Over 350 medical workers have caught #COVID19 in Java, Indonesia 🇮🇩despite being vaccinated with Sinovac’s CoronaVac—dozens of HCW even hospitalized, officials say, as concerns grow on vaccine efficacy versus #DeltaVariant, believed to be driving cases.🧵
reuters.com/world/asia-pac…

2) Most of the workers were asymptomatic and self-isolating at home, said Badai Ismoyo, head of the health office in the district of Kudus in central Java, but dozens were in hospital with high fevers and falling oxygen-saturation levels.

3) Kudus, which has about 5,000 healthcare workers, is battling an outbreak believed to be driven by the more transmissible Delta variant, which has raised its bed occupancy rates above 90%.

📍SLOW ACTION ENDANGERS HEALTH & ECONOMY—Why does an epidemic take hold? #DeltaVariant surging—but what if the CDC had warned or acted earlier? Epidemiologists say we can likely prevent a big outbreak if just a cases, but harder if hundreds or 1000’s of cases… thread 🧵 #COVID19

2) And early fast action buys us precious time for vaccinations if we acted fast. Even if spread was inevitable, we could prevent the worst of it if we bought ourselves more time to fully vaccinate and prepare for the #delt

3) In terms of travel restrictions, we all acted much too late— epidemiologists and experts were warning about India in early April already. Yet govts didn’t act until mostly late April. One major country’s CDC didn’t act until May. 👀

⚠️Confirmed—#DeltaVariant is by far the *most contagious** variant found to date, with a transmissibility that is ~2x faster than older strain. #P1 is 2nd fastest, says @WHO study.🧵

📍#B117 #Alpha—29% faster

📍#B1351 #Beta—25%

📍#P1 #Gamma—38%

📍#B16172 #Delta—97% #COVID19

2) “Effective reproduction number of SARS-CoV-2 variants of concern/interest compared against each other, 64 countries, data until 3 June 2021”
eurosurveillance.org/content/10.280…

https://twitter.com/mvankerkhove/status/1405603481847832576

3) “Of the six variants currently designated as VOI, five were considered in our analysis and among these, only B.1.617.1 (#Kappa) and B.1.525 #Eta demonstrated a statistically significant increase in the effective reproduction number of 48% and 29%, respectively.”

Top question asked right now: what to do about J&J 1-shot #COVID19 vaccine & rise of #DeltaVariant? Not medical advice: lots of immunologists are hypothesizing & predicting mixing vaccines of different types could yield equal/better response. Trials TBD.🧵
bloombergquint.com/coronavirus-ou…

2) “If you can mix and match, it’s going to look better, something that immunologists have known for decades” said Danny Altmann, professor of immunology. “I’d bet my house on working hypothesis that it’s doable and would produce immunity that’s at least as good if not better.”

3) “After years of reading research on mixing vaccine types -- known as heterologous prime-boosting -- Morgon concluded that getting one dose of the AstraZeneca shot, and another from Moderna Inc.’s or Pfizer Inc.’s newer messenger RNA technology would pack the most punch.”

Jeez—an explosive 968% spike in #COVID19 in just one week—where the G7 Summit recently took place (and many security planners arrived 2 weeks ago). Is this related to the #G7Cornwall #G7Summit2021? Hmm, but a ~1000% increase is not something seen everyday.

HT @Dr_D_Robertson.

2) We can debate whether it’s because it started from a low base. But going up that fast is not normal at all. UK is very concerned about the spike there too. google.com/amp/s/www.bbc.…

3) Dr Ruth Goldstein said they were mainly Delta variant cases in under-30s.

Public health consultant, Dr Goldstein, said the rise was thought to be down to people from Cornwall travelling out and back during the school half-term break, as well as people coming in.

“Double wave” is coming—An internal NHS email sent to hospitals warn them to prepare for a 3rd #COVID19 wave with the 96% dominant #DeltaVariant - at the same time as a spike in serious infections among very young children. 🧵
channel4.com/news/hospitals…

2) The email, sent by a London NHS trust to clinical staff, says “national guidance on planning” has been issued telling hospitals to expect 50 per cent of the Covid cases seen in the first wave of the pandemic.

3) At the same time the third wave of severe Covid cases is likely to peak in hospitals, in early August, NHS leaders are also predicting a national wave of Respiratory Syncytial Virus or RSV infections.

Two patients positive for the #DeltaVariant in Calgary🇨🇦 have died. One death was in patient with 2 doses of #COVID19 vaccine and fully immunized. Although patient in 80s for age, it also suggestive of incomplete protection against Delta. Must be cautious.
calgaryherald.com/news/local-new…

2) Delta Variant is more contagious and much more severe.

