Discover and read the best of Twitter Threads about #testtraceisolate

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I have set my clock to 10:30 AM to get @jkwan_md's amazingly informative updates on Ontario's #COVID19 situation.

Want to take this opportunity to thank her immensely, but also reflect on 4 #COVID19 curves that really worry me.
The first is the fact that we have no known Epi-link for 50% of our new cases -- @IrfanDhalla points this out repeatedly as a major barrier to properly #TestTraceIsolate Image
The 2nd is the fact that our testing turnaround time is getting longer -- for the first time since early April, we have more pending test results than reported test results (a whopping 48,000 tests pending) -- which means a delay to identifying cases and proper #TestTraceIsolate Image
Read 6 tweets
Today (or maybe yesterday, or maybe a few days before that), our country hit 200,000 #COVID19 deaths.

It's a sobering number. It's the population of a small city. It's 67 times the number who died in 9/11. It's 200,000 families' lives changed.

>A thread on what comes next:🧵
We know it didn't have to be this way. The US has ~4% of the world's population, but ~23% of the world's #COVID19 deaths.

But here we are.…
Reasons for our failures are innumerable:
* lack of early national strategy for detection of the virus
* lack of public trust of the gov't
* lack of smart utilization of strategic stockpiles
* continued underfunding of #publichealth…
Read 24 tweets
#Covid19Ontario Key Indicators 1030am Sep 20
New cases 365 Trend 350📈
Rt 1.48🛑 Speed🛑
Wkly positivity 1% 📈⚠️ (40.1K tests!)
Hospitalized 63 (23 ICU) Deaths 1
More ⤵️
#Covid19 #Onhealth #OntEd #OnPoli… ImageImage
The case incidence rate continues to rise faster than testing, now at 2.3. (1 is low, 3 is high.) Image
Magnified this chart, to look at the LTC situation. West End Villa in Ottawa is the main spark for these numbers by MLTC. Image
Read 5 tweets
Telling the story that those of us on the frontlines already knew: “Policy shouldn’t be based on scarcity.”…

#TestTraceIsolate #maskup #GetUsPPE
"Truly, you just want to get the information that you need to do the right thing." .... and the information didn't come.
"This pandemic has spotlighted shortcomings within our nation’s public health system, including the need for long-term and sustained funding for state and local health departments,” the agency said in its statement."
Read 4 tweets
Thread: I've tweeted before that I find this the most worrying graph in Ontario.

This figure shows that we are contact tracing less successfully in September than we were in June.
This is of course because people have more contacts. But we must invest in #TestTraceIsolate so that we can continually improve the effectiveness of contact tracing even while we increase the number of contacts we have.
Given that #TestTraceIsolate isn't good enough right now, we need blunter instruments in many areas while we improve #TestTraceIsolate.

Some blunter instruments:
-stop indoor dining
-encourage work from home
-lower social gathering limits
-travel advisories
-universities online
Read 3 tweets
Absolutely, it's important for culture to bring people back in.

It's important for ALL our culture.

📊get us reliable data (Epic Systems knows this!!)
I am so sick of people blaming employees, teachers, and children - and blaming #publichealth officials - for continued safety measures.

Want to fix it? Wear a darn mask. (Universal mask-wearing seems to be JUST AS EFFECTIVE as full lockdowns.)…
Our country was built on individualism.

But it was also built on community. *It is up to us* to insist on caring about the group.

WE - each of us - can set our own norms. And drop by drop, we create a sea-change.
Read 3 tweets
Three new important studies came out in the past week about kids & #COVID19. All have limits (the science isn't perfect). But together, they matter, & you deserve to know about them!

