%%tags : %% --- SARS-CoV-2, Waning immunity and viral evolution === > by [Adam Hamdy](https://twitter.com/adamhamdy) ## Highlights - 1. A few of us warned about the consequences of allowing SARS-CoV-2 to spread in January and February 2020. We were called alarmists. We warned coronaviruses escape immunity over time as a result of waning immunity or viral evolution. We've now seen both with SARS-CoV-2. ([View Tweet](https://twitter.com/adamhamdy/status/1467037020690075653)) - 2. We warned about airborne transmission, long-term sequelae and many of the other troubling aspects that have since come to pass. We warned vaccine-only strategies would not work, and at each step of the way were abused for our efforts to communicate the risks. ([View Tweet](https://twitter.com/adamhamdy/status/1467037023240216578)) - 3. But we weren't just sharing alarmist takes. Many of us were trying to implement changes that would have protected against some of the adverse risks that have since become realities. ([View Tweet](https://twitter.com/adamhamdy/status/1467037025618382848)) - 4. If early reports are to be believed we now have a variant that is extremely transmissible and shows evidence of immune escape. Hospitalisation data from Gauteng suggests our one hope that it is mild may not be borne out. ([View Tweet](https://twitter.com/adamhamdy/status/1467037027971461121)) - 5. I stopped tweeting about COVID three months ago, because it was disheartening to see what was going to happen and not be able to do anything to prevent it. And the abuse. Lol. 20 months of abuse from thousands of people who don't know better takes a toll. ([View Tweet](https://twitter.com/adamhamdy/status/1467037030274064385)) - 6. I'm not planning to resume COVID19 tweeting. I just wanted to say media and policy makers need to stop listening to those who've been wrong about almost everything in this pandemic. People who said there would be no second wave, that herd immunity could be achieved, ([View Tweet](https://twitter.com/adamhamdy/status/1467037032585125891)) - 7. that the HIT was 20%, that the infection fatality rate was less than 0.1%, that Delta was the fullest extent of viral evolution, that the pandemic would be over in summer 2021, that infections in children would be harmless and a net benefit to population immunity... ([View Tweet](https://twitter.com/adamhamdy/status/1467037034862632963)) - 8. I could go on and on and on. Listen instead to the people who've been telling us that transmission is bad, that viral evolution poses a grave risk, that we must be mindful of the long-term harms of this disease. ([View Tweet](https://twitter.com/adamhamdy/status/1467037037488271362)) - 9. Listen to the experts who've been telling us for almost two years that we must implement airborne mitigations against this virus. People like @trishgreenhalgh @kprather88 @DFisman @linseymarr @jljcolorado @microlabdoc @Orla_Hegarty ([View Tweet](https://twitter.com/adamhamdy/status/1467037039925207041)) - 10. Listen to the experts who've been warning that you do not protect people from becoming sick by letting them get infected. People like @fitterhappierAJ @dgurdasani1 @ChristosArgyrop @DrZoeHyde @DrKatrin_Rabiei @NjbBari3 ([View Tweet](https://twitter.com/adamhamdy/status/1467037042294939648)) - 11. Listen to the experts who caution about the long-term consequences of infection. People like @Daltmann10 @VirusesImmunity @aaronmring ([View Tweet](https://twitter.com/adamhamdy/status/1467037044538888194)) - 12. Listen to the experts who are concerned about the toll taken on public health. People like @martinmckee @chrischirp @equibotanica @AndrewEwing11 @GabrielScally @TJRyan_77 @Dr2NisreenAlwan ([View Tweet](https://twitter.com/adamhamdy/status/1467037046652866561)) - 13. Listen to the experts who are warning about the continued uncertainty of viral evolution. People like @ArisKatzourakis @SGriffin_Lab @hjelle_brian ([View Tweet](https://twitter.com/adamhamdy/status/1467037048859074564)) - 14. Listen to the experts who have been warning about the impact of the vaccine-only or herd immunity by infection strategies. People like @Kit_Yates_Maths @DavidSteadson @DGBassani @GosiaGasperoPhD @AshTuite ([View Tweet](https://twitter.com/adamhamdy/status/1467037051065278476)) - 15. Listen to the activists and advocates who've been warning about the consequences of COVID19 and Long COVID, and campaigning for better research and treatment. People like @dianaberrent @ahandvanish @doctorasadkhan @LongCovidKids @katemeredithp @jakesuett ([View Tweet](https://twitter.com/adamhamdy/status/1467037053296648192)) - 16. Listen to the experts who've been calling for vaccine equity around the world. People like @GYamey @Tuliodna @SharkawyMD ([View Tweet](https://twitter.com/adamhamdy/status/1467037055523819521)) - 17. The choice we face is pretty stark. We can continue to try to ignore this virus and pretend we can go back to 2019, in which case SARS-CoV-2 will continue to adapt to us and gain advantages. Or we can adapt and implement the changes needed to suppress it. ([View Tweet](https://twitter.com/adamhamdy/status/1467037057633558533)) - 18. The most important of all these changes, in my opinion, will be measures to prevent airborne transmission. This will require a wholesale change in policy from @WHO @CDCgov and national governments, but I think it is essential. ([View Tweet](https://twitter.com/adamhamdy/status/1467037059848171520)) - 19. The multi-faceted advantages the virus is gaining through evolution suggest Omicron will not be the end of our problems. As @DrMikeRyan said in the early days of the pandemic, "be fast, have no regrets." Change is needed. Act quickly. https://t.co/MZ1ouBSej1 ([View Tweet](https://twitter.com/adamhamdy/status/1467037062104711171)) - 20. There is little doubt SARS-CoV-2 will become endemic, but policy makers need to understand the differences in cost and risk between high and low endemicity, and the general public needs to know that high endemicity is not inevitable. It is a political choice. ([View Tweet](https://twitter.com/adamhamdy/status/1467037064738705409))