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Mina's tweets are all over the place, and mostly speculation. It's also strange that he's arguing that the vaccines are working in one breath, and then basically telling people to retest daily if possible and go into isolation the minute they think they're going to sneeze in another breath.

The cold is a minor annoyance to most people's immune system, as almost everyone has prior exposure to cold-causing viruses, but colds still manage to spread. We don't test obsessively or quarantine for "the cold."

If "Symptoms don't = contagious virus", how in the world is the virus spreading at such a blistering pace? Is Mina suggesting that literally everyone is getting this thing, including in highly vaccinated populations, by magic? Occam's razor, combined with basic knowledge about how respiratory viruses work, tells us that people who have symptoms are very likely contagious. They might also be contagious before noticeable symptoms arise, and as they subside.

As for viral loads, with Delta, research found that vaccinated individuals were capable of having viral loads as high as unvaccinated individuals[1]. Until there's data about the viral loads with Omicron, it seems dubious for Mina to suggest that the reports of rapid tests failing to pick up omicron infections are related to low viral loads.

Instead, Mina's 5th tweet is worth paying attention to:

https://twitter.com/michaelmina_lab/status/14723880511462645...

There is a lot of chatter about how people are getting positive rapid tests when they swab their throats instead of their nasal passages. It's anecdotal at this point, but if we're going to engage in speculation, this seems a much more valid form of inquiry.

The vaccines are very effective at reducing the risk of hospitalization and death, and Omicron seems more mild to begin with. It is very effective at spreading in vaccinated populations, which isn't surprising given that the decreasing size of the SARS-CoV-2 naive population means that the virus is now under pressure to select for immune escape. It's strange to me that a "Epidemiologist, Immunologist, Physician" would tweet as if he didn't know this.

[1] https://www.bmj.com/content/374/bmj.n2074




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