Dr. Tom Frieden Profile picture
President & CEO @ResolveTSL | Sr Fellow @CFR_org | Former Director @CDCgov & Cmish @nycHealthy | Focused on saving lives | COVID-19 pandemic response & recovery
Stan Downs (Version 8.2.1) *Per La Resistenza* Profile picture Oy Vey Profile picture Annette Profile picture Norris Battin Profile picture KJ Sawyer Profile picture 47 added to My Authors
31 Jul
Perspective: Here's the most revealing set of graphs I've seen in a long time. The UK's latest surge started about 33 days before the surge here in the US. 1/thread of 5
If the US case trend follows that of the UK, we'll have more than 200,000 cases a day by early September, possibly many more. See how the lines on the right are almost perfectly parallel. 2/5 Image
What was somewhat reassuring is the relatively modest increase in the UK hospitalization rate. This suggests that because of the UK's very high rate of vaccination of seniors, the proportion of infections that are life-threatening is much lower. 3/5 Image
Read 5 tweets
30 Jul
I’ve heard concern over the past few days about the impact of Delta, and questions about new guidance from the CDC. The bottom line is the virus has adapted and we must adapt too. Delta is different, but our vaccines are still doing their job. 1/thread
Earlier this week, CDC issued new guidance that everyone—vaccinated and unvaccinated​​—should wear masks indoors in areas with high rates of Covid. And last night, information was published referencing new evidence and new challenges posed by Delta. wapo.st/3lfovuy 2/
Delta is at least 2x as transmissible as the original virus, and appears to be among the more infectious viruses, estimated to spread about as readily as chickenpox. But Delta can be controlled, just as we’ve controlled chickenpox​​—through vaccination & other measures. 3/
Read 22 tweets
28 Jul
Thanks Dr. Rasmussen! Important points on the virology, but I believe the epidemiology is important also. We seem to agree there's a non-zero risk of strains emerging that aren't well protected against by current vaccines. We may disagree about how far from non-zero that risk is.
Yes, flu mutates faster—but we haven't seen two-fold changes in flu transmissibility in one season with one strain. With so much transmission, many new variants of SARS-CoV-2 are likely to continue to emerge.
There’s debate about whether vaccine-induced immunity can result in vaccine escape. As you correctly note, it’s not analogous to antibiotics, where use clearly drives resistance.
Read 8 tweets
26 Jul
What's scarier than Delta? These are three things I worry about.
1) The emergence of future variants that can escape vaccine-induced immunity. Delta may not be the worst variant the virus deals us. Continued uncontrolled spread around the world makes this scenario more likely.
2) Resistance to effective disease control measures such as masking & vaccination that results in many preventable deaths. We underestimate Covid at our peril. Listening to/addressing concerns of every community, and implementing proven ways to save lives must be our way forward.
Read 4 tweets
23 Jul
Schools will open in weeks in the US with the Delta variant spreading rapidly. What does this mean for kids—especially those under 12 who aren’t eligible for vaccination? How can we keep them safe? These are important questions that require practical, thoughtful answers. 1/thread
The Delta variant is much more transmissible than the original virus and makes up at least 83% of sequenced cases in the US. Although most adults are now fully vaccinated, that’s not the case for adolescents, and kids under 12 can’t be vaccinated yet. 2/
Good news: Most kids who get Covid will have mild or no symptoms, and there’s no evidence that Covid caused by the Delta variant causes more severe illness among kids. 3/
Read 18 tweets
21 Jul
I’m hearing from vaccinated people who are frightened about breakthrough cases, the Delta variant, and new waves of Covid. But it’s not vaccinated people who should be most concerned. Here’s what I expect to happen over the coming weeks. 1/thread
Globally, we’re far from the end of the pandemic. Delta is at least two times more contagious than the original virus, which means it will infect and kill more people. 2/
Many countries have so far avoided big surges but haven’t had access to the vaccines needed to vaccinate their populations. Many of these countries will likely see explosive spread of Covid over the coming weeks and months. 3/
Read 20 tweets
9 Jul
How big of a threat does the Delta variant pose? New developments show that the challenges we face in controlling Covid are immense. Millions of lives are at stake globally. 1/
It’s now clear that Delta spreads more readily than initial strains of Covid. It’s at least two times as infectious. bit.ly/3hLFTU0 2/
Delta may or may not be more deadly on a case-by-case basis, but because there are so many more cases, more people will get very sick, and more will die. 3/
Read 15 tweets
8 Jul
Vaccination gives you higher antibody levels and much stronger protection against Covid than natural infection, according to the best data we have today. If you recovered from Covid but still haven't been vaccinated, you may be vulnerable to reinfection—especially by Delta.
We're still learning about the duration and robustness of different types of immunity, but research suggests that people who've already had Covid are safer when they're vaccinated. Some examples:
In one study, antibody titers in people who received mRNA vaccines were up to 10 times higher than in people who recovered from natural infection. biorxiv.org/content/10.110…
Read 7 tweets
2 Jul
Vaccines Stop Cases…If They’re Given

