Eric Topol
@EricTopol
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physician-scientist, author, editor. Ground Truths:
La Jolla, CA
Joined November 2009
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Pinned Tweet
Our comprehensive review of
#LongCovid
has just been published
Phenomenal work by
@ahandvanish
@LisaAMcCorkell
@juliamv
@NatureRevMicro
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This will go down in history as one of science and medical research's greatest achievements. Perhaps the most impressive.
I put together a preliminary timeline of some key milestones to show how several years of work were compressed into months.
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You don’t get 3+ million shots a day without tens of thousands of volunteers. A salute to them. A sign of unity for a common, vital purpose
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The way to end the week: best US vaccination day
2.2 million, a new record
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Today, Canada surpassed Israel for fully vaccinated, a very high bar. Congratulations 🇨🇦
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The patient had a whopping (8g) dose of a
#SARSCoV2
neutralizing IgG antibody cocktail. Then they detected antibodies. You must be kidding me, Dr. Conley?
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Ivermectin: the largest randomized, double-blind trial yet conducted, with early treatment, indicates there is no difference compared with placebo. It doesn't work. Period.
just published
@NEJM
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Over 110 million Americans have now had a taste of universal health care.
Free vaccines.
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Almost the whole country is in the "Uncontrolled Spread" category 1/
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Who would ever have thought that the same country that couldn't even get a covid test working and scalable for 2 months could vaccinate more than 4 million people in a day? Quite a turnaround.
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How can a country that has required you to take your shoes off at airport security for a 2001 foiled attempt without a single person hurt ......
be the same one that has no systematic plan to address >73,000 Americans dead, >1.2 million confirmed cases?
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It keeps getting better: 2.1 million vaccines administered in the USA today! 👏
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If we wanted to get serious vs B.1.1.7
—get N95/K95 masks to all and enforce their use
—get rapid home testing big supply to each household for daily use
—amp up digital, mobility, genomic and wastewater surveillance 100X
—vaccinate 24/7 like it's an emergency. Because it is.
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About 5 million children age 5-11 now vaccinated with their first dose (nearly ~1 million with 2nd dose) and I've yet to see a case of myocarditis reported 👍
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One per thousand Americans have now died from covid-19.
How does that compare with 12 other select countries with >20 million population?
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Airborne it is. 🦠
The 10 streams of overwhelming evidence
@TheLancet
by
@trishgreenhalgh
@kprather88
@Rschooley
@zeynep
@jljcolorado
@dfisman
a 5-★ succinct summary
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What happens when one of the best vaccinated (90% total population) countries in the world gets Omicron?
🇵🇹
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It is despicable that the Covid vaccine manufacturers are going to charge more than $110/dose for the new XBB.1.5 boosters when available in mid-September.
The US government previously paid ~$25/dose, supplied free of charge, and subsidized these companies with untold $ billions.
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That over 3 million children age 5-11 in the US have been vaccinated without a reported case of myocarditis so far is encouraging
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It's pretty impressive that vaccines directed to the ancestral strain spike from 2 years ago, w/ the virus that's evolved thru >290 million confirmed cases, and now to the hyper-mutated Omicron, have preserved efficacy of near 90% vs severe disease with a 3rd shot
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I get a lot of questions about "my team" who helps with my twitter posts. Let me make it clear. The "team" is me. >12 years, >40K posts, most since the pandemic began. Every one comes from me alone. N of 1.
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You know it's a good day in the pandemic when:
—The 1st anti-Covid pill is cleared
—More indications that Omicron is associated with less severe illness and tends to come down from its big surge as quickly as it ascends
—The 1st pan-coronavirus vaccine is ready for Phase 2 trials
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Anyone who thinks BA.5 is just another variant isn't paying attention
>200,000 new cases yesterday. Vertical.
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At the airport, with no interest for a visit with BA.2 or serving as an asymptomatic vector. Tight fit KN 94 underneath
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The pandemic only lasted 103 in New Zealand and it has now gone 100 days since without a single new case.
This paragraph is the key.