3) It took the CDC a long time to declare #DeltaVariant a variant of concern, even though @WHO declared it 3 weeks ago.

https://twitter.com/drericding/status/1404847230205505550

Over 500 fully vaccinated tested positive for #COVID19 in Massachusetts in <3 weeks. As of June 5, 3,641 cases among ~3.5 mil fully vaccinated in MA–likely undercount due to lower testing in vaccinated. Yet CDC stopped counting unless hospitalized/dead🧵
nbcboston.com/news/local/mor…

2) According to the U.S. Centers for Disease Control and Prevention, a total of 10,262 breakthrough infections were reported throughout the country as of April 30, at which time 101 million people had been vaccinated.

3) More cases have likely gone unreported, federal officials have said, because they only have data from 46 states and territories. Additionally, most vaccinated people don't show symptoms that are serious enough to get tested.

Outbreak of 232 active #COVID19 cases in Ontario 🇨🇦 First Nation area of Kashechewan—majority are children under 12, those who aren’t yet eligible for vaccine, & kids <18 who are 1-dose vaccinated. A 12-year old is hospitalized too. ➡️Vaccinate kids ASAP.
theglobeandmail.com/canada/article…

2) Do kids get infected? Oh yes they do. Don’t listen to naysayers who say they don’t. And don’t listen to those who say kids don’t get sick. #LongCovidKids is real too.

https://twitter.com/DrEricDing/status/1401863233288474630

3) let this sink in — 1% of all #COVID19 confirmed cases in kids lead to hospitalization.

Is that really an “acceptable” level of kids morbidity that we will allow in society?

https://twitter.com/jneill/status/1401860709538013186

?

DIFFERENT SYMPTOMS—‘Loss of smell’ is no longer a top 10 symptom of the new #DeltaVariant. A headache, sore throat & runny nose are now the most common. New study says catching Delta #COVID19 can feel different— "more like a bad cold" for younger people.🧵
bbc.com/news/health-57…

2) Since the start of May, we have been looking at the top symptoms in the app users - and they are not the same as they were," he says.
The change appears linked to the rise in the Delta variant, first identified in India and now accounting for 90% of Covid cases in the UK.

3) Fever remains quite common but loss of smell no longer appears in the top 10 symptoms, Prof Spector says.

"This variant seems to be working slightly differently," he says.

📍1 in 4–almost a quarter of people infected develop at least one lingering health problem after 30 days with #COVID19. The most common included pain, breathing trouble, high cholesterol, malaise and/or fatigue and high blood pressure. 🧵 google.com/amp/s/time.com…

2) But the reported post-COVID symptoms were quite varied, running the gamut from depression and anxiety to skin conditions to heart issues and gastrointestinal distress.

3) most Long COVID symptoms are more commonly reported by women than men.

Health analyzed private health care claim records for nearly 2 million people diagnosed with COVID-19 in 2020. The people in the study ranged in age from babies to the elderly;

BREAKING—CDC now officially declares #DeltaVariant a “variant of concern”—because much more transmissible (50% faster than #B117, 2x than original strain), more severe (2.5x hospitalization risk than B117, 4x original) & 1 dose vaccine evasive.🧵 #COVID19
cdc.gov/coronavirus/20…

2) This comes on the heels of the urgent advocacy by many to demand CDC upgrade to VOC. Even WHO and UK 🇬🇧 raised #DeltaVariant to VOC weeks ago. CDC is very late on this.

https://twitter.com/DrEricDing/status/1404469114928828419

3) We have known #DeltaVariant has been rising fast in the Us for quite a while. Over a week ago, we already knew it was exponentially rising across the US. It’s doubling every 2 weeks overall, but doubling every week in certain states.

https://twitter.com/drericding/status/1402062059890786311

⚠️New CDC warning on rising RSV again. Coincided with dropping of mask mandates & usage. ➡️ “The CDC is issuing this health advisory to notify clinicians and caregivers about increased interseasonal respiratory syncytial virus (RSV) activity across parts of the Southern US.” 🧵

2) CDC: “Due to this increased activity, CDC encourages broader testing for RSV among patients presenting with acute respiratory illness who test negative for SARS-CoV-2, the virus that causes COVID-19. RSV can be associated with severe disease in young children and older adults”

3) “RSV is the most common cause of bronchiolitis and pneumonia in children under one year of age in the United States. Infants, young children, and older adults with chronic medical conditions are at risk of severe disease from RSV infection.

So, vaccines good against hospitalizations, yes, but not when just 1 dose against #DeltaVariant, not when <50% fully vaxxed. Despite new controversial case-control efficacy study (very small & assumption laden)—🇬🇧hospital #COVID19 surges just don’t lie.🧵 assets.publishing.service.gov.uk/government/upl…

2) Note how much weaker 1 dose is versus 2 doses for the #DeltaVariant for both infection and hospitalization.

3) What is the first clue the new controversial study is unreliable? The Pfizer 2 dose results aren’t even significant due to wide 95% CIs. Second, the 1 dose is stronger than 2 dose for Pfizer? Hog wash. We know that’s not true and opposite. This is why this study unreliable.