The Delta variant poses a huge threat—but not to vaccinated people. Unvaccinated people are still being hospitalized and killed by Covid, and we’re seeing worrying Delta-fueled outbreaks, particularly in places with low vaccination rates. 1/
Don’t get caught up in fears that Delta is evading vaccine immunity. Our vaccines are working. Evidence has shown that mRNA vaccines provide excellent protection, J&J announced that their vaccine is likely also effective against Delta. bit.ly/3he9SoU 2/
Good news: Getting vaccinated virtually eliminates your risk of being hospitalized or dying from Covid. bit.ly/3jztwwT 3/
Read 11 tweets
21 May
Taming the World’s Leading Killer

An article was published this week that has findings which could save millions of lives. Why did you miss it? Because there was zero media coverage of it. Zero! Tells you something. Tells you a lot, actually. So, here are the details. 1/thread
High blood pressure is the world’s leading killer – and will kill more people, including more young people, than COVID-19 this year. It can be prevented (mostly by lowering sodium) & treated, but, globally, only 1 in 10 people with high blood pressure have it controlled. 2/
Elegant studies by @SarahLewington2 prove for every 20-point increase in blood pressure, the death rate from cardiovascular disease DOUBLES. What’s more, this starts at a blood pressure of 115/75 – way below the usual level at which we treat, or toward which we aim treatment. 3/
Read 14 tweets
18 May
Estimated excess mortality during the pandemic far outstripped officially reported Covid deaths in most countries. However, many countries, and in particular low- and middle- income countries, don’t estimate excess deaths econ.st/33VduV6 1/
Statistical modelling by @TheEconomist suggests the Covid death toll is between 7.1m and 12.7m. That means the official death toll represents, at best, about half the true toll and, at worst, a quarter of it. 2/
Most uncounted Covid deaths occurred in LMICs. In OECD countries, the true death toll was estimated to be 1.2 times the official number; in parts of Africa, it was estimated to be 14 times the official number. 3/
Read 4 tweets
14 May
A Tale of Two Pandemics

The pandemic won’t be over until most of the world is vaccinated, but access is a HUGE challenge.

Globally, we must scale up manufacturing and vaccinate the 50M health workers & 1B people over 60. In the US, we must proactively reach the unreached. 1/
Vaccine inequity is a serious problem, both ethically and epidemiologically. It increases the risk that dangerous variants will emerge. Wealthy countries have excess vaccines while lower and middle-income countries go without. 2/ Image
The reality is that global vaccine supply will lag the need for at least a year. Open IP is a step, but we need much more—transfer of vaccine technology and hubs for production. We can also be more strategic in use of the vaccine that is available. 3/
Read 23 tweets
13 May
The Last Pandemic?

The Covid pandemic has killed 3+ million people and driven 115M people into extreme poverty. It will cost the world $22 trillion by 2025. And it didn't have to happen.

A new report could be pivotal in efforts to prevent the next pandemic. 1/
The Independent Panel for Pandemic Preparedness and Response (@TheIndPanel) was created last year by @WHO to ensure the world is better able to address health threats such as Covid. They released a sweeping new report. nyti.ms/2RS1TTV 2/
Because the recommendations detailed in the report are so important, I’m going to highlight some of them in the hope that the story of Covid isn’t repeated. Read the report here: bit.ly/3w6nEyr 3/
Read 24 tweets
30 Apr
Globally, the end of the pandemic isn't near.

More than a million lives depend on improving our response quickly.

