It has been instructive to look back at our tweets re' the pandemic from early in 2020. So here are the questions we have today as we start in 2021. Feel free to add to the list. Let us see how these age a year from now:
1/n👇

1. Getting the world vaccinated -
How can we get the vaccine to everyone? First, we must make enough, then overcome the hesitancy, solve the problems of logistics of distribution and administration. We are struggling in all these areas.
2/n 👇
2. The dosing regimen-
Is it better to give 1 dose of 2-dose regimen to more people vs. give both doses to few?
Data from both Pfizer and Moderna vaccines that if you look at the cases after 12 days of 1st shot to the second shot, the efficacy may be in 80-90% range
3/n 👇
3. Vaccine prioritization:
Should we first give the vx to younger HCWs to keep hospitals open or to all the elderly who are likely to be sicker and the reasons hospitals will be overwhelmed?
Israel is doing a fantastic job getting all the elderly vaccinated first.
4/n 👇
4. Variant strains:
RNA virus tend to mutate. Vx are targeting the Spike protein of the Sars-Cov-2. Will there be enough mutation at critical points to make the virus resistant to the Vx?
This will require regular sequencing/monitoring. Besides the UK, who will do this?
5/n 👇
5. Duration/typeof immunity:
How long will immunity from Vx and natural infection last? Immunity is >just antibodies. Complex to study. (see #2 above - what if we give only 1 dose?).
Also, will Vx prevent transmission?
6/n 👇
6. Development of Public Health/Pandemic preparedness
Will we put in place permanent public health and pandemic preparedness plans with long-term funding that cannot be taken away by the whim of a political party?
7/n 👇
7. Science
Separate Science from politics - figure out an ideal system that provides balanced transparent independent scientific input to make public health decisions.
8/n 👇
8. Misinformation
Work with various stakeholders to help control and tap down on misinformation particularly via social media. This is unlikely to be solved in 2021.
9/n 👇
9. Health & economy
Reflect on 2020 and be honest in recognizing that health and economy are inextricably linked. You cannot have one without the other. Study the models adopted by various countries, find best practices & socialize these to be ready for next pandemic.
10/n 👇
10. Disparities
Outcomes driven by socio-economic disparities, structural racism in systems controlled by the rich and privileged laid bare how uncaring and self-centered humans can be. Will any country change its approach to ensure each citizen has equal right to be healthy?

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