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Michael Lin, MD PhD 🧬 Profile picture
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Mar 8 • 5 tweets • 2 min read
Huge issue with Test2Treat is it's unknown if antiviral drugs is any use for vaxxed or previously infected, which is 90% of everyone now.

But Test2Treat is advertised as if for everyone. That encourages bad medicine. Topol should be against, not for, it.

washingtonpost.com/health/2022/03…
As I've said before, antivirals are merited in vaxxed cases of high-risk conditions or advanced age, who have more severe and longer-lasting breakthroughs. But this program is being promoted without those qualifications (they're not mentioned in the article for example)
About Topol's concerns that supply won't meet demand: would certainly be a problem if a bunch of people who didn't need it demanded it and answered questionnaires in a way to get it.

Thus worried by govt pushing this without better education. Could create unneeded run on drugs.
Happen to agree with AMA on this one. "This approach oversimplifies challenging prescribing decisions by omitting knowledge of a patient’s medical history"
And if we're ditching masks because COVID19 is no longer an emergency, I don't think we should be liberally handing out drugs with serious side effects (Paxlovid) and the ability to mutate the virus (molnupiravir) that were approved only under EUA at the height of the pandemic.

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More from @michaelzlin

Michael Lin, MD PhD 🧬 Profile picture
Mar 7
HK saw 1 in 23 people get COVID19 in the last 2 weeks. Death rates are higher than they were at the peak of the pandemic in Italy, when COVID19 decimated the elderly population. How can this be?

Two words: Vaccine hesitancy
It's not the case rate that's the problem but the death rate. New Zealand has a similar case rate over the same period of time, but so far almost undetectable deaths.
The problem is a simple one: In HK, "at the start of this year, just 25% of people age 80 or over had been vaccinated." That's amazingly bad.

In NZ, it's >90%.

The reason was widespread word-of-mouth fears about vaccine side effects among the elderly.

cnn.com/2022/03/05/asi…
Read 5 tweets
Michael Lin, MD PhD 🧬 Profile picture
Mar 4
Not surprised that FDA rejected the inactivated vaccine Covaxin (produced by Bharat, marketed by Ocugen) for 2-18yo. Bharat-Ocugen presented data that their vaccine produced higher antibody levels than adults, and applied for EUA based on that:
ir.ocugen.com/news-releases/…
The data were only collected in late 2021. Impressive Ocugen was able to complete a EUA application so quickly, but they apparently did so without feedback from FDA as to the sufficiency of the data (or ignored such feedback). Data are below
medrxiv.org/content/10.110…
The problem is that among 2-5yo, whom we don't have a vaccine for, we don't know the relationship between antibody titers and VE in terms of protection from infection or symptomatic cases, at least not publicly. The only people measuring those outcomes are Pfizer and Moderna.
Read 10 tweets
Michael Lin, MD PhD 🧬 Profile picture
Mar 3
Not a big fan of test-to-treat. It just codifies what HCWs should do anyway. Plus it gives in to expensive pills and gives up on the more efficacious vaccines.

Disappointing when 35% = 115M are still not fully vaxxed.

usafacts.org/visualizations… Image
Since certain internet trolls like to ask me about COIs when I talk about pills, I'm developing protease inhibitors that function similarly to Paxlovid, the drug Biden mentioned (and we had ours first, so we're not copying Pfizer). But I tend to call things as I see it.
Vaccination prevents hospitalizations by ~90%, the same as Paxlovid, and you can carry that benefit with you 24/7; you don't need to run to get tested with every sniffle.
Read 9 tweets
Michael Lin, MD PhD 🧬 Profile picture
Mar 2
Started tweeting to discuss protein engineering and biosensor development. Interrupted by COVID, an unexpected societal threat that called upon scientists to address. COVID tweets now interrupted by an even more urgent threat, one that we all must learn about and assess.
There's a role for everyone in educating themselves using knowledgeable sources, people with a track record of honesty and accuracy, and rejecting the biased or bought ones. Then we can move forward as a society to support the right policies. Equally true for Ukraine and COVID19.
Unfortunately it looks like both issues are going to be with us for a while, so I'll have to continue tweeting about COVID19. It means no disrespect to Ukraine even though Ukraine is the more immediate and tragic issue.
Read 6 tweets
Michael Lin, MD PhD 🧬 Profile picture
Feb 28
Okay then.

Russia wants to make Ukraine a satellite state, but will end up as China's satellite. China, with 10x the popn in 1/2 the area, will happily be sole buyer for Russia's natural resources.

Hope Russia enjoys being strapped into the aptly named Silk Road Economic Belt
Put another way... Image
Sure Chinese banks don't want sanctions, but CCP could order rescuing of Russian companies easily enough. Why though. It can let Russian companies' operations degrade. Then when they need investment or equipment, China can provide them at steep terms wsj.com/articles/why-c…
Read 5 tweets
Michael Lin, MD PhD 🧬 Profile picture
Feb 28
What do Putin and Frodo from the Lord of the Rings have in common?

An essay by Vladimir Sorokin putting events into Russian historical (and literary) perspective.

theguardian.com/commentisfree/…
Sorokin sees being leader of Russia as a position that, since Ivan the Terrible, has had an indefatigable power to corrupt. He traces it to Ivan installing a tyrannical system to rule the vastness of Russia. Image
Since Ivan, being leader of Russia has had an indefatigable power to corrupt, like the Ring of Power in the Lord of the Rings.

Sorokin mentions that Putin seemed sensible at the beginning, even saying "I have no intention of holding onto this chair". Image
Read 5 tweets

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