Reporting on this terrible pandemic for Nature @naturenews and former fellow @KSJatMIT. Views are my own. She/her. Email: amy.maxmen at us.nature. com.
Media: Stop freaking people out with scary variant headlines! They're frazzled & we want the public to know when a variant *ACTUALLY* escapes vaccines regularly.
Questions to ask when you see a press release 🧵:
-Why do scientists think it's deadlier, etc?
("Double mutant"👇🏼🙄)
-If scientists think a variant is contagious because cases are up, ask about the correlation. At UC Berkeley, @staciakwyman found that outbreaks on campus were from parties, not B117.
-Behavioral reasons for surges are less newsy than Scary Mutant, but people can change behavior
-If scientists think variants evade an immune response because of studies in petri dishes or in mice, put that in the headline. eg biorxiv.org/content/10.110… This isn't the same as finding that vaccinated people get COVID.
So many stories on reaching vaccine herd immunity! But there's a massive dilemma. Here's a 🧵on what I mean...
About 50 countries have fewer than one nurse per 1000 people. Israel has 6x that rate. UK has 10x. US has 15x. Belgium has 20x. Guess which countries want it all?
Have you seen what 1 nurse/1000 looks like?
Picture people hurt in car accidents who die by the road when wounds could have been stemmed; women dying in childbirth; untreated diabetes; children dying from infected wounds, burns, stomachs. A lack of healthcare is palpable.
What do most countries few nurses have in common?
Many are former colonies, where colonizers subsidized just enough medical care to ensure that people were healthy enough for labor, but they didn't invest in national health systems. Slave traders did less.
There's a persistent myth that pathogens become less deadly over time.
@rkhamsi & @dylanhmorris just reminded me of this since people are apparently acting assured that SARS2 can't become more deadly? Psh.
Short 🧵of history beginning w/hopes of an end to infectious disease
According to Frank Snowden's "Epidemics & Society", 'eradicationists' of the 60s & 70s foretold the end of infectious disease. We had some cures, and they said the bugs become less deadly over time. But like evolutionary psychologists(dis!), they didn't study evolutionary biology
If they had, they'd realize that evolution doesn't have directionality. Anyways, time proved them wrong. eg New strains of dengue evolved, and a second infection with a new strain can be deadly. The HIV epidemic showed that unknown viruses emerge from nature fairly regularly.
Azar just released a delusional, alternative history of Covid testing in the US. I’m mad because our testing failures allowed this outbreak to blow-up. We can’t fix our system if we ignore where it is broken. I suspect @PublicHealth agrees.
“It is indisputable that the United States has built the most extensive testing system and strategy of any major country,” says Azar.
False. Several countries have had percent positivity ~1% whereas US has never been below 5% and is >10% today. Refs KCDC & USA @JohnsHopkins
"The federal government got out of the way of test development in safe and sensible ways,” says Azar.
False. In Feb, CDC & FDA blocked labs from testing as the disease spread exponentially. I broke this story👇🏼& wrote more like it as the year wore on. nature.com/articles/d4158…
First 20 min of this delusional evaluation of the Trump Admin's response to Covid is all about blaming China, with some vitriol for WHO. "If a novel virus like this emerged in a Democratic nation, this epidemic would have never happened," says Azar.
As Covid spread in March, Azar says the government acted swiftly to control spread (they definitely did not). He says the key driver of the pandemic -- ready for it -- was thousands of Chinese workers flying to Italy.
Azar says it's a myth to say that if we had a better testing and surveillance system we could have curbed the virus in February.
(Why is this session even called 'lessons learned'?)
In contrast to the US, many low income countries were scaling up tests, building isolation centers, & enforcing quarantines BEFORE THEY EVEN HAD A HANDFUL OF CASES.
They don't have the luxury of relying on hospitals to care for floods of patients. nature.com/articles/d4158…
In 1995, Congolese Ebola discoverer @MTamfum treated Ebola patients with blood from survivors, despite being told not to by the CDC & WHO. 7 of 8 survived. nature.com/articles/d4158…
The NIH failed to replicate his findings in monkeys, but @MTamfum, "Professor Muyembe", didn't give up. “There should be a truth in here,” Muyembe told me.
He hired one of the survivors in his lab & convinced him to fly to the NIH in 2006, along with his sister & a grad student.
At the NIH, the student & other researchers isolated the survivors' antibodies. These antibodies became the basis for an experimental drug, mAB114, that @MTamfum pushed to test in the 2019 outbreak. It was HARD to conduct this trial. nature.com/articles/d4158…
☹️One of the most upsetting CDC reports yet: Wedding leads to 177 Covid cases & 7 deaths among people who weren’t even there.
Aug 7. Wedding w/55 guests in a Maine town with no corona.
A guest goes to a school meeting. Others go to jobs at a nursing home & jail, with symptoms.
Wedding screened for fever but guests don’t wear masks indoors. Wedding hosts don’t give health dept a list of phone # of guests. So contact tracing isn’t fast enough to stop spread.
After 23 days health dept determines that 30 of 55 guests were positive. By then it’s too late.
Because of the wedding:
-120 staff & residents of a care facility & correctional facility were infected & scared & may have long term health issues.
Lesson 1: Epidemics depend on context. “The outbreak of Ebola is a symptom; the root cause is political instability,” said @Tedros.
Many places are unstable. DRC is very. Since 2017, in Kivu provinces alone, 3860 people have been killed & 5274 abducted. kivusecurity.org
Many governments, including DRC, ignore or fuel conflict & poverty in east DRC. When the president barred eastern cities from voting “due to Ebola” the link between politics& the virus hardened. Next came attacks.
Does politicization of a virus in an election yr sound familiar?
