🧵On this anniversary of the pandemic's start, I revisited horrors of early 2020. My hope is fading bc I don't see *any* big changes to protect us.

My latest piece on the CDC suggests the next pandemic will be worse. @KFFHealthNews / @NBCNews

nbcnews.com/health/health-… Flashbacks to 2020. Remember nurses in garbage bags? Hospital & nursing home leadership told staff to forego N95s, pointing to CDC advice that they weren't warranted. >3,600 health workers died of Covid in 2020.

🧵My latest: Inequality becomes entrenched with each new booster rollout. Gone are the days of intensive vaccine campaigns.

“Urging people to get boosters has really only worked for Democrats, college graduates, and people making over $90,000 a year,” says @gregggonsalves

https://twitter.com/KFFHealthNews/status/1702698790451626363

<55% of nursing home residents in several states got the last booster, no reason to expect rates to be different this time around.

<11% of incarcerated people in Minnesota go the last booster.

And gaping disparities between Black & white people are back. kffhealthnews.org/news/article/n…

🚨I've talked with dozens of experts & officials who worked on the pandemic response.

Here are 7 transformations that must happen if the US doesn't -- once again -- get utterly destroyed by a virus.

Not simple. This is real talk. 🧵
Mine @washingtonpost
washingtonpost.com/opinions/2023/… 1. Testing centers should remain everywhere, for HIV, for flu, etc. washingtonpost.com/opinions/2023/…

80% of women in US jails are mothers & nearly 60% of women in prisons. Many are the primary caretaker.

1.3 million people in the US have been separated from their mothers before age 18 due to their mothers’ imprisonment

So let's write about incarcerated moms but this is not it. Ref to the NYT Holmes piece and prisonpolicy.org/blog/2022/05/0…

My 2c on the latest in Covid origins @PostOpinions

Genetic sequences from the Wuhan market can reveal so much, curbing baseless debates & accusations.

Ideally, China shares the data soon. But if not, I think the scientists on this week's report should. washingtonpost.com/opinions/2023/… This week's analysis from @acritschristoph et al was exciting. It showed the potential of genetic data in this investigation. zenodo.org/record/7754299…

But their work needs to be verified by other scientists analyzing the raw data. And there's much more to be seen. eg 👇

⭐️Essential, new study analyzes the natural experiment of Covid in the US: State by state comparison.

🧵of important findings on inequality, mandates & more.

From @TomBollyky @CFR_org et al @TheLancet thelancet.com/journals/lance… High rates of Covid infection & death linked to states with:
-higher poverty
-more income inequality
-fewer yrs of education
-more people who are Black & Hispanic
-less healthcare
-more people who voted for Trump in 2020
thelancet.com/journals/lance…

We, the public, fund science so that it can improve our lives, not turn a few people into billionaires.

🧵 on how government can protect our public investment into R&D.

https://twitter.com/amymaxmen/status/1638518685936615424

Case in point is Moderna's awesome Covid vaccine. It shows the power of govt investment.

Taxpayers put $337mil into mRNA vaccines pre-pandemic & another $337 billion to Moderna to develop it further.

But...

(ref @DrHussainL)
bmj.com/content/380/bm…

Hats off to NZ's @jacindaardern. Depressing to see her go like this.

NZ had a very brief lockdown <50 days & yet the lowest Covid deaths in the western world due to science-led Covid policies. By Dec 2020, its economy bounced back.
🧵 on how:
nature.com/articles/s4159… (2/5)
-NZ used their <1.5 months of lockdown to WISELY to massively scale-up testing & tracing while US flew blind w/out tests.

-NZ sequenced viruses to learn pathways of spread and target interventions, as opposed to harmful blanket measures.

nature.com/articles/s4159…

Biden's incorrect remark that "the pandemic is over" may give Moderna & Pfizer justification to raise prices - according to analysis @Airfinity

Price hike likely in US as sales drop. As high as $100/Moderna dose. Pfizer&Moderna by far leading in 💰
assets.ctfassets.net/poihmvxzgivq/i… Biden's statement also signals a move to private market, as fed likely to curb vax coverage in 2023.

Newer vaccines aren't expected to gain significant ground as demand drops & buyers already committed to existing vaccines, according @Airfinity.

ie Pfizer, Moderna, AstraZeneca

*New* paper lists the Covid questions the US couldn't answer because of shoddy data collection. By @sdbaral et al

I hope @CDCgov has a plan for how to collect such data, or at least goes public with why not.

🧵 We didn't have data to reliably answer:
journals.plos.org/plosone/articl… Some unanswered or poorly answered questions:
-Case fatality rates for Covid after prior infections
-Duration of immunity post infection
-Fatality rates over course of pandemic, following changing treatment.
-Incubation period for diff variants
(2/4)...

Personal news: I’m leaving my dream team @Nature for a fellowship at the Council on Foreign Relations @CFR_org.