Science-based
Empathic leadership
United
Public Confidence
Adherence to burdensome-control measures
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We now have solid evidence that there are vaccines that protect against all variants of concern:
✓ B.1.351 (S Africa)
✓ P.1 (Brazil)
✓ B.1.1.7 (UK)
✓ B.1.526 (NY)
✓ B.1.429 (CA)
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This is our
@CDCgov
X No warning on BA.5
X Still says 2 vaccine doses ="fully vaccinated"
X Says 5 days is all that's needed for isolation when 5 days is the median length of infectiousness
X 1 in 4 age 50+ w/ 2nd booster (<-survival benefit)
X Transmission is the accurate map👇
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Epstein-Barr virus is the leading cause of multiple sclerosis
Summary of one of the most important advances in life science this year
@ScienceMagazine
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When South Korea, a model country for the pandemic, has >400,000 new cases in a day, leading the world per capita, you take notice. Tests 4X the US with <1/6th the population. BA.2 is 26% as of this week's report.
Very high 2-shot vaxx 87%, 3-shot 63%. The pandemic isn't over.
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Vaccines don't just work. They work across all the variants, providing protection from illness, hospitalizations, and deaths.
Summary including today's multiple updates.
(and we're damn lucky)
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How to reduce your chance of dying from Covid by 99%?
Get vaccinated and a booster.
One of the most impressive graphs I've seen for the impact of vaccination in the US pandemic
(thanks
@redouad
@OurWorldinData
for re-plotting my makeshift graph from earlier today)
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The mRNA vaccine story was by no means fast. Both it and lipid nanoparticles for its delivery took several decades
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The 🦠 continues to evolve, gets more fit, but has yet to outsmart the vaccines that humans made to block it. If only more humans could outsmart the virus by getting vaccinated. And block its capacity to evolve further.
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There's been a lot of new data for Omicron in the last day, much still preliminary, but here's my summary of the good and bad
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This is big, folks. The
@WhiteHouse
is supporting next generation—nasal and variant-proof Covid vaccines —and therapies with a $5 billion program by
@ddiamond
Thanks to the relentless efforts of
@AshishKJha46
and
@WHCOVIDResponse
👍
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Don't tell me "cases are irrelevant"
That means you don't understand:
—Cases beget cases. People getting sick. Surges.
—Cases beget
#LongCovid
—Cases beget hospitalizations & deaths
—Cases drive🦠evolution and the pandemic
—That you have no idea what your are posting about
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The Delta waves in the US and Canada, a striking contrast. Fully vaccinated of total population:
Canada 64%
US 50%
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An inhaled Covid vaccine booster was more than 5-fold effective for inducing neutralizing antibodies at 28-days, and more durable at 1-year, than shots, vs Omicron BA.5 in a randomized trial
@TheLancetInfDis
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Just published
@TheLancet
The largest study of hydroxychloroquine shows a significant increase in death (~35%) and >2-fold increase of serious heart arrhythmias. ~96,000 patients, ~15,000 on HCQ or CQ from 671 hospitals, 6 continents.
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My oped on the JN.1 variant and the 2nd biggest US wave of infections (after Omicron) since the pandemic began
@latimes
@latimesopinion
#LongCovid
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Besides South Africa and Botswana, 12 countries have now reported confirmed cases of Omicron. And many more will do so in the next few days.
Had it not been for the sequencing and transparency efforts of South African scientists, how many countries would have found Omicron?
Zero
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What will go down as the biggest breakdown in the US response to
#COVID19
is the lack of test kits. South Korea and the US had their 1st patients on Jan 20 and Jan 21, respectively. Look at the difference in daily testing. By March 4th, SK was ~18,000 per day.
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How Rudy Giuliani didn't get covid until now is the more interesting question.
They're likely getting a
#SARSCoV2
monoclonal antibody ready for infusion. This treatment an affinity for politicians and friends, including Trump, Christie, and Carson. Otherwise very hard to come by.
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Wish this was true. What's over is
@POTUS
's and our government's will to get ahead of it, with magical thinking on the new bivalent boosters. Ignores
#LongCovid
, inevitability of new variants, and our current incapability for blocking infections and transmission
“The pandemic is over. We still have a problem with COVID. We’re still doing a lot of work on it. But the pandemic is over,” President Biden tells 60 Minutes in an interview in Detroit.
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Today's "breakthrough" announcement is unlikely to be any breakthrough.
1. Convalescent plasma has no randomized trials. It contains many antibodies that have no neutralizing effect. If it has efficacy, it will be be relatively modest, at best.
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Hello 🇺🇸
You just got over a wave of the most transmissible
#SARSCoV2
variant the world has seen, with the highest level of hospitalizations in the pandemic.
Now you are facing a variant w/ 30% more transmissibility, w/o mitigation measures, low vaxx coverage, and gutting funding
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As of today, 3 countries have reached ≥ 60% of their total population with their 1st vaccination dose.
