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Céline Gounder, MD, ScM, FIDSA 🇺🇦 Profile picture
@celinegounder
Jan 27, 2020 • 11 tweets • 9 min read • Read on X
Big developments re: #Wuhan #nCoV2019 #coronavirus outbreak in China since Friday. It looks like the virus has been spreading since November, maybe even October, and may not have started at the Wuhan market. thelancet.com/journals/lance…
This means that the virus may have already spread more widely in the region than we'd realized... just under the radar. Now that our radar is up, and we're looking and testing for #coronavirus cases, we may be picking them up.
So the dramatic increase in cases over the last couple days not actually be as sudden as it seems... but something that's been building up over months.
It's hard to find a needle in a haystack when the haystack is big. It's cough/cold/flu season. The symptoms of the #coronavirus are the same. So it's tough to pick up a #NovelCoronavirus outbreak in the middle of that.
Lesson 3 from the #Ebola epidemic for the #Wuhan #nCoV2019 #coronavirus outbreak: Signal-to-noise. It was hard to differentiate #Ebola patients from those with fever from run-of-the-mill malaria, typhoid, and other fever-causing diseases in the region.
When you're looking for a needle (in this case, the #Wuhan #nCoV2019 #coronavirus) in a haystack, anything you can do to reduce the size of the haystack helps! Please get your #influenza #flu #flushot. Wash your hands. Cover your mouth with your elbow when you cough/sneeze. Image
The other big news: the Chinese health minister says the #Wuhan #nCoV2019 #coronavirus might be spread by infected persons without symptoms. This would be a gamechanger. businessinsider.com/coronavirus-ca…
Note that whether #Wuhan #nCoV2019 #coronavirus might be transmitted by asymptomatic persons has yet to be confirmed by @CDCgov scientists. But *if* true, this is scary.
@CDCgov When we don't have drugs/vaccines for a disease, we rely on the basics: identify cases by screening for symptoms & testing for disease and conduct contact-tracing. But case-finding and contact-tracing rely on looking for symptoms.
@CDCgov I really hope the #wuhan #nCoV19 #coronavirus isn't transmitted by asymptomatic persons.
@CDCgov More on the #Wuhan #nCoV19 #coronavirus: bloomberg.com/news/videos/20…

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More from @celinegounder

Céline Gounder, MD, ScM, FIDSA 🇺🇦 Profile picture
Apr 23
1/ H5N1 bird flu has been detected in the milk supply




We currently believe the milk supply to be safe.

Some other key points:washingtonpost.com/health/2024/04…
nytimes.com/2024/04/23/hea…
fda.gov/food/alerts-ad…
2/ The levels of virus fragments being found in milk by PCR are high.

Milk from different cows is combined into big vats.

You wouldn't see such high levels of virus if only a couple cows were infected... it would be diluted down.

This implies many cows have been infected.
3/ I suspect there's been a ton of asymptomatic transmission among cows.

They've only been testing symptomatic cows.
Read 8 tweets
Céline Gounder, MD, ScM, FIDSA 🇺🇦 Profile picture
Apr 2
1/ The 2nd human case of H5N1 bird flu was reported in the US yesterday.

This case was in Texas & likely involved transmission from an infected cow🐄 to this individual.

The 1st case was reported in Colorado in 2022.

with @tonydokoupil @GayleKing @nateburleson
2/ The person in Texas became ill with H5N1 bird flu after direct contact with infected dairy cattle🐄.

The patient's primary symptom was conjunctivitis (i.e. pink eye).

The patient is isolating & is being treated with an antiviral for flu... as are their close contacts.
3/ The risk to the general public is believed to be low at this time.

Risk factors for H5N1 bird flu:
🔹Close contact with animals suspected of having H5N1 bird flu
🔹Close contact with someone infected with H5N1 bird fluImage
Read 23 tweets
Céline Gounder, MD, ScM, FIDSA 🇺🇦 Profile picture
Mar 18
1/ Health workers fear it's profits before protection as CDC revisits airborne transmission by @KFFHealthNews' @amymaxmen

So incredibly brave of Dr. @sonyastoked to speak out:
nbcnews.com/health/health-…
Image
2/ Image
3/ Image
Read 7 tweets
Céline Gounder, MD, ScM, FIDSA 🇺🇦 Profile picture
Mar 12
1/ U.S. Healthcare System Reels from Cyberattack

with @CBSNews' @errolbarnettcbsnews.com/news/change-he…Image
2/ The February 21st cyberattack on a medical payment processing company Change Healthcare, a unit of insurance giant UnitedHealth Group's Optum division, is the worst cyberattack on the U.S. healthcare system in history.
3/ Change Healthcare company processes 15B health care transactions annually & touches 1 in every 3 patient records.

Change Healthcare controls providers’ ability to process claims for payment, patient billing & patient cost estimation services.
Read 11 tweets
Céline Gounder, MD, ScM, FIDSA 🇺🇦 Profile picture
Dec 1, 2023
1/ Ohio is reporting an outbreak of pediatric pneumonia cases.

This is similar to the "white lung syndrome" (aka ARDS) that is being seen in Europe & China.

THIS IS NOT DUE TO A NOVEL PATHOGEN CAUSING A NEW PANDEMIC.

on @CBSEveningNews @CBSNews with @noraodonnell & @megoliver
2/ Lung "white out" = acute respiratory distress syndrome (ARDS)

This can be caused by viral & bacterial infections as well as other conditions.

Before people had much immunity to COVID in 2020, this was how people with COVID most often presented to the hospital.
3/ This seems to be a similar phenomenon to the pediatric pneumonia outbreak in China... but that is NOT to say that they are connected.

It's being caused by a combo of viral (e.g. RSV, COVID, flu, adenovirus, rhinovirus) & bacterial (e.g. Mycoplasma pneumoniae) infections.
Read 12 tweets
Céline Gounder, MD, ScM, FIDSA 🇺🇦 Profile picture
Sep 27, 2023
1/ New @KFF polling data on flu/COVID/RSV vaccines


with @CBSNews' @AMGreenCBS
kff.org/coronavirus-co…
cbsnews.com/video/long-cov…
2/ We're entering respiratory virus season:
flu + COVID + RSV

For the first time ever, we have safe & effective vaccines against ALL THREE!

But will people get them?

% of adults planning to get the annual FLU vaccine:
🔹more than 50% of all adults
🔹almost 75% of adults 65+ Image
3/

% of adults planning to get the annual COVID vaccine:
🔹just under 50% of all adults
🔹64% of adults 65+ Image
Read 6 tweets

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