Last month South Africa halted rollout of the AstraZeneca #COVID19Vaccine because it provided "minimal protection" against the B.1.351 variant first identified there.

We now know more details about what drove this decision, and it's concerning. (1/6)

statnews.com/2021/02/07/sou… Study data published in @NEJM today found the A-Z vaccine "had no efficacy against the B.1.351 variant in preventing mild-to-moderate Covid-19." There were no severe cases in vaccine or placebo group, so we don't know if it prevents severe COVID. (2/6)
nejm.org/doi/full/10.10…

One week ago today President Biden took the oath of office. For those of you keeping track, here are the concrete steps @POTUS has taken in his first 7 days to implement a national strategy to beat #COVID19: ✅ ↑ weekly vaccine distribution to states/tribes/territories by 16% (an extra 1.4 m doses per week)

✅ ↑ USG’s total vaccine order by 50% to 600 million doses – enough to fully vaccinate all adults by the end of the summer or early fall. 2/

Pence said many things last night that bothered me, but one line in particular stuck in my head this morning. He said, President Trump and I have the same plan as Joe Biden - we’re talking about testing, creating new PPE, and developing a vaccine.

But, here’s the truth. 1/ Public health is about doing the right things at the right time. You don’t get credit for a testing strategy if millions couldn’t get tested when they needed it. You don’t get credit for creating PPE in Oct if health workers were dying because they lacked N95s in April. 2/

As an infectious diseases physician & someone who has practiced public health for the last 25 years, I'm appalled by @VP Pence's lack of respect for basic protective measures. This disregard for science- and more importantly, the health of those in the room with him- is stunning. With President Trump & many other senior staff ill, the @VP has cast aside CDC guidance by breaking quarantine. Putting aside concerns about continuity of government, ask yourself - would I want to be maskless in a room with someone who had his exposures?

cdc.gov/coronavirus/20…

The President’s medical team started him on the steroid dexamethasone yesterday. Of the COVID therapeutics I’ve discussed this weekend, dex is the only one shown to reduce mortality in patients w/ severe COVID-19. But it can also be risky for patients with mild illness. 1/7 Data published earlier this year showed that dex reduced deaths by one-third in COVID patients who had been sick >7 days and were on mechanical ventilators. Among patients receiving oxygen by less invasive means it reduced deaths by one-fifth. 2/7

nejm.org/doi/full/10.10…

Americans are getting a crash course in novel therapies for #COVID19. This is a hotly debated topic, even among physicians. As we saw with hydroxychloroquine, the decisions Trump/his docs make affect what patients expect in their own care, so it’s worth talking about remdesivir. Remdesivir is an antiviral originally developed to treat hepatitis C and later tried as a treatment for Ebola & Marburg. It didn’t work against those viruses, but it appears to have an effect on coronavirus (a good reminder that research on rare viruses can benefit us all)
2/n

Earlier today President Trump received a polyclonal antibody cocktail made by the company Regeneron. Here’s what we know about this drug, and the additional drugs a patient in his situation might receive in the coming days.

Thread. The cocktail is a combo of 2 lab-generated antibodies. The goal here is to boost an individual’s immune system rather than waiting for the body’s response to kick in on its own. When given early in the course of infection, this can theoretically shorten the length of illness 2/n

COVID-19 will be one of the most important debate topics tonight. As he has since Jan, Trump will try to distort the facts about his response.

We can't allow this.

A brief timeline thread–using Trump’s own words–to remind you how tragically wrong he has been at every step. January: “We have it totally under control. It’s one person coming in from China. It’s going to be just fine.” (2/x)

#Debates2020
washingtonpost.com/health/2020/01…

.@gatesfoundation's Goalkeepers report is the blueprint for an effective global health response that the US & allies should have set in motion months ago. It's a clear-eyed assessment of where we stand & what we need to do. Quick highlight thread (1/x):
gatesfoundation.org/goalkeepers/re… First, where we stand: “We’ve been set back about 25 years in about 25 weeks.” This sobering assessment sums up the tragic fact that because of COVID, we risk losing gains made in reducing poverty, hunger, maternal mortality, HIV infections, & virtually every SDG indicator (2/x)

We now know a bit more about the safety event that led @AstraZeneca’s COVID vaccine trial to be put on hold. The trial has since resumed, but the event (and the way it was handled) has important implications for how we develop a safe, widely trusted coronavirus vaccine.