A thread on the takeaways for all of us, as parents / teachers / communities? 🧵
1) First, this one from S Korea and @CDCMMWR:…

Like all the studies, this one wasn't perfect, but the takeaway: Older kids most likely transmit #COVID19 to their household at rates similar to adults. And younger kids transmit the virus, too.
What does that mean for the rest of us? It means that:

a] in schools, kids can likely transmit to teachers & vice versa, BUT

b] this study was done in households: so NO MASKS OR DISTANCING. (Very important point!)
Read 18 tweets
4 months of the US pandemic
1st reported death Feb 29th, now >152,000 deaths
1. Phase 1, no testing capacity, rapid spread, ascension to 30,000 cases
2. Phase 2, an 80-day plateau, 20-30,000 cases and ~2,000 deaths per day
3. Phase 3, a 3X surge of cases, new plateau 60-70K/day
4. The more than doubling of deaths from 500-> >1,000/day in the past 3 weeks during Phase 3
Much (case surge and deaths), if not all, could have been avoided by following reopening guidelines (down to ~10/million cases as in EU, #TestTraceIsolate) prior to reopening
5. The real number of Americans infected is not 4.5 million now, but more than 37 million (>11.5%) @youyanggu
—The number of people experiencing #LongCovid is substantial and unknown
—Each person who died has lost an average of 11 years of life
Read 4 tweets
It's almost time!! Follow along with the hashtag #COVIDdynamics as we head into the first day of our three-part series on #SARSCoV2 #COVID19 Dynamics & Evolution, with this 1-day virtual conference covering the *latest* science behind the pandemic!! 🧬🙌🏽👏🏽
We start today with a session on #COVID19 Epidemiology! with @nataliexdean @JustinLessler @StephenKissler & @kathysleung covering topics like vaccine evaluation 💉, #TestTraceIsolate 🧑🏾‍🤝‍🧑🏻, geographic disparities 🌍, and the D614G mutation 🧬...

#COVID19 #SARSCoV2 #COVIDdynamics
First up is @nataliexdean - "#COVID19 Vaccine Evaluation" - reminding us the data does not exist yet! However, what should we be expecting in the data coming in the next few months?
Many trials to assure safety, immune response, & primary outcome (prevention)

Read 69 tweets
If we knew funding was coming to ramp up a coordinated testing strategy, we could push short-term social distancing hard to flatten the curve to the point where #TestTraceIsolate is feasible again.…
But the Senate bill doesn’t provide enough funding for that to work. So, what we’re left with is a much less ambitious goal. We can tighten business closures & gathering limits as needed from place to place & time to time to slow the spread & protect health care capacity
Given the near-total abdication of federal responsibility for implementing a well-funded & coordinated testing strategy, state & local governments need to be clear about what social distancing can and can’t achieve on its own. It can blunt peak impacts.
Read 4 tweets
1/ Are you a #SARSCoV2 #COVID19 researcher interested in viral dynamics & evolution? Join us at the #COVIDdynamics virtual conference on 30 July!

We have 12 incredible talks by top scientists on the latest research - Read more & register here:

Preview: Image
2/ Session 1 will cover the Epidemiology of #COVID19 #SARSCoV2, including vaccines, mobility & geography, #TestTraceIsolate evaluation, & transmissibility of the S: D614G mutation, covered by
@nataliexdean @JustinLessler @StephenKissler & @kathysleung

#COVIDDynamics Image
3/ Session 2 will includes modelling #SARSCoV2 #COVID19 with @C_Althaus @manonragonnet @SheetalSilal & @joshuasweitz speaking about transmission characteristics, government response impact, near- & long-term dynamics, & modelling & decision making.

#COVIDDynamics Image
Read 5 tweets
1/ I don't understand leaders announcing they don't want a second lockdown.

Nobody wants a 2nd lockdown. But saying it is meaningless & making promises to your populace that may cost lives to keep.

Actions speak louder: just do what's necessary to avoid a 2nd lockdown. #COVID19
2/ I feel like we're stuck on a roundabout of leaders announcing how things will or will not be. Haven't they noticed yet that *this isn't how it works*?

