Many places in India had very large initial epidemics, and it has been proposed that some cities (i.e. Mumbai) might have been at or near herd immunity towards the end of last year
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The new massive waves even in areas with many infections before raise several possibilities, none of them great 1. reinfections 2. variants 3. large over-ascertainment of past infection
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Reinfections without variants are quite unlikely to be driving this, based on past evidence. So either we dramatically over-estimated how many people had been infected in the past (possible, not that likely) or there are numerous reinfections due to variants
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Unless there's another explanation? I really don't see how else you could get a second massive wave in a place that reportedly had 40-60% of the population infected in pretty well-done serology studies last year
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If explanation 3 is true, then it means that even in really hard-hit areas we are probably far away from any herd immunity threshold long-term If explanation 2 is true, then herd immunity through natural infection may be entirely impossible
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In terms of explanation 3, I think it is entirely possible but I have talked to the researchers who conducted seroprevalence studies in India and they are some of the better ones I've seen in the developing world
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There are still many sources of bias, and it's entirely possible that they over-estimate seroprevalence, but I'm not sure it is the most likely explanation any more
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Folks in India have been saying “things are back to normal” for months. I was concerned about the inevitable outcome of that mentality (largely driven by politicians saying we’re back to normal), and the resulting behavioral changes. All the best to the lovely people of India.
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I wish people could embrace an adjusted normal that emphasizes wearing masks, increasing distance as we interact and keeps things outside. God bless and protect the people of India
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