BC GOVERNMENT
Saved by @CodyyyGardner

THREAD
There’s much debate around the UK's recommended use of the AZ vaccine with a two-dose schedule and flexible timing of second dose. Some thoughts on the AZ recommendation (not Pfizer) based on available data with refs to some excellent threads.

 UK’s MHRA and JCVI are highly-experienced in vaccine assessments and recommendations, and they've surely weighed the benefits & risks of this recommendation carefully. That said, it would be good to see all the data underpinning their recommendation. 2/
https://t.co/NRcHbYxRIw
In general, vaccines should be taken on a schedule tested in an efficacy trial. But it wasn’t possible to conduct the typical dose and schedule optimization prior to these Ph3 trials, and those trials provided valuable data to inform these recommendations. 3/
The UK recommends a two-dose schedule, with the second dose between 4-12 weeks. This *is not* a single dose schedule. Given the data provided, and in the setting of limited supply, overstretched hospitals, and emergence of a more transmissible variant, this seems justifiable. 4/
The UK has important data on the AZ Vx that wasn’t available for Pfizer & Moderna at FDA's VRBPAC, including:
* single-dose efficacy through 4+ months; and
* single-dose immunogenicity (12+ weeks). 5/
https://t.co/vtbviE9VEx
The data shows the AZ vaccine maintains efficacy in the setting of a delayed second dose, although it’s not clear how fast this wanes over time. Delay of the second dose provides a better booster effect as measured by antibody levels, which is seen with other vaccines. 6/
The second dose is important because it can drive a more robust and higher quality antibody response through a process called affinity maturation. It's well-understood that longer intervals can provide a better boost. 7/ https://t.co/cqKIpomUHg
In my view, the immediate priority is prevention of severe disease that drives deaths and the strain on health systems. Efficacy against severe disease is likely better than overall vaccine efficacy. Data after the first dose is promising although the numbers are small. 8/
There’s nothing magic about the (short) 28d interval between doses, which was presumably chosen to ensure rapid onset of protection in Ph3. Vaccine efficacy won't disappear overnight with a delayed 2nd dose - it will wane over time, if at all. Ph3 data supports that concept. 9/
Yes there are risks of waning immunity, non-compliance with the second dose, confusion among the public, etc. Many are implementation considerations that can be addressed with planning and strong communication. 10/
It will be critically important to collect efficacy data around this “flexible second dose” schedule, esp in older adults & against severe disease, to inform licensure and recommendations in countries around the world that are counting on the introduction of this vaccine. 11/
Yes the AZ/Oxford studies had a number of issues, but we must remember that this highly-complex development program was executed in less than a year. And that Pfizer & Moderna's Ph3 execution & vaccine efficacy created very high expectations for all subsequent programs. 12/
The bottom line is that every country needs to make difficult policy decisions with the data they have, not what they'd like to have. There's no perfect answer here, but now that a decision has been taken, the UK can focus on maximizing the benefit and mitigating any risks. 13/

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Ernie Plumley-POTUS WON\u2b50\ufe0f\u2b50\ufe0f\u2b50\ufe0f
Ernie Plumley-POTUS WO...
@ernie_plumley
1 of 19) A number of tweets were posted by @LLinWood beginning late last night and into the morning. There are a total of 19. This thread has compiled all.

{“Shots fired across the bow”}
{Warning to traitors}
{Light will reveal the evil plans}
{You were warned traitors}
GOVERNMENT
Karl Grubaugh
Karl Grubaugh
@kgrubaugh
A story ...

In 1994, I was teaching U.S. history and American government at Oak Ridge HS in El Dorado Hills, California.

I had three bright students who were my TAs. The 20th anniversary of Richard Nixon's resignation was a few months away. I decided to have ... 1/


my students -- Sherilyn Peek, Aaron Leahy and Nicole Poimiroo -- take on an extra project. They contacted dozens of people who were in some way involved with the Watergate saga. Politicians, lawyers, political appointees, journalists and others. 2/

They spent weeks, before the internet existed, tracking down addresses. Then they sent a short letter that asked the recipients to respond to one question: What should America learn from Watergate?

Before long, responses started to show up in my mailbox at school. 3/

Archibald Cox replied, and I'm especially struck by this sentence: "...we should be reminded of the corrupt influence of great power, especially when the power is in the hands of someone who is willing to resort to any tactics, however wrong, to retain and increase his power."4/


Richard Kleindienst wrote his response by hand ... "Our Constitution worked! The federal judiciary worked. The Congress and a free press worked. That our Constitution works is the magic of America." 5/
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Kavita Krishnan
Kavita Krishnan
@kavita_krishnan
My account in @thewire_in of meeting Muskan and Rashid, victims of a series of violent acts by the Bajrang Dal, and by a range of UP government authorities including the police, shelter home and hospital.

Advised by @SartajAlamIndia Muskan was taken to Bijnor, where she got an ultrasound done at a private clinic. The report shows that there are “retained products of conception” (foetal matter left over after a miscarriage or abortion) in her uterus.

The hospital denies causing Muskan to miscarry – but their denial rings false. They declared no miscarriage had occurred – which is now proven to be a lie. Most shockingly, in actions that befit a Mengele, they did not prescribe any antibiotics to Muskan after the miscarriage.

See how calm, confident Muskan is in the face of Bajrang Dal thugs: asked on camera if her father or “guardian” has given her permission to marry Rashid, she replies, “I am an adult, I am 22, I have married him of my own choice five months ago.”

Muskan told me: “I am an adult, know my own mind, was living on my own when I met Rashid. I knew he was Muslim. We loved each other. I converted to Islam of my own accord, & we married. My mother does not know him, she has just parroted whatever the Bajrang Dal men asked her to.”
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Claire McInerny
Claire McInerny
@ClaireMcInerny
I'm watching the City of Austin press conference:

Judge Andy Brown says today's ice storm made roads incredibly dangerous, so please stay home if possible.

.@austinenergy : we are starting to get more power and are prioritizing turning on the power for people who have been without power the longest. if we can sustain this level, we can do true rotating blackouts

.@austinenergy : we have crews out in the community trying to fix things, but they are having people screaming at them and throwing things at them. Jacquie Sargent asks that people let them do their jobs and not harass them.

.@AustinWater : we ask that you DO NOT drip your faucets, stop using laundry machines, dishwashers, and if you know how to take care of a burst pipe please do.

City Manager Spencer Cronk: We know this is frustrating and I'm sorry this is happening. We have shelters open.

(Here is a list of the various shelters, some are for warming, some are for staying the
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Larry Middleton
Larry Middleton
@l78lancer
The U.S. national security and intelligence apparatus has said for years that climate change is the single greatest threat to the nation and world. While systems intrusion and hacking by foreign actors could potentially have replicated some of what happened in Texas, it didn't.

Climate change and failure to plan did that, along with incompetence, ineptitude, and sheer greed.

Not only was what happened in Texas the failure of governance and malfeasance, it was a complete failure of imagination, vision, and insight.

While some folks want to call it a "black swan event," the fact is what happened in Texas was not. Not only was it anticipated, it was predicted. The people in charge were told what the problems were, how to fix them and why. They were told what to expect if they didn't.

Not only was it a cyclical occurrence (the third time in just over 30 years), both the periodicity and severity are increasing and intensifying. Therefore, the choices for inaction paved the way for the occurrence. It was inevitable.

In this regard, conservative ideology, philosophy and fiscal beliefs are their own worse enemy. That's because conservatism's most natural response is at best to do nothing, at worst to resist. Therefore, the disaster was a multi-layered, time induced, mountain of self-sabotage.
GOVERNMENT

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