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Dr. Lucky Tran :verified:

UPDATE: In the US, COVID wastewater levels are now low.

If you've been holding off getting healthcare or doing other indoor activities, now is one of the best times of the year to do these things more safely.

Based on patterns from previous years, in the US, spring and early summer are usually the times when there is lower COVID-19 transmission compared to other times of year.

Although COVID wastewater levels are relatively lower now, there is still a "substantial" baseline level of COVID (thanks to more transmissible variants), so it still makes sense to take precautions like masking when possible (e.g. in healthcare settings).

@luckytran Not to mention, if we all masked when levels are low we could actually knock Covid down (to something seasonal).

@jeffsamsonow @luckytran it always has been seasonal. We get an initial wave in Jul-Sep and then a larger wave Dec-Jan. It's a key part of how it became endemic.

This will probably have to be repeated indefinitely

Only wearing masks when cases are high is how they become high in the first place, and if people see drops in wastewater levels as an opportunity to stop masking, they are creating the conditions for the next wave -- one in which they might be patient zero for a new variant

@currentbias 💧️ doing the same thing over and over again expecting a different outcome

@currentbias I really don't see people reacting to data any more. Those who mask are committed to masking forever, and those who don't are not putting them back on with the rise and fall of cases. At this point masks are a lifestyle choice not a reaction.

@currentbias

1)Looks to me like they're using BA.2.86/JN.1 as a firebreak. The lack of Complement Control Proteins has a ratchet-like effect that prevents a sublineage from backsliding to a less aggressive (lower affinity) means of challenge. It's a time thing. JN.1 looks like it's pretty maxed out. EG.5 and XBB.1.5 are maintaining chains. I have no clue as to cross neutralization between those 3, but if those holdouts can't figure out a way to get into JN.1 converts, this could be it.

@currentbias
2)Complement control proteins buy the viruses that use them more time. CCPs keep them from making the fatal mistake of selecting towards the most aggressive Spike the sublineage can mathematically produce by allowing more mild members of the swarm the chance to contribute genes too. A fire that gets too hot can burn itself out. JN.1 appears to have made a fatal mistake with L455S.

I see some are calling L455S 'Leu455Ser'. Too aggressive is definitely a thing.

@currentbias
@noyes Would you mind expanding on "this could be it"?

@noyes @TheSeege

What are the implications if EG.5 and XBB.1.5 can't get into (establish reservoirs in?) JN.1 seroconverts?

@luckytran I know there's not enough data to draw any conclusions, but does the way the lull pushes later each year seem coincidental to you, or does it suggest any hypotheses?

@luckytran Thanks for his. One (of many) things I don’t understand is how this risk level compares to current risk levels from other contagious viruses, like the flu or RSV. Is it relatively still much higher or is it comparable? Or is this an apples vs. oranges kind of question? I have no idea. I’m not asking for an answer, just thinking about it as I weigh this information.

If only we could get people to stop flying all over the place in airplanes in November and December. It's not the cold that causes a spike in disease in the USA every January. Still wouldn't stop that July spike in '22. Dunno what was up with that.

@luckytran The seasonal pattern sort of makes sense - fall peaks at the start of school and lagged peaks around the holidays - but why a minimum in July 2023 and a double peak in July 2022? I'd love to get my hands on the raw data.

@luckytran I appreciate how he severely truncated the Y axis to make it look so much more significant. There's a reason this turd only uses Twitter, he's a grifter whose only goal is to get attention.
He says there's "substantial" Covid about, yet the percentage of the population that is hospitalized with Covid is: 0.000026%.

@Beeks @luckytran Who are you talking about? Who is only on Twitter???

@Beeks @luckytran
Meanwhile, 5.5% of US adults currently have some activity limitations due to long covid, including 1.7% of US adults with significant activity limitations

People can be quite thoroughly sick, for weeks or months or years, without being hospitalised

@sabik @luckytran of course, but that doesn't change anything. There are few exact metrics left to us, but all of them point towards minimal Covid at this time.

@Beeks I agree with this perspective. I live in San Francisco and follow the number of patients hospitalized with COVID at SF General Hospital. At peak it was >60, but for the past 2 weeks it has only been 1 or 2. And that is pts hospitalized with COVID, not necessarily because of it. I'll still wear my mask in a healthcare environment, but COVID is not a major worry at the moment.

@Beeks you do realize that being hospitalized with covid is not a metric for how much covid there actually is in a community, right? Or that hospitalization is not the only serious outcome? Or that numbers can still be clinically significant with a truncated Y axis, because of how uniquely fucked up Omicron's peak was?

@currentbias alas hospitalization is one of the few metrics we have left that is being actively tracked. It's also indicative of severity of the current variant, efficacy of current vaccines, etc...

@Beeks @luckytran

To make WHAT look more significant, how? What are you even talking about?

@violetmadder @luckytran the numbers. He's fear mongering for attention. The next wave will come at the end of Summer and it will be small.