Thanks to my *amazing* editors, I’ve had the privilege to cover a range of stories over the past 5.5 years.

🧵of memories Pre-pando, I admit to being a giddy to cover stories such as this one on duck dicks.

If this is the only story you read in this thread, know that you are not alone.
nature.com/articles/natur…

🚨My latest: An in-depth feature tackling global vaccine inequality🧵

1/ This is bigger than Covid. It’s about unsafe policies & practices ensuring that profit & power stays in the Global North.

It’s about what needs to change.

#longreads #CovidVaccine nature.com/immersive/d415… 2/ COVID demonstrated the folly of relying on goodwill & the West.

Nearly 80% of people in rich countries have been vaccinated & fewer than 20% in poor countries. This is cruel AND dumb. Economies are connected. Variants spread. nature.com/immersive/d415…

Woo! Glad to see 40 yrs of evidence making its way into Senate hearing on abortion. 🧵

@SecYellen says research has shown that Roe had a favorable impact on the well-being of women & children & that denying access can deepen poverty. reuters.com/legal/litigati… In October, I wrote about this body of evidence on abortion access, presented by >800 economists & researchers studying reproductive health & @PublicHealth.

They filed several briefs to the Court in advance of this case from Mississippi👇🏽 #RoeVWade nature.com/articles/d4158…

I read Paul Farmer's excellent work while writing his obit @Nature. Here's a 🧵 of some of lines I highlighted from his papers & books.

Feel free to add.

1. “What happens to poor people is never divorced from the actions of the powerful.”

nature.com/articles/d4158… 2. "Relying on the moral compass of companies that answer to shareholders to voluntarily license their technologies will have limited effect on vaccine equity. Their market is driven by profit margins, not public health."

🧵Why is Africa CDC asking for a pause in vaccine donations? It's not because of a lack of demand or because supplies are adequate.

1. Distribution requires $$$$ and humans. US vaccines didn't magically appear in pharmacies, stadiums & churches across the US. 2. Distribution requires massive logistics & planning. So, dumping millions of doses in random batches of donations, rather than a reliable supply, overwhelms the system. endpts.com/africa-cdc-to-…

Vaccinated people w/breakthroughs probably transmit far less disease.
🧵Studies cited in a paper by @mlipsitch @florian_krammer et al.
-Lower viral loads in vax vs unvax
-Less household transmission from vax to unvax
-Contact tracing finds vax less likely to infect contacts
... -Even when viral levels ARE similar in vax & unvax (per Ct), some studies suggest most virus shed by vax is non-viable & so less infectious.
-Boosters lower Delta virus levels in vaxxed breakthrough infectious.
-No strong word on Omicron YET
...
ref nature.com/articles/s4157…

The Supreme Court is poised to ignore data presented by 1000+ scientists on the negative affects of abortion bans.

Chief Justice Roberts: "Well, putting the data aside" I covered these studies by researchers, filed to the Court, on the importance of abortion access to people's lives, education, careers & economic stability.

Legal decisions aren't typically based on philosophical questions about when life begins...nature.com/articles/d4158…

Today the Supreme Court hears a case to overturn 50 yrs of Roe v Wade, which could result in 22 states banning abortion.

Mississippi argues women don't need abortion & it may harm them. These claims are not supported by data.

My piece:
nature.com/articles/d4158… If the Supreme Court reverses 50yrs of Roe, economist @Caitlin_K_Myers estimates that 100,000 women in 22 states will be unable to get the abortions they seek each year because they cannot afford the time & cost of travel to the nearest clinic.
nature.com/articles/d4158…

Powerful words @DrTedros today. Selected 🧵 👇🏽

"The highly-mutated Omicron variant underlines just how perilous and precarious our situation is.

South Africa & Botswana should be thanked for detecting, sequencing and reporting this variant, not penalized." "Omicron demonstrates just why the world needs a new accord on pandemics: our current system disincentivizes countries from alerting others to threats that will inevitably land on their shores," says @DrTedros

Abortion may soon be banned in many states, after Supreme Court cases in Nov & Dec that could overturn or curtail Roe v Wade.

100s of researchers have weighed in with evidence, urging the court to uphold Roe.

My latest on this pivotal moment 🧵:
nature.com/articles/d4158… If the Supreme Court reverses Roe -- a 50-yr old precedent -- 22 states may ban abortion & an estimated 100,000 women will be unable to get the abortions they seek each year because the travel distance is too far.

Analysis by economist @Caitlin_K_Myers:
nature.com/articles/d4158…

Researchers identify 3 new family members of SARS-CoV-2 found in bats in Laos & name them BANAL.

The coronavirus in horseshoe bats in China, RaTG13, remains SARS2' closest known relative. assets.researchsquare.com/files/rs-87196… Neither BANAL nor RaTG13 have the furin cleavage site that helps SARS2 enter cells, but these sites have been gained & lost many times in coronaviruses so this doesn't mean much. nature.com/articles/d4158…