Want schools back? Get cases down, make schools safe. Want more re-opening? Up #TestTraceIsolate & source PPE

3/ At the end of the day, it's actions that matter. And you hurt your own people when you set expectations that you may not be able to deliver. Saying "social distancing might end in November" creates hope that may be dashed - after so many have already gone through so much.
Read 6 tweets
Sweden has officially declared that they we can't provide contact tracing according to international norm!

#TestTraceIsolate is officially not existing in Sweden @WHO! Brace yourselves for winter!
This is what tracing involves btw! 👇🏽

Read 3 tweets
We're doing this all wrong. We've been doing it all wrong from day 1. Social distancing and face covering were never meant to be a strategy by themselves. They were always intended to be combined with large-scale testing & tracing.
Social distancing is meant to reduce the overall number of non-household contacts in the general public to levels that allow ramped-up public health infrastructure for #TestTraceIsolate to get outbreaks under control. That's how other countries achieved suppression & containment.
In March, state & local govts did their part. They used the blunt instrument of widespread business closures to buy time. But the federal govt - as the only actor w/ the resources & interstate authority to ramp up testing - failed to use that time.
Read 17 tweets
"Just hang in there a little longer" 🤞🏻😖

We *must* stop treating the #COVID19 #SARSCoV2 pandemic as if this is something to be endured for a few more weeks. 🗓️

We're in this for the long-haul, & the sooner we start behaving that way, the better we'll do.

This *doesn't* mean we need to be in lockdown 🔐 (or anything like it) long-term.

But it *does* mean we need to be prepared for long-term social distancing 🧍🏾↔️🧍🏻, mask-wearing😷, & hand-hygiene 🧼👏🏻, as well as a fluctuating state of 'open'.

Even in countries like S Korea, where full lockdown never happened & where containing spread has been largely successful, multiple 'spikes' 📈 have happened. We see this in other re-opening countries.

Success depends on being able to effectively contain these increases.

Read 19 tweets
On the #Elimination debate,I see a lot of strawman arguments against it.
"We can't suspend travel/trade forever, importation of #covid19aus is inevitable". But this is not failure if we identify cases in quarantine and rapidly #TestTraceIsolate cases identified post-exit.
'Ah but that's not elimination'. This is 1 of the problems- what precisely is the definition? Absolute 0 cases? What if cases are only in quarantine/iso with 0.0% local or community transmission? etc etc. Parsing the semantics used on either side of the debate=1/2 the battle.
I don't have an opinion yet, but it is informative to watch the debate.
Read 3 tweets
1)Mal eine ganz banale Frage:

Wie geht es eigentlich weiter mit Covid19?

Gerade in der aktuellen Debatte um #Lockerungen finde ich es wichtig eine Antwort auf die so häufig gestellte "Bis wann"-Frage zu finden

Daher dieser THREAD 1/x


2)Eins vorab:

Die Antwort ist NICHT: "DAUER-Restriktionen bis zum Impfstoff", wie viele vermuten.

Was wir brauchen sind klare Kriterien und Absprachen, wann wir Restriktionen lockern können UND (ganz wichtig!) wann wir sie wieder einführen müssen (Bidirektionalität)
3)Um diese formulieren zu können, brauchen wir erst mal eine epidemiologische Strategie. Leuchtet ein, oder?

(Einschub: Es ist hoffentlich allen klar, dass SARS-CoV2 nicht von alleine weg geht?)

Was ist also unsere Strategie? Die Kanzlerin sagt dazu:

Read 14 tweets
I completely agree with @kj_seung (a great person to follow by the way). Pessimistic takes on the value of #TestTraceIsolate are easily interpreted as "don't bother." But there are so many reasons why it is a critical feature of our response. A thread. 1/11
First and foremost, conversations tend to focus only on tracking down contacts to break chains of transmission. This is too narrow a view of its value. What else does it achieve? Targeted education & testing, symptom monitoring, helping people isolate, gathering data. 2/11
The core of the strategy is hiring and training teams of community health workers, whose value goes beyond the detective work of tracing. Want people with confirmed infections to stay home? Make sure they have food and medicine. 3/11
Read 11 tweets
COVID-19 is exploding in the US. Our public health response is fragmented, disjointed, confused.

