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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
Aug 15
1/ Yesterday, the @WHO declared mpox a public health emergency of international concern (PHEIC).

This is the 2nd time in 2 years that the WHO has declared a PHEIC for mpox.

with @vladduthiersCBS on @CBSMornings
2/ There have already been more than 17K cases in Africa so far this year – more than the total for all of last year.
3/ @WHO announces a Public Health Emergency of International Concern (PHEIC) when there is a significant risk to global health & it requires an internationally coordinated response.

A PHEIC:
🔹helps marshal funding for a public health response
🔹pressures governments to act
Read 22 tweets
Céline Gounder, MD, ScM, FIDSA 🇺🇦 Profile picture
Jul 27
1/ COVID study shows mask and vaccine mandates saved lives

with @CBSNews' @LanaZak cbsnews.com/video/covid-st…
Image
2/ A new study published in the JAMA Health Forum yesterday found that:
🔹mask requirements & vaccine mandates were associated with ⬇️ deaths
🔹prohibitions on vaccine or mask mandates were associated with ⬆️death rates

jamanetwork.com/journals/jama-…
3/ Activity limitations (e.g. closing schools, restaurants, bars; stay-at-home orders; restrictions on leisure time activities & public gatherings) likely provided minimal benefit while imposing substantial cost.
Read 6 tweets
Céline Gounder, MD, ScM, FIDSA 🇺🇦 Profile picture
Jul 26
1/ New Hope Against Dementia: study says singles vaccine also appears to delay onset of dementia
with @CBSMornings' @tonydokoupil @AdrianaDiaz @nateburleson
2/ A study published yesterday in Nature Medicine found that the new Shingrix vaccine was more protective than the old Zostavax vaccine in delaying dementia.

The Zostavax shingles vaccine was discontinued after the Shingrix vaccine was approved.

nature.com/articles/s4159…Image
3/ The Shingrix vaccine is also more protective than Zostavax in preventing shingles.

Shingles is caused by the varicella-zoster virus (VZV), a herpes virus that also causes chickenpox.
Read 15 tweets
Céline Gounder, MD, ScM, FIDSA 🇺🇦 Profile picture
Jun 19
1/ Why are People Promoting Raw Milk?
by @elizabethics for @RollingStone


If you drink unpasteurized milk, you don't just risk getting #H5N1 bird flu.rollingstone.com/culture/cultur…
2/ Image
3/ Image
Read 5 tweets
Céline Gounder, MD, ScM, FIDSA 🇺🇦 Profile picture
Jun 19
1/ Tick-borne infections are on the rise around the country

with @CBSMornings @GayleKing @tonydokoupil @nateburleson
2/ A unique collaboration among hunters,
the Texas Parks & Wildlife Department @TPWDnews,
& researchers at @Baylor University
is helping to map what tick-borne diseases can be found where.
3/ Lyme disease is the most common tick-borne infection in the US, but it's far from the only one.
hopkinslymetracker.org
Read 13 tweets
Céline Gounder, MD, ScM, FIDSA 🇺🇦 Profile picture
Jun 14
1/ #H5N1 bird flu update on @CBSMornings with @GayleKing @vladduthiersCBS @nateburleson

Who's at risk for bird flu right now?
🔹You're at risk if you're a dairy farmworker &/or if you drink raw milk.
2/
🔹If the virus mutates (which is what viruses do!) & becomes transmissible between humans, we could have a pandemic virus on our hands.
3/
 🔹Flu viruses can mutate incrementally (drift) or dramatically (shift).
🔹We see dramatic shifts when 2 flu virus strains infect the same animal or person.
🔹Those 2 flu strains can swap "body parts" & form a Frankenstein virus.
Read 9 tweets

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