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nataliexdean's profile
Natalie E. Dean, PhD
Natalie E. Dean, PhD
Natalie E. Dean, PhD
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@nataliexdean

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Natalie E. Dean, PhDVerified account

@nataliexdean

Assistant Prof of Biostatistics at @EmoryRollins, @EmoryBIOS, @EmoryEPI. Emerging infectious diseases & vaccine study design. Previously @UF @HarvardBiostats.

Emory University
nataliexdean.com
Joined June 2018

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    Natalie E. Dean, PhD‏Verified account @nataliexdean 9 Dec 2021

    A sketch to explain how a new variant may appear milder even with no change in underlying virulence. This can occur because, when calculating the fraction of cases that are severe, the denominator now includes many re-infections that had previously been averted. A thread. 1/8pic.twitter.com/XxrYHnb6XY

    8:57 AM - 9 Dec 2021
    • 4,073 Retweets
    • 11,150 Likes
    • Real Joe Albany🖖☕ Charbel Harika Lukas Burk KHB rakibul islam Nora Abdulkarim نورة الدعيجي Jennifer Hoffman Jorge Restrepo Dr David Armstrong
    288 replies 4,073 retweets 11,150 likes
      1. New conversation
      2. Natalie E. Dean, PhD‏Verified account @nataliexdean 9 Dec 2021

        Imagine a variant with little capacity for re-infection. The susceptible population is exposed to enough virus to infect. The infections include severe, moderate, mild disease, and asymptomatic infections. (Here I point out that these sketches are not to scale.) 2/8pic.twitter.com/8rCcVMNLCJ

        7 replies 102 retweets 770 likes
        Show this thread
      3. Natalie E. Dean, PhD‏Verified account @nataliexdean 9 Dec 2021

        But imagine our population also has a large fraction who have been previously infected. Because the variant has little capacity to re-infect, these potential infections were averted. 3/8pic.twitter.com/YkX88PBs39

        4 replies 92 retweets 697 likes
        Show this thread
      4. Natalie E. Dean, PhD‏Verified account @nataliexdean 9 Dec 2021

        When we restrict our attention to the observed cases, some fraction of these are severe. This calculation necessarily excludes any infections that were averted. 4/8pic.twitter.com/R2kVzkpDRp

        2 replies 86 retweets 671 likes
        Show this thread
      5. Natalie E. Dean, PhD‏Verified account @nataliexdean 9 Dec 2021

        Now imagine a variant with high capacity for re-infection. Amongst the susceptible population, the severity of the cases has not changed. Still the same fraction severe, moderate, mild, asymptomatic. But now we see re-infections, and these are generally not severe. 5/8pic.twitter.com/651717ArnM

        3 replies 95 retweets 696 likes
        Show this thread
      6. Natalie E. Dean, PhD‏Verified account @nataliexdean 9 Dec 2021

        So we can still calculate the fraction of cases that are severe, but this is now lower. It is not lower because there are fewer severe cases, but because there are more mild cases (re-infections). 6/8pic.twitter.com/SEZrJ2adGj

        13 replies 237 retweets 1,157 likes
        Show this thread
      7. Natalie E. Dean, PhD‏Verified account @nataliexdean 9 Dec 2021

        Thus, the severity profile of Omicron cases must be interpreted along with an understanding of its capacity to re-infect (and infect the vaccinated). I haven't talked about vaccines, but the relationships are similar. We expect a rise in milder cases in the vaccinated. 7/8

        10 replies 183 retweets 1,245 likes
        Show this thread
      8. Natalie E. Dean, PhD‏Verified account @nataliexdean 9 Dec 2021

        Natalie E. Dean, PhD Retweeted Ridhwaan Suliman

        So when I look at data out of South Africa or elsewhere, I am thinking not just about the proportion of cases that are severe, but also the sheer number of severe cases, which demonstrates the public health impact of the variant. 8/ENDhttps://twitter.com/rid1tweets/status/1468686815158808587?s=20 …

        Natalie E. Dean, PhD added,

        Ridhwaan Suliman @rid1tweets
        Finally, a look at hospitalisations in Gauteng? New admissions doubling ~ every 5 days, and up to 31% of previous peak levels Note: hospitalisations lag cases by 1-3 weeks, and with reporting delays need to wait a week to understand actual hospital admissions for previous week pic.twitter.com/YiokSuTKfZ
        31 replies 212 retweets 1,155 likes
        Show this thread
      9. Natalie E. Dean, PhD‏Verified account @nataliexdean 9 Dec 2021

        Addendum... excuse my color choices. I didn't have highlighters and I made do.

        69 replies 27 retweets 864 likes
        Show this thread
      10. End of conversation
      1. Nicholas (Sedgewick) Thompson‏ @niksthompson 9 Dec 2021
        Replying to @nataliexdean

        Thanks yeah Denmark etc will give us perhaps data to refine all of this in coming weeks definitely get a booster and plan for small events etc as 2022 approaches for sure 🤯

        0 replies 0 retweets 2 likes
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      1. New conversation
      2. Wolfgang‏ @wolfgang_xl 9 Dec 2021
        Replying to @nataliexdean

        But this just highlights we should have chilled out after everyone got vaccinated, omicron or not.

        7 replies 1 retweet 16 likes
      3. LarryB‏ @602Larry 9 Dec 2021
        Replying to @wolfgang_xl @nataliexdean

        Except everyone isn't vaccinated, hospitals could be overwhelmed again, largely with unvaccinated people, affecting care for everybody. Further stress on healthcare workers, more variants...

        7 replies 0 retweets 20 likes
      4. Show replies

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