Masks are coming off—the cold and flu is now back. Coincidence? No. The CDC just issued a health advisory about increased cases of respiratory syncytial virus, or RSV, across parts of the southern US — something CDC hadn’t seen since April 2020. #MaskOn
bostonglobe.com/2021/06/14/met…

2) RSV is a cold-like respiratory illness that produces symptoms similar to COVID, and can cause severe illness in older adults and young children. It disappeared for a year because of #COVID19 mitigations. It’s now back because masks are coming off, especially in the South.

3) Since the state’s mask mandate was lifted at the end of May, face coverings have started to come off — and stay off. But according to infectious diseases doctors, the return of facial freedom might come with some downsides, like a resurgence in cases of the common cold and flu

⚠️Annoyed—the US CDC still does **not seem to classify the #DeltaVariant as a “Variant of Concern”**!! #B16172 is still merely “variant of interest” on @CDCgov website, updated just this weekend. Both @WHO & 🇬🇧 upgraded Delta to VOC weeks ago. CDC act now! cdc.gov/coronavirus/20…

2) Because this is what new cases of #DeltaVariant #COVID19 is doing in the UK 🇬🇧… US 🇺🇸 is a trouble if don’t act now

https://twitter.com/DrEricDing/status/1404379339144245253

3) Is #DeltaVariant growing quickly in the Us? Yes. Hell yes. Yet CDC doesn’t rate it a VOC.

https://twitter.com/DrEricDing/status/1402062059890786311

Good news—Novavax protein-subunit vaccine phase 3 trial shown to to be 90.4% effective overall, 100% against moderate to severe disease. This is different type from mRNA and from AZ/J&J adenovirus vaccines, and different from inactivated types. #COVID19
nytimes.com/2021/06/14/hea…

2) Here is a good refresher on how the Novavax vaccine works. nytimes.com/interactive/20…

3) The protein units of the spike are harvested and then assembled together. There is no virus—just proteins linked together.

⚠️90-96% of all #COVID19 in 🇬🇧 caused by #DeltaVariant.🧵

📍32% of all Delta cases visiting the hospital emergency room are at least 1 dose vaccinated

📍33% who are then hospitalized vaccinated

📍45% of all deaths got at least 1 shot—➡️ 29% got 2 shots.
theguardian.com/world/2021/jun…

2) Similar #DeltaVariant worries from a Canadian hospital— ➡️Outbreak even w/ 2 dose of mRNA vaccines—16 patients & 6 healthcare staff #DeltaVariant positive. 6/16 patients & 5/6 HCWs had received 2 doses of #COVID19 vaccine; 7 patients & 1 HCW had 1 dose cbc.ca/amp/1.6063802

3) this is why @WHO_Europe chief is now sounding the alarm on #DeltaVariant.

https://twitter.com/drericding/status/1404236100764381186

📍Outbreak even w/ 2 dose of mRNA vaccines—🇨🇦 hospital—16 patients & 6 healthcare staff #DeltaVariant positive. 6/16 patients & 5/6 HCWs had received 2 doses of #COVID19 vaccine; 7 patients & 1 healthcare worker had 1 dose. 1 patient now in ICU. #dontletup
cbc.ca/news/canada/ca…

2) Outbreaks of the delta variant at the Foothills Medical Centre in Calgary are sparking concern as some with both doses of the vaccine are still getting affected with the variant.
"We're scared, very concerned," said Wayne Stopa, a RN of United Nurses of Alberta Local 115.

3) "A lot of us have had the double vaccines already … and to find out people are still getting affected with the delta variants is quite concerning to all the staff."

Delta variant fears coming true—@WHO_Europe director says #DeltaVariant of #COVID19 is "poised to take hold"—#B16172 evades 1-dose vaccine & “shows increased transmissibility & some immune escape” & more severe. It is exponentially ⬆️ in 🇬🇧 & 🇺🇸 too.🧵
thehill.com/policy/healthc…

2) Hans Henri Kluge expressed concern about the Delta variant, known by the scientific name B.1.617.2, pointing to recent research appearing to show it can spread quickly and infect those who have received one of two vaccine doses at higher rates than the fully vaccinated.

3) "We have been here before."

"Over the course of last summer, cases gradually rose in younger age groups and then moved into older age groups, contributing to a devastating resurgence, lockdowns and loss of life in autumn and winter of 2020. Let's not make that mistake again."

JUST IN—A judge has dismissed a lawsuit against Houston Methodist Hospital by employees who opposed a #COVID19 vaccine mandate as a condition of employment. Judge rejected analogy that it’s akin to "forced medical experimentation during the Holocaust”. 🧵
cnn.com/2021/06/13/us/…

2) The privately run Houston Methodist Hospital that under Texas law, workers are protected from termination only if they refuse to commit a criminal act that carries criminal penalties.

Receiving a Covid-19 vaccine is not an illegal act, and it carries no criminal penalties.

3) The judge agreed with Houston Methodist Hospital. Hughes admonished Bridges' analogy that her threat of termination in this case was like "forced medical experimentation during the Holocaust."