Monica Gandhi MD, MPH Profile picture
MD, MPH; ID/HIV MD; UCSF (tweets own); No conflicts; Wrote book on COVID & pandemic playbook pub. Mayo Clinic Press called Endemic: A Post-Pandemic Playbook

Dec 11, 2021, 11 tweets

1. WHY HOSPITALIZATIONS ARE NOW A BETTER INDICTOR OF COVID'S IMPACT: This is my 50th op-ed on @COVID this year, round number. Suggest with @LeslieBienen and @citizen_oregon how to shift US strategy on restrictions & policies at this stage in pandemic
nytimes.com/2021/12/11/opi…

2. New strategy likely even more important to institute (with our current tools) with the new #Omicron variant which - since likely more transmissible but more mild by accounts to date- can be in people's noses without disease. Public health sworn to protect us against illness

3. The US (and any other country) accepting that a highly transmissible virus with animal reservoirs will be endemic is not "giving up" & cases will still be tracked by health departments, but by focusing on disease, we can work harder to prevent iy

4. We know immune system will protect us against severe disease via knowledge of B/T immunity (please see cellular immunity thread) so case counts becoming even more complicated now

5. Singapore is doing this and increases trust in public health not to have see-saw pattern of restrictions based on short-term bumps or declines in case numbers now

6. Health departments must and will keep tracking cases as they do for influenza but two counties side by side (Marin & SF) using different parameters for restrictions and decreases trust in public health which badly needs our trust

7. Case counts will still be tracked but restrictions based on hospitalizations with vaccination now. Moreover, we need to focus on getting Americans who are older (retired so not part of vax mandate) & disabled vaccinated - 10 to 20 million in US

8. Finally, important shift in strategy as it is good public health to turn our attention to the effect of restrictions & school closures on young people given Surgeon General @vivek_murthy's recent report on mental health crisis in our youth

9. Not in article but this strategy will depend on determining who is in the hospital for COVID or with COVID as we swab everyone's noses for COVID in hospitals for infection control. If we switch, need proper adjudication on reason for hospitalizing

10. Also there is concern about long COVID not in article: Very reassuring podcast from infectious diseases experts (2000 surveyed) on how they are not seeing long COVID with breakthroughs after vax. Please listen.
microbe.tv/twiv/twiv-828/

NYT op-ed discussed here on podcast with @jarod_ormsby - thanks
podcasts.apple.com/us/podcast/cli…

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