There may be limits to what antibiotic stewardship can do. by Amesh Adalja

There may be limits to what antibiotic stewardship can do.

Amesh Adalja

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Categorized in : Health

I think it is pretty easy to say if you are fully vaccinated, the breakthrough you get with Omicron is going to be milder, even if this gets around some of our vaccine-induced protection, it is not an all-or-done effect.

It raises the possibility that maybe this is not going to be as bad as some people were fearing, that doesn't mean it's not bad at all.

I think the focus needs to be on vaccines, not on masks for vaccinated individuals, i don’t see that being a major way the trajectory of cases changes. If it’s a rare occurrence maybe contagious in a small number of people- how is that going to make a dent in transmission going on from unvaccinated [people]?

There's definitely issues with stigmatization where the variants are being described and then labeling them based on that country. We know that there's already backlash in India, regarding the Indian variant and people mentioning it that way, so, I understand why it's happening. I think it's just a lot for people to think about this far down the line.

The primary objective is to deny this virus the ability to kill at the rate that it could, and that has been achieved, we have in effect tamed the virus.

We’ve gotten spoiled because we’ve seen the Moderna and Pfizer numbers. I know people are going to be alarmed, but 60% efficacy against the new variant is acceptable.

The current system appears to be faltering at multiple levels so I do think having more distributors involved is prudent, it will be important however to maintain central coordination.

There's starting to be some level of evidence, but I don't think it's ironclad, it's not definitive yet.

That's likely what dogs are reacting to, we know for other purposes, we use dogs that way for bomb-sniffing, for drugs, and they have tried to use them in cancer diagnosis. They've been trying to use them for C. diff diagnosis as well.

There has not been enough vaccination to see a full effect nationally.

I wouldn't let our guard down, biologically speaking, nothing is changing.

The virus has established itself in the human population and it's not going anywhere, we're going to see a lot of transmission until we cross the threshold for herd immunity.

The virus will find it harder to move around between person to person, especially when people are doing activities outdoors in the summer, we didn't really see the seasonality this summer because there were so many people who were not immune to the virus.

My big concern is because we are so intensely privatizing this rollout and relying on pharmacies, we really are giving our wealthier folks more access to this vaccine.

I think the overarching goal of getting all eligible people vaccinated has to take precedence, we can’t let an overly dogmatic adherence to priority groups to cause inefficiencies in vaccine administration.

I think it’s the right move based on epidemiological data and the difficulty people have in adhering to 14 days.

They're only testing for what they know -- this [ coronavirus ] is an unknown unknown, we're just not that great at diagnosing them. We look for the usual suspects. We're always looking for the horses, but never the zebras.

We need to figure out the mechanism and understand it at the molecular level to be able to say for sure how this is occurring -- that this is really the O blood type and not something that kind of tracks with O blood type, we're starting to see enough now that I think it's an important research question to answer.

This is part of the idea of not having just one vaccine candidate going forward, it gives you a little more insurance.

It does appear in this study that there is a significant proportion of individuals that have this cross-reactive T cell immunity from other coronavirus infections that may have some impact on how they fare with the novel coronavirus. I think the big question is trying to jump from the fact that they have these T cells to understanding what the role of those T cells might be.