Why? Mixed messages from our own experts. Experts who believe that #TestTraceIsolate is not possible in this country.

Case study: 👇


Humphreys is a public policy expert, yet his argument is that American CULTURE is incompatible with masks, testing, isolation.

In other countries, experts explain why these are necessary.

In our country, experts explain why these are impossible. /2

He argues widespread testing is impossible because Americans will refuse to get tested. Isolation is impossible because Americans will be non-compliant.

Meanwhile Arizonans line up at 4AM desperately trying to get tested. /3

Read 7 tweets
The key US failures around testing back in January-February-March (and continuing like a broken record) were well documented in this piece, which I've gone back to again and again in my writing projects:…
Yesterday's companion piece documents the key global governance failures around understanding and communicating the role of asymptompatic/presymptomatic spread is a similar tour de force:…
The two problems - asymptomatic spread and lack of widespread testing - exacerbate each other in ways that have been devastating for the US response.
Read 13 tweets
.@DanielAndrewsMP just about to start today's #COVID19Vic briefing and the TV just froze. Shot across the bow that we will see an increase in numbers because we are doing a testing blitz. 7 in hospital, 1 in ICU, over 18,000 tests yesterday, saturday record. Thanks all Vic. 1/
Thanks each and everyone of the 40,000 people tested over past 2 days in the testing blitz. Shout out to other states helping us achieve the testing we need to. Thanks everyone. Boost in capacity very important #BetterTogether 2/
Thanks all Victorians who’ve comes forward and been tested. Helps us know where to target and how we keep Victoria safe, how we avoid going back to tighter restrictions. 3/
Read 31 tweets
1/ Q. How does #ContactTracing work again? How is that component of #TestTraceIsolate going so far?

A. Contact tracing is a tried and true #publichealth measure that’s been successfully used to contain other infectious diseases (see graphic). But there are challenges. Image
2/ When adapting this strategy for #COVID19:

First, because people are #contagious even BEFORE developing symptoms, tracing (identifying and notifying contacts) needs to happen quickly. But tracing takes time.
3/ There is also currently no #treatment to offer to individuals who test positive, so there is less personal incentive to cooperate. Instead, contacts are asked to #quarantine, not for their own benefit, but to reduce exposure to others.
Read 10 tweets
1.46 million new UI claims to state programs for week ending 6/20

This matched the prior week. The slow, steady declines over last couple months seem to have stopped. Image
That makes 43.3 million new claims to state programs over the last 14 weeks.

Continuing claims under all programs rose to 30.55m from 29.26m to the week ending 6/6, while state claims fell slightly.

Continuing claims in state programs fell by 0.8m to 19.5m in week ending 6/13.
The mid-March massive tsunami of layoffs eased to a very fast flood.

Most employers trying to hang onto their teams, but U.S. failure to control the virus undermines their business models.

Each week, more employers break. Could easily accelerate again.
Read 7 tweets
One of the worst criticisms of #masks is a false binary presented by experts - that alone, widespread mask use is unlikely to be a powerful intervention. But who is saying we need to decouple this from #TestTraceIsolate? Feels like a strawman. Also: #COVID19Aus
The fact that improper mask use is common is surely not enough to dismiss them as a strategy. Surely education about PPE is on the table.
BTW I'm not saying that implementing masks today in Aus would be effective. That's a separate issue. Although, I'm sure even mask skeptics...
are glad that #BlackLivesMatterAustralia protesters used masks so widely. If we could turn the clock back, would we want to run the experiment without them using masks? Is there truly equipoise here?
Read 3 tweets

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