James Krellenstein Profile picture
nuclear power, hiv+mpx+covid (previously), energy, physicist by training, gay
3 subscribers
Jun 25 30 tweets 5 min read
.@tednordhaus's "It's the Nuclear Regulation, Stupid" reduces an intricate engineering & policy challenge to a simplistic slogan. Catchy rhetoric? Sure. Supported by evidence? Hardly. Let's dissect this claim. 🧵 To be clear: nuclear regulatory reform is necessary. But claiming regulation is the "primary challenge" in the US nuclear industry today? That's not just an oversimplification—it's contradicted by the evidence. 2/n
Oct 2, 2022 18 tweets 7 min read
The #ebola outbreak in Uganda is alarming. Already the 3rd largest outbreak of Sudan virus in history, with 54 suspected/confirmed cases since it was detected <2 weeks ago. The response is a perfect example of what is going right & wrong with global pandemic prep.🧵w/ @Garrett_W_ TL;DR There are 40,000 doses of a Sudan virus vaccine candidate in bulk that has proven safe & effective in a phase 1 trial. But our inability to put those “bulk” doses into vials means it may be months to deploy them to Uganda to study & possible slow the outbreak.2/n
Jul 1, 2022 25 tweets 11 min read
Proud of the activism @PrEP4AllNow and others did to get CDC to send more #monkeypox doses to NYC & US. Due to that work, vaccinations will restart soon. But Biden's vaccine strategy is too small & slow to protect 🏳️‍🌈🏳️‍⚧️ communities. We must demand better. What needs to happen: 🧵 The USG OWNS more than a MILLION doses of monkeypox vaccine *ready to go* stuck in freezers in Denmark. These doses COULD have been brought to the US weeks ago had the Biden admin. ordered @US_FDA to inspect the facility, but they didn't, so now they may not come till AUGUST.
Nov 27, 2021 11 tweets 5 min read
This @mattyglesias tweet is getting a lot of play, but it is fundamentally wrong. Let's start with the basics; Omicron is not the "South African variant"; although it was first *detected* in South Africa, it probably did not *originate* there. Short 🧵 New variants of SARS-CoV-2 are detected by RNA sequencing. But inequity in healthcare systems means in much of the world, few if any, cases of COVID are sequenced. Of the 6 states that border🇿🇦, 5 have been unable to sequence a *single case* in the last 30 days. From @GISAID.
May 4, 2021 9 tweets 3 min read
So this is a common question to ask -- if Moderna has pledged to not enforce their patents, why can't we start production everywhere? Three reasons:🧵 The 1st, Moderna doesn't own every patent that is used in its vaccine and in the machines used to make their vaccine. Put simply, it can't pledge to not enforce patents it doesn't own. Let's take the most obvious example of this. 2/n
Apr 25, 2021 7 tweets 4 min read
I know we are all applauding @JoeBiden for his response to India today, but, to be honest, I think Biden's response is actually really bad. And it shows that nearly 100 days into his administration, they still don't have a plan for ensuring global vaccination. 🧵 First, as @zainrizvi has pointed out, the WH was clear that the materials that would be sent to Serum Institute of India would be for Covishield (the SI version of AZ/Oxford). The only problem? There was NO materials shortage for Covishield that was inhibiting production.
Mar 23, 2021 8 tweets 4 min read
As the world reels this morning from the @AstraZeneca news, remember that this problem + the general difficulty of comparing different COVID-19 vaccines is due to a decision by the @NIH to not run head to head trials because pharma *didn't want them to*. 🧵 The problem is that each COVID-19 vaccine was evaluated in its own clinical trial(s), each with a different statistical design, end point definition, recruitment strategy etc. A better way would have been to compare each vaccine against each other in a "platform clinical trial".
Feb 5, 2021 19 tweets 7 min read
The @Dereklowe piece sort of misses the point. Yes, there is no idle mRNA vaccine production capacity in the pharma industry that could simply be repurposed to make more COVID-19 vaccines. But we could rapidly *build* more capacity, as we did across the world last year. 🧵 Before we get deep into the weeds, lets remember, in January/Feb, the world had basically no commercial scale mRNA vaccine production capacity. By December, private industry (with a lot of public funds) built 3 billion+ doses / year scale capacity
Feb 3, 2021 5 tweets 3 min read
I am a little confused by this @nytimes reporting by @MarcSantoraNYT and @RebeccaDRobbins on the new AZD1222 data. First of all, the claim that this data is the “first” to document evidence that a COVID vaccine can result in a reduction in transmission seems to be wrong. Image In fact, just last week, Israeli researchers documented a 50% reduction in both symptomatic and asymptomatic infections in individuals who took a single dose of the Pfizer mRNA shot in a retrospective cohort study. medrxiv.org/content/10.110…
Jul 2, 2020 4 tweets 2 min read
When I was 22, I watched a friend become HIV+ cuz he couldn't afford Truvada PrEP which cost s$1,300/m but costs <$6 to make. CDC invented & patented PrEP, but they refused to stop Gilead's price gouging for yrs. Today, the the same thing is happening with remdesivir for COVID. Last month, @cmorten2 & I showed that not only did (h/t @zainrizvi ) the US government spend >$70 million on developing & inventing the drug, the government is legally entitled to be co-owners of the patents for remdesivir. prep4all.org/news/remdesivir
May 6, 2020 11 tweets 5 min read
This is an important q from @mynameisjro. The convo around physical distancing reminds me a lot of the pre-PrEP conversations about HIV prevention. THREAD but tl;dr u can shame as much u want, but it doesn't change the fact that our methods of COVID control are not sustainable. I am NOT saying we should stop physical distancing. But the idea that we can ask people to not see friends, lovers, family etc. for a basically unlimited period of time is BS. Let's not repeat the mistakes of the HIV epidemic in our response to this plague. 2/n
Feb 15, 2019 4 tweets 8 min read
@Surgeon_General @POTUS @NIAIDNews @HRSAgov @IHSgov @VP @gregggonsalves @fcraw4d Respectfully, that is bullshit. HIV epidemics in PWIDU are not "unprecedented" and interventions to bring them under control, like needle exchange, have been well understood since the 1980s. You and @VP could of implemented needle exchange sooner, but didn't, so Hoosiers suffered @Surgeon_General @POTUS @NIAIDNews @HRSAgov @IHSgov @VP @gregggonsalves @fcraw4d 2. The idea that you did not know that SC was at risk for an HIV epidemic is also BS. Increases in overdoses had been happening in IN since 2004, local officials recommended needle exchange in 2008, there was a huge HCV outbreak in IN in 2010-11, but still no needle exchange.