Don’t be blinded by the light at the end of the tunnel. There isn't enough vaccine and the virus is gathering strength & speed. Global cooperation is crucial. 1/
India’s surge is a reminder that the virus is learning about and adapting to us faster than we're learning and adapting to it. Covid, fueled by variants, is an ongoing & increasing risk. The pandemic is more severe than ever—more transmissible, more deadly, more human fatigue. 2/ Image
Dazzling scientific progress resulted in Covid vaccines that are more effective than many experts dared to hope. But although Israel, the UK, and, soon, the US will have a new reality with the virus largely tamed by vaccines, global vaccination lags badly. 3/ Image
Read 21 tweets
16 Apr
Benefits, Risks, and Future of Vaccines and the Pandemic

Our vaccine safety monitoring system works. Reports of blood clots led to quick investigation, quick action, and transparency about what is known, not known and next steps. Vaccines remain our way out of the pandemic. 1/14
Global collaboration has been critical throughout the pandemic. Public health and medical experts around the world are collaborating to determine whether the events associated with AstraZenenca vaccine are the same as these events which may be associated with the J&J shot. 2/14
Tech transfer is crucial. The pandemic is the world’s most important problem. mRNA technology is our best solution. Create high-quality manufacturing platforms and hubs around the world to improve vaccine access. mRNA technology is an insurance policy against the pandemic. 3/14
Read 14 tweets
9 Apr
The US vaccination campaign is facing a fundamental challenge: getting the vaccine where it’s needed most. Millions of Americans are still unprotected, many of them at high risk of severe illness. Our 4th surge is beginning. Lives are at stake. 1 of thread/
1 in 3 people in the US have gotten at least one dose of vaccine—but that means 2 in 3 haven’t. Millions of people age 50-64 and 65+ who haven’t yet been vaccinated can still get Covid and are at much higher risk of severe illness or death, especially with the new variants. 2/
Some states are doing much better than others reaching older people: NH, VT, ME, RI, CT, MA, SD have given >1 dose to more than 85% of residents 65+ years old. In TN, WV, MS, Alabama, HI, and PR that proportion is less than 70%. 3/
Read 18 tweets
2 Apr
Covid Epi Weekly: The Centrality of Equity

Lots of good news on vaccines, but the virus and variants are gaining ground. Variants are spreading rapidly in the US, driving (along with premature opening) the fourth surge that’s now underway. 1/
I had planned to stop Friday night threads, but couldn’t help sharing thoughts on this week’s developments—there have been so many.

Fourth surge is building. Cases up 8%, test positivity up to 5.1%. Michigan situation worse, other states could follow. bit.ly/3duo8GL 2/
News on vaccines just keeps getting better. CDC study of mRNA vaccines found that Pfizer and Moderna vaccines blocked 90% of infections. Vaccinated people won’t spread much disease. HUGE implications for guidance for fully vaccinated people and the trajectory of the pandemic. 3/
Read 22 tweets
27 Mar
Covid Epi Weekly: An Epidemic of Vaccine Inequity

As predicted, a US 4th surge appears to be beginning, fueled by variants and reopening. Cases up 7%. Positivity inching up, to 4.7%. Because of vaccination, deaths won't increase substantially. We must solve vaccine inequity. 1/
Michigan hospitalizations are increasing rapidly esp. among 40-49 y.o. Middle and high school 30% increase in cases associated with outbreaks in tandem with increased community transmission. Fewer people staying home, similar to prepandemic levels. Harbinger of spring surges? 2/
Important new data on the mental health harms of the pandemic in the US. Large increases in depression and anxiety, especially among young people and those with less education. Treatment hasn’t kept up. At least 12 million more Americans are struggling.3/ bit.ly/3fflh7a
Read 23 tweets
26 Mar
It's very unlikely that SARS-CoV-2 was created in a lab. The genetic information strongly suggests that the virus evolved naturally.
Is unintentional lab release a possibility? Yes, as the review commission has noted.
The last human case of smallpox was the result of a lab error in the UK. It is believed—though not proven—that a flu strain accidentally released in the former Soviet Union in the 1970s spread around the world.
Read 6 tweets
24 Mar
Vaccination is the way out of this pandemic. Five facts about Covid vaccines:
The risks of infection are vastly higher than the risks of vaccination. Even healthy young people can become severely ill, die, or suffer long-term harm from Covid infection.
Covid vaccines prime your immune system to fight the virus, then disappear. They don't stay in your body.
Read 6 tweets
20 Mar
Covid Epi Weekly. Progress and Peril.

Vaccinations have already saved 40,000+ lives in the US and the pace keeps increasing. But explosive spread of variants in Brazil and lower interest in vaccination are ominous portents.

A 4th surge is likely, but a less deadly one. 1/thread
First, the epi. Cases have stopped decreasing in many places and are increasing in some. Vaccinations are preventing deaths. Cases (~50,000/d) and test positivity plateauing nationally, with a concerning trend of PCR test positivity increasing slightly to 4.3% last week. 2/
The faster decline in deaths is striking and undoubtedly from vaccination. Look how steep the red line is below. Because vaccination rates in people over 65, especially those in nursing homes, are so high, the lethality of the virus is, as a result of vaccination, decreasing. 3/
Read 20 tweets