Thread First, as many have noted, the fact that a clinical hold was placed is a sign that the regulatory process is still working, despite considerable political pressure to rush a vaccine. Clinical holds are not uncommon, even for products that ultimately prove safe & effective. (2/10)

7 of every 10 new COVID-19 cases are now in red states. While the early pandemic mostly affected blue states because of travel and demographic characteristics, Trump’s denial of basic science is to blame for most of these new cases (and the deaths that will surely follow)

Thread

https://twitter.com/washingtonpost/status/1301603944708349956

Views on mask use and other basic public health interventions are now driven by politics. Shockingly, even America’s massive death toll is a partisan issue. More than half of Republicans say the number of fatalities from COVID-19 is “acceptable” (2/6)

today.yougov.com/topics/politic…

Anecdotal reports have been followed by widespread data suggesting that #COVID19 is beginning to have a substantial impact on the hard-fought gains made against the #HIV pandemic. We can’t afford not to act. (1/10) We now know that people living with HIV are struggling to get their lifesaving medicines. As of July, @PEPFAR reported that the median delay in receiving treatment was 35 days for adults and 29 days for children. (2/10)

Just like we’ve seen with other countries, U.S. states are increasingly falling into one of two groups: those that act early and those that fall behind. This is especially true with mask mandates, but has implications for other decisions we face in the coming months.

Thread States that announced mask mandates early have far fewer new infections than states that waited. This is in part because those states bore the brunt of the early epidemic, but it’s also in keeping with ample evidence that masks are effective (2/7)

Failure of the U.S. #COVID19 response has highlighted rampant disparities within the U.S. health system. Drawing from our own global health experiences, @Georgetown_CIGH affiliate @DrEricGoosby & I share 7 lessons to improve U.S. response @Health_Affairs healthaffairs.org/do/10.1377/hbl… 1. We must refocus on public health within the COVID-19 response.
2. Structural inequities can be addressed by linking development with health

The consequences of the coronavirus pandemic for TB, HIV, & malaria are staggering. @apoorva_nyc’s excellent piece lays out the high stakes on the table right now. The question is, how can we stop the COVID domino effect on these other pandemics?

Thread
nytimes.com/2020/08/03/hea… Just some of the devastating projections the article cites: gaps in care for TB patients could result in 6.3 million add’l cases of TB and 1.4 million deaths. Drug shortages may cause 500,000 add'l deaths related to HIV. Malaria deaths could double to 777,000 per year. 2/11

Still not convinced that the US is back where we were with coronavirus in March/April? In fact, there may be even more red flags now. Here’s a graph showing NY & NJ’s trajectory compared with current hotspots, starting from when each state hit 2,000 daily new infections

Thread The date each state hit 2,000 daily new cases is listed next to state name. NY peaked at an average of just under 10k cases per day on April 10. FL is now averaging almost 12k daily cases and still rising. TX has now matched NY’s peak and shows no sign of slowing. 2/8

Great news at the #saaids2019 conference in Durban! The #ECHO trial shows #NoLink between contraceptive method and HIV who.int/reproductivehe…. The #ECHO trial was needed due to concerns from observational studies that progestogen-only injectable contraception (e.g., DMPA) could be linked to HIV acquisition in women. This concern has at long last been put to rest: health-e.org.za/2019/06/13/saa…

Even as HIV/AIDS-related deaths have reached lowest level of this century, new @UNAIDS report unaids.org/sites/default/… notes that we're NOT on track to reach 2020 global goals for reducing #HIV deaths.

https://twitter.com/GU_CGHPI/status/1020003866245582849

We believe reductions in mortality cannot be taken for granted with treatment scale-up. Deaths must be tracked at the subnational, and program-level in order to ensure program performance. This is especially impt as we implement @WHO advanced HIV care guidelines and #diff care