And Canada became the world's leader
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We are fortunate that vaccines induce such a strong immune response and provide protection from all of the virus variants that have evolved to date
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From incalculable to 5X incalculable. Unfathomable.
Mostly preventable.
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Just published
@NEJM
A striking 90% reduction in death for booster shots (vs not receiving the 3rd shot) among over 840,000 people, age 50 or older
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Just published
@ScienceMagazine
A phenomenal, tour de force review of aerosol transmission of respiratory viruses, from the experts.
#COVIDisAirborne
w/
@ScienceVisuals
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"We estimated that a single-payer universal healthcare system would have saved 212,000 lives in 2020 alone. We also calculated that US$105.6 billion of medical expenses associated with COVID-19 hospitalization could have been averted by a Medicare for All system."
@Alison_Galvani
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American exceptionalism
The United States comprises 4% of the world's population
✓ 16% of the world's Covid confirmed deaths
✓ 40% of world's guns
✓ Only industrialized nation in the world with states making abortion illegal
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Zero.
First time.
Congratulations UK.
Saluting the incredible hard work and solidarity that got you here 🇬🇧
#VaccinesWork
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Over 2.9 million vaccines today. The new record!
Blew by 100 million total given. 👏👏
Today's the day we'll cross 100 million vaccine doses administered and >65 million Americans with ≥ 1 dose 👍
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The good news is that South Africa is back to its pre-B.1.351 baseline in covid cases. There's no proof this variant is more infectious. Its immune evasion is enough to explain how it took off. And the descent occurred without vaccines.
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The use of high-quality masks (like N95/KN95 respirators) by patients, compared with surgical masks, substantially reduced Covid infections among nearly 4,000 health care workers
@JAMANetworkOpen
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How to manage a Delta wave?
Iceland. 78% total population fully vaccinated.
A+
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How to lose public confidence?
1. Announce a booster program on Sept 20 for all at 8 months post-vaccine
2. Change it to 6 months, then 5 months, then back to 8
3. Lack of agreement among leadership group
4. Have no US national data
5. Announce the program will be "scaled back"
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Summary of the 5 Phase 3 vaccine trials.
One theme: 100% protection from death and hospitalizations
That is impressive!
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Not exactly. You can be vaccinated and carry the virus (carrier). But if the viral load is so low you can't transmit (not a transmitter) spread is blocked and we move onto the pandemic exit ramp.
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Japan fully contained after its worst surge related to Delta, 💉 quickly rose to now 78% of total population w/ ≥ 1 dose, test positivity went from 25% to 1%, cases >23,000 to <400.
Everything is open, no restrictions except use of masks. The mood is celebratory
It can be done.
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More than 3 years in, with tens of millions of people still suffering, this is the comprehensive list of validated treatments for
#LongCovid
, as established through rigorous, randomized clinical trials
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Today's the day that Canada exceeded the US for fully vaccinated. Congratulations 🇨🇦
And 15% points ahead in 1st dose.
Your belief in the evidence and support of the science is abundantly clear 👋👋
With Canada vaccinating 1.2% of their population each day, and US <0.2%, they will exceed US fully vaccinated in the next 2 days.
1st dose, total population: Canada 70% vs US 55%
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NEW RECORD and a big jump from the one set yesterday
4.58 vaccine doses in the US today!
And a new Y-axis.
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Interrupting covid news for some good news.
A new granddaughter. Who has a big sister and brother.
Our social bubble here in San Diego.
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There needs to be truth-telling about the reduced protection of mRNA vaccines vs symptomatic Delta infections.
It was 95% pre-Delta.
Many are claiming it's still ~80%.
It isn't.
50-60% is best estimate from all sources (not US, since we don't have the data)
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We're about to hit the lowest death rate in the US for the pandemic
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Leave it to Canada to show how to vaccinate their population.
First, despite a late start, they exceeded the % 1st dose ceiling set by Israel.
Now on a tear for 2nd dose, and moving faster than any other major country or EU
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Looking good, Japan👍
Almost ~80% of population fully vaccinated.
This is what containment looks like (vs 100% Delta)
~100 cases/day, 1-2 deaths/d, among 126 million people
It can be done.
@ourWorldinData
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Debunking the myth that vaccination promotes mutations. Being fully vaccinated actually suppresses them
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When Los Angeles, one of the worst hit covid counties of the United States, starts to look like Israel, that's a good sign
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