✈️NEW flight report on corona transmission on flights:
13 people appear to have been infected on a 7-hr flight to Ireland this summer, leading to 59 cases as passengers visited friends & family. The plane was at 17% capacity & required masks.
Why do researchers think infection occured in ✈️?
-5 show symptoms w/in 4 days of flight & have no other exposure; 8 could have gotten it during layover but seat map suggests in-flight
-Sequencing finds that the virus is 99% similar despite travelers coming from diff continents.
Impressive contact tracing made this possible. European CDC has a guidance to alert all flight passengers when there is a positive case on board. Perhaps @CDCgov might consider such a thing given that people will be traveling during the holidays, and staying with loved ones.
Psst: It is your civic duty to watch "Totally Under Control." We must hold leaders accountable.
I've interviewed some of the scientists in the film & dozens more this year. Here are my thoughts after viewing @undercontrolmov from @alexgibneyfilm. 🧵
Spot-on portrayal of how the CDC & FDA stood in the way of testing in Feb @undercontrolmov, including @RickABright asking Azar for 10 billion to ramp up testing & drug/vaccine R&D around Jan 20. He’s later told that was an offensive ask.
But...
But the big question remains unanswered: Who at the CDC/FDA/HHS said DON'T push hard on testing?
Tho @RickABright says Kadlec told him there was “no reason for concern” in Jan & @scottjbecker@APHL admits it was hubris to not use the German test vetted & distributed by WHO.
With 5.7 million cases in the US, we should have a good sense of how often people are infected in grocery stores, on planes, at protests, on construction sites.
Data on #Covid transmission is critical as people socialize & schools & businesses open.
eg in #NewZealand, the country's daily dashboard suggests people get tested if they went to locations linked w/current outbreaks. health.govt.nz/our-work/disea… Screenshot from today
The daily dashboard from the @KoreaCDC reveals that 50 people from a 915-person #COVID outbreak at Sarang Jeil Church in Seoul have left for other districts; that 22 venues, listed, have since had transmission that traces back to that outbreak & MUCH MORE
We spoke with researchers who ran simulations like Dark Winter, Atlantic Storm, Crimson Contagion, Clade X, Event 201. They foresaw a lot of problems happening now. But most thought we were better than anywhere else because of technological capacity, medical & science excellence.
As a long-time government researcher told me: "You need gas in the engine and the brakes to work, but if the driver doesn't want to use the car, you're not going anywhere." nature.com/articles/d4158…
I spent months in SierraLeone during the biggest #Ebola outbreak in history & I've just caught up with doctors I met who are now fighting #coronavirus. Lots of interesting comparisons to that outbreak -- and to the USA -- in my latest piece @NatureNews. nature.com/articles/d4158…
Some African researchers I talked w/were surprised that the CDC—so helpful during #Ebola—seems sorta powerless in the US. “I was shocked to see the US struggling to understand what contact tracing is, to organize a response, to put in place risk communication,” said @NyenswahG.
Another twist is that because many cases are mild or asymptomatic due to the young population in Liberia, SierraLeone & Guinea (3% of people >65), a lot of people might be taking this less seriously than public health authorities wish. (Btw this photo is worth 1000 words.)
New CDC report on #COVID19 in the US January-May 30:
-5% of people who tested positive died
-14% hospitalized
-Deaths 12x higher in people w/diabetes or other underlying conditions
-Median age 48
-Incidence HIGHER among 40-60 yr olds than 60-80 but highest >80
(1/2)
Incomplete data on symptoms and race/ethnicity:
-Only 4% were asymptomatic. BUT testing has mainly been for people with symptoms and this data is incomplete
-33% of cases Latinx, 22% Black BUT almost half of reports don’t include race/ethnicity.
Trump just announced he is suspending funding to @WHO while a review is conducted *THIS IS DESPICABLE* Let me lay out how WHO has responded to #COVID19 since Jan 5 & why not funding them now spells disaster to many low and middle-income countries. THREAD.
First, a timeline of their activities, backed up by their #coronavirus situation reports. Jan 5 on the outbreak in Wuhan, China: "The occurrence of 44 cases of pneumonia requiring hospitalization clustered in space and time should be handled prudently."
2nd week of Jan: First sequences of #coronavirus revealed from China w/guidance from WHO & a recommendation on how to diagnose the disease. Late Jan they recommend PCR-based test. Classify this as a risk for the world.
I asked leaders @CDC@WHO & @jeremyfarrar how badly coronavirus is spreading under the radar in cities around the world. Spoiler: It’s bad. Here’s how they get a handle on community transmission when many people aren’t tested & how to lessen disaster. nature.com/articles/d4158…
Epidemiologists have a few tricks for making ballpark estimates – important when true case # is unknown. Because estimate is uncertain, they look at several lines of evidence & see if results align. These models assess death tolls, genome sequences, travel routes & much more.
CDC dangerously dropped the ball w/testing but it employs incredible researchers who work overtime to investigate covert #COVID spread w/@trvb among many others. CDCs Armstrong: "Health departments will tell you this is the most complex public health emergency we have dealt with"
Everyone is yelling right now about #COVID19 but scientists in Seattle @uwmedicine have their heads down at the lab bench because, as @helenchumd told me, “We are past the point of containment.” Thank goodness they're finally able to charge ahead. My latest:
Behind the scenes notes: 🍕 & 🍩 are fueling the effort at a high tech virology lab able to screen 1K samples/day. These scientists just got a green light to test Saturday.
And they’re working on 3 hours of sleep to catch up. Researchers @SeattleFluStudy are sending these kits to people who feel sick. If positive for #coronavirus, @lea_starita et al sequences genome
