Virus researcher & chief physician of 🇩🇰’s CDC @SSI_dk says you can get **reinfected with #BA2 sub-variant** of #Omicron after being infected with Omicron BA.1. ➡️ This is why we shouldn’t risk COVID or chase mass infection. nyheder.tv2.dk/2022-01-21-ny-… Image
8) It’s also surging in UK 🇬🇧 as well. #Ba2 d doubled in one week. It’s also surging in Netherlands and in Germany and elsewhere. It’s everywhere now- and quickly displacing the old Omicron 1.0.
9) How different is #Omicron BA2 from BA1? #BA2 has **17 additional mutations** that BA1 doesn’t have! There is also a BA3 but that one doesn’t have much difference beyond BA1 and BA2.

HT @WmHaseltine Image
10) Notably, “Each of BA1/2/3 variants is as different from one another as Alpha, Beta, Gamma, and Delta are from one another”! says @WmHaseltine ImageImage
11) BA2 #Omicron is not a child-lineage of BA1 #Omicron. They are more like “cousins” that branched off earlier - hence they are much more different than parent-child versions of each other. This is also why reinfections could be higher. Image
12) If you still have any doubt in your mind about #BA2 being a 2.0 Omicron that will displace the old Omicron and cause a new surge— just look at how #BA2 (aka ‘Omicron 21L’ in the charts) is surging like mad across multiple countries (& this is just late Jan data!). Get ready. ImageImage
13) 🇬🇧 data also shows a higher secondary attack rate in households for #BA2 versus the old BA1 Omicron. And the growth rate is indeed more than doubling per week. Exponential rise will beget exponential trouble - earlier Omicron immunity clearly isn’t slowing it much—not good.
14) Now the real bad news— two new studies say “immunity based on #Omicron-infection is weak for (another) Omicron reinfection” — if unvaccinated ⚠️

This means protection from your earlier Omicron may not be great if unvaccinated! 👀
15) Some relatively good news on #BA2 is that it seems to responds similarly to vaccines as BA1– but it responds well only to 3 vaccine shots if you get a booster. Without booster, the symptomatic efficacy is very poor —13% and that’s not even significantly different from 0.
16) Update on UK #BA2– it has doubled again and it’s now likely ~17% of all cases in England. And it has a much higher attack rate — altogether bad.
17) the reinfection risk of #Omicron is real. We need to take it seriously folks. Don’t feel like you’re invulnerable. That leads to blase attitude and risky behaviors.
18) Further—“results indicate that Omicron infection enhances preexisting immunity elicited by vaccines, ➡️but on its own **may NOT induce broad, cross-neutralizing humoral immunity in unvaccinated** individuals.” ⚠️

Don’t risk #Omicron BA2 if unvaxxed! medrxiv.org/content/10.110…
19) It now seems the @WHO is getting very concerned about #BA2 variant outcompeting and displacing old #Omicron. @mvankerkhove is now warning about likely looming surge. We must be vigilant.

HT @Cleavon_MD.
20) It is now 100% clear that the @WHO needs to declare #Ba2 a high risk “variant of concern”. Dear @mvankerkhove @doctorsoumya @DrTedros @gabbystern @DrMikeRyan — please make it so. VOC declaration of BA2 now ASAP!

See 🧵 below.

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More from @DrEricDing

Eric Feigl-Ding Profile picture
Feb 26
BREAKING—FDA suddenly cancels meeting to update next season’s flu vaccines, with zero explanations. Any delays will jeopardize next year’s vaccine supply chain. Image
2) Folks who follow me know that I’m no bullshitter. I criticized past pandemic response right and left, and have called balls and strikes without bias. And I often say things that doctors & epidemiologists are whispering among themselves but don’t say publicly. (Cough cough) ⬇️
3) While I don’t recommend hoarding… I think stocking up on flu antivirals, which you can obtain prophylactically (preventively) from doctors if you ask nicely why you’re high risk, can be a good idea. I know many doctors, epidemiologists and virologists who do for their family.
Read 6 tweets
Eric Feigl-Ding Profile picture
Feb 26
Doctors are debunking RFK Jr’s claim that 20 hospitalized measles cases in Texas are there for mainly quarantine. Doctors on the ground say the 20 kids hospitalized are having trouble breathing. Oh and they are all unvaccinated against measles, which RFK Jr neglects to mention. Image
2) RFK Jr told Trump today there’s now 2 measles deaths.
3) RFK Jr is a tear with his FDA today. A dark Darwinian future lies ahead for America.
Read 4 tweets
Eric Feigl-Ding Profile picture
Feb 26
BREAKING—Reports coming in about potentially *2 measles deaths* in Texas, not just one, according to an HHS briefing to the White House today.
2) Earlier today, one measles death in an unvaccinated child was reported in Texas. Image
3) It seems to be RFK Jr who said it in an official Trump WH cabinet meeting today. Not saying he doesn’t lie, but he is now HHS Secretary
Read 6 tweets
Eric Feigl-Ding Profile picture
Feb 21
Woke or biology? There are actually more than the basic “male” XY & “female” XX sexes. Why? Because biology also creates people with single X chromosomes, or extra chromosomes like XXX, XXY, XYY, or XXX+, plus many 🧬genes. 👉All I’m asking is— please be kind to others. Thanks🙏 Image
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2) “The most frequent SCAs include Turner syndrome (45,X), Klinefelter syndrome (47,XXY), Trisomy X syndrome (47,XXX), and Double Y syndrome (47,XYY).”

pmc.ncbi.nlm.nih.gov/articles/PMC10…
3) “The phenotype seen in SCAs is highly variable and may not merely be due to the direct genomic imbalance from altered sex chromosome gene dosage but also due to additive alterations in gene networks and regulatory pathways across the genome as well as individual genetic modifiers.”
Read 5 tweets
Eric Feigl-Ding Profile picture
Feb 16
I'm shocked a lot of doctors don't know about this newer flu antiviral drug called Baloxavir (XOFLUZA)... that shortens your flu illness by 33%, and reduces your viral load by day 2, versus what a placebo takes 5-6 days to achieve. Baloxavir also seems superior to TAMIFLU (oseltamivir) for smashing your viral load on 2 day, achieving what takes Tamiflu 3-4 days. CDC even lists Baloxavir on their website as one of the top 4 drugs that it tracks whether it works against new flu strains (it works)Image
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2) "Baloxavir was associated with significantly more rapid declines in infectious viral load than placebo or oseltamivir (Figure 3A and 3B)."
nejm.org/doi/full/10.10…
3) Adverse events for baloxavir were no different than placebo. in fact theres even hints that it could be lower than Tamiflu.

"Adverse events that were considered to be related to the trial regimen were more common in oseltamivir recipients (8.4%) than in baloxavir recipients (4.4%, P=0.009)"Image
Read 13 tweets
Eric Feigl-Ding Profile picture
Feb 14
⚠️WORST FLU SEASON ever since 2002-2003 when we began to track flu (red, first graph). Worst hit this year are children ages 0-4 and 5-17. ▶️We also have significantly LOWER flu vaccine uptake this year, one of the lowest flu vaccine coverages (red 3rd graph). Indisputable facts. Image
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2) I don't need to tell you that certain US states have vastly lower vaccination rates than others. See map (lighter green, less flu vaccination coverage), and which have higher (darker green)...

If you want to see details and demographics on which state has the LOWEST flu vaccine coverage rates... the data is here.
cdc.gov/fluvaxview/das…Image
3) It’s not just the flu that is going around… Gaines County, TX, where the epicenter of the measles outbreak is, has one of the lowest measles vaccination rates too.
Read 7 tweets

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