We saw this in Manaus in January. ~76% of the pop had immunity due to natural infection. <1 month after the detection of P1 variant, spread increased explosively, overwhelming hospitals. And on that timescale, we can’t vaccinate our way out of this.https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)00183-5/fulltext …
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Even our faster production technology, mRNA vaccines, take around 6 weeks for the commercial production process to switch to a new antigen sequence. And that ignores the time needed to run immunogenicity trials etc.
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Tl’dr I don’t think it is wrong to think that, absent rapid global vaccination, even places like the US will experience devastating new outbreaks that will cause death and very significant disruption.
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Finally, I think you are misremembering your AIDS history. No one ever made the argument that absent treatment expansion, transmitted drug resistance will threaten rich folks, because that makes no sense.
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ART drug resistance only evolves in ppl exposed to treatment drugs, drug resistance mutations don’t get selected absent this.
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In fact the *opposite* argument was made by pharma, that because Africans can’t tell time and other racist bullshit, they will poorly adhere to their meds, so that increased treatment access would increase drug resistance, threatening rich folks.
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Replying to @jbkrell
I think I wrote enough long-form on this to explain my concern, especially with how the intended target (purely selfish, rational, informed person) could reasonably draw other conclusions. But this may move policy people regardless, so if that works, guess that works.
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Replying to @zeynep
I guess a lot of us are still confused about the argument about why global vaccination is not imperative to stopping variant — ignoring the messaging for a second.
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Replying to @jbkrell
I think that’s why the longform is better. Nobody’s disagreeing as, far as I can tell, that’s stopping proliferation is good, including for any potential future mutation through either mechanism. But the target may decide, for example, herd immunity through infection “works” too+
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Replying to @zeynep
I think it was these two paragraphs in your long form piece that still confuse me.pic.twitter.com/kPuDd9wtHq
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I do think it’s a *possible* world. We see it for other diseases. “Boosters won’t work or be fast enough” for variants is a guess, and I think good reasons to think that’s not the only viable guess.
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