but it seems pretty obvious that repeated covid exposure is stochastically debilitating, and seems plausible that lifetime viral exposure is an appreciable component of aging, so sterilizing indoor air is a pretty easy qalys win
I know it feels impossible to avoid COVID these days, but I just traveled for 4 weeks, took 10 flights, gave 4 in-person presentations, and attended 3 conferences without catching COVID... and you can too. Yes, COVID is highly transmissible, but it's not magic. A brief 🧵. pic.twitter.com/2b1WM2Zlpx
I figure it’s worth posting a summary thread about my current thoughts on COVID to refer back to: Like many great blunders in history, we went into this without an exit plan. The landscape has changed such that risk is now individual cost/benefit more than public health. 1/
Children born during the pandemic have experienced a catastrophic - no other word I think - drop in cognitive development of 22 IQ points. medrxiv.org/content/10.110… pic.twitter.com/IwHhtF10NG
As the Omicron epidemic continues to expand in South Africa and as case counts and sequencing data continues to come in, we can better estimate the current transmission rate of Omicron. 1/19
Good news for your morning. “The new Omicron variant of the Coronavirus results in MILD disease, WITHOUT prominent symptoms.” -Angelique Coetzee, the chairwoman of the South African Medical Association.
There have been a number of overview threads on the emerging variant designated as @PangoNetwork lineage B.1.1.529, @nextstrain clade 21K and @WHO Variant of Concern Omicron. I'm not going to attempt to be comprehensive here, but will highlight a few aspects of the data. 1/16
So, we’ve reached 34 deaths per day from COVID. It’s a shocking number that really gets swamped over by all the other numbers. I’m going to describe the usual dying process in the ICU from this disease. I’m wearing my clinical hat, be warned.
Economies crashed. Hundreds of thousands dead. Lives ruined across the globe. What must the world learn from the great pandemic of 2020? I volunteer this lesson: Discard the myth of panic. A thread.
Scenario Z: Covid is never brought under control, mutates too much every season to be managed like the flu, and goes endemic with higher base fatality rate and is too costly to chase with vaccines. Joins the top-3 ranks of steady modern killers alongside heart disease and cancer.
4 weeks tomorrow since first (Pfizer) vac. No sign of second appointment.
An outbreak involving a variant with 484K in a vulnerable vaccinated population still showed *very* strong (86.5%) protection against symptomatic illness. This is *very* good news, and should build further confidence in vaccination cdc.gov/mmwr/volumes/7…
I have now been sick with #longcovid for almost a year—below, some reflections on my convalescence. (1/10)
mutant strain in SA strongly resistant to past immunity. ~8x reduction in neutralization (which is threshold used for updating flu vaccine). almost a new virus. existing covid vaccines powerful but likely getting less so. need to rapidly scale vax to keep new strain at bay. twitter.com/trvrb/status/1…
A 🧵 on COVID Living Room Spread: Saturday: - Older, out of the house brother wants to visit younger siblings. Mom says "get a test on the way, if you are negative you can come." - Rapid test is (-), family spends a day together inside, laughing, playing, eating. 1/
Late last week, it was announced that a new variant of SARS-CoV-2 (VOC 202012/01) was detected and appeared to be spreading rapidly in the south east of England. We analysed the transmissibility and severity of this new variant. [cmmid.github.io/topics/covid19…] NOT PEER REVIEWED 1/9 pic.twitter.com/Zhh38iDplP
Why a SARS-CoV-2 variant that's 50% more transmissible would in general be a much bigger problem than a variant that's 50% more deadly. A short thread... 1/
The mRNA vaccines (Pfizer and Moderna) are kind of brilliant at a science level. I’ve had a few people in my real non-Twitter life ask me to explain how it works so I’m going to try my best here in this thread while I’m waiting for a patient to show.
Age as the dominant risk for #COVID19 admission 7,995 people in New Haven @hmkyale @VirusesImmunity @YaleMed medrxiv.org/content/10.110… pic.twitter.com/O4qiCBBcng
- Covid flying seems safe
❗️Did you know that *study after study* finds most people don't seem to transmit COVID at all? That a small percent is responsible for almost all infections? That R is not that informative? My new piece on why this may be key to controlling the pandemic. theatlantic.com/health/archive… pic.twitter.com/veHa1BRwMO
- Most covid spread comes from super spread events.
- Response that most reflected that so far - Japan.
- Indian study - 70% of infected people (out of 500k) didn't infect anyone else.
1) SARS-CoV-2 Vaccines - I promised a Tweetorial and here we go. This is going to be long and nerdy. But I'll make sure it is easy to understand. If you want more details, please just read this: nature.com/articles/s4158…
- Loooong thread - 138 tweets ~8000 words.
- TLDR: 40 current vaccine candidates in progress across many different methods (lots experimental) in many different regions. Rollout will be very decentralized.
- Normal vaccine lifecycle: ~15 years
- Cov2 - many steps were done already e.g we already knew a lot about coronaviruses. "Fiddling around was skipped and antigen was plugged into existing tech."
- This acceleration shouldn't be expected to compromise safety.
- 40 vaccines currently in development, 10 in Phase 3 trials. And can be licensed under "Emergency Use Authorization."
- Several ways to make a vaccine
- Classic: Grow virus in cell culture, isolate it, concentrate it, then kill it "chemically or physically". No EU/US companies currently using this approach.
- Live attenuated - more advanced - genetically modifying live virus and infecting people so their body fights a weakened version and develops antibodies. Only 3 of 40 currently use this method & progress "far behind".
- Modern - no live infectious disease involved - antigens are grown in cells. Well tested - used for flu, Hep B & HPV already. Novavax (Author's recommended candidate) using this method in UK.
- Other methods: Replication Incompetent Viral Vectors (trigger strong t cell response but can be problematic for immunocompromised people).
- Completely New Methods:
- DNA ("Current progress seems slow").
- RNA ("Absolute new kid on the block") - impressive technology. Two western frontrunners (Moderna & Pfizer) using this approach - won't work in lower income regions as they need to be stored frozen.
- Authors recommendation for which one to take: Pfizer or Novavax
🚨I wrote about what COVID-19 does to the heart, the controversy around the emerging science, and how it ties into this key lesson that I've talked about before: "As pandemics get wider, they feel weirder." theatlantic.com/health/archive…
- "Anytime a pathogen invades the body, the whole body reacts.” SARS-CoV-2 is no exception"
- "The researchers showed that 78 percent of people who had recovered from COVID-19 (including many who had never been hospitalized) still had some kind of heart abnormality that was detectable on MRI scans two months later"
- "Some long-haulers have been diagnosed with dysautonomia—a group of disorders that disrupt involuntary bodily functions, including heartbeats (which can become inexplicably fast) and blood pressure (which can suddenly crash)"
Over the last 6 months, we've learned a lot about how SARS-CoV-2 spreads🦠 What does the evidence so far tell us about SARS-CoV-2 transmission dynamics, high-risk activities and environments? Thread 🧵 (1/n) papers.ssrn.com/sol3/papers.cf…
We will need to stop discussing COVID-19 as alive or healed and start measuring chronic as well. Somewhere between 10-50% of COVID cases report not being back to normal within 2 months. 18/
- Interesting take on long covid.
Always amazed by how good of an interviewer @tylercowen is. a. Always knows his subjects work deeply. May just know *everything* deeply. b. Asks slightly tangential/non-obvious questions which the subject has to think about/answer but is also not too tricky/out of their zone.