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Despite the catchy headline, the mandate of the CDC is far broader than pandemics, and the problems at the CDC precede COVID-19. But yes, the response to the COVID-19 pandemic was deeply flawed and systemic
1/
 nytimes.com/2020/06/03/us/…
Vaccination is a key public health responsibility, and the US does well on influenza vaccination of the elderly, but we are middle of the pack on childhood vaccination rates
2/
 data.oecd.org/healthcare/inf…
The Obesity Epidemic has been a disaster. Remember back when Surgeon General Luther Terry took on big tobacco and won? Big food not so much
3/
 thelancet.com/journals/lanpu…
The CDC was also asleep at the wheel during the fentanyl epidemic reporting (see 2020 report below with 2018 data). For years CDC blamed physician over prescribing while drug dealers were shipping massive quantities of synthetic opioids into the US.
4/
 drugabuse.gov/related-topics…
Firearms deaths, well, Congress and the Dickey Amendment are to blame for kneecapping the CDC, but we have an epidemic of firearms suicide and too little research on how to fix these problem
5/
 washingtonpost.com/news/wonk/wp/2…
Bottom line: the CDC is our nation’s premier public health agency. It has been struggling and failing on multiple fronts for years. We need to fix it.
6/fin
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David States
@statesdj
Let’s talk about Fall Semester. Colleges and universities have to make some big decisions soon
1/
And it won’t affect just students. For example, the University of Michigan #GoBlue has 46,000 students but it also has 25,000 faculty and staff. While students may be mostly young, many faculty and staff are in vulnerable age groups
2/
 cupahr.org/wp-content/upl…
There’s also real meaning to “university community”, schools are densely linked social networks with multiple paths linking students, e.g. classes. Eliminating large classes can reduce but not eliminate the potential for epidemic spread
3/
 osf.io/6kuet/
Read 18 tweets
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David States
@statesdj
Epidemiologists and economists say we need millions if not tens of millions of tests/day to convince people it's safe to re-open the economy, e.g. this Harvard study estimates we'll need 20 millions tests per day ethics.harvard.edu/Covid-Roadmap
1/
Nobel Laurette Paul Romer’s @paulmromer simulations say we need to test everyone in the US every two weeks, or about 25 million tests per day paulromer.net/covid-sim-part…
2/
The most sensitive and specific tests for COVID-19 use quantitative RTPCR. We have about 1,000 instruments each able to run about 1,000 RTPCR tests per day for a national capacity of about a million tests per day.
3/
Read 20 tweets
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David States
@statesdj
The explosive growth seen in early outbreaks within community may be a result of highly exposed individuals rapidly spreading to their many connections. As we re-open we may see slower spread because many of the highly connected people are now immune 1/
But it’s important note that this phenomenon only applies after the virus has been spreading in the community for a while. As the people of Albany Georgia learned, it only takes one individual in the wrong setting to trigger a large outbreak 2/
Also we talk to much about testing as binary “+” or “-“, but positive at Ct 16 on an RTPCR is a millions times more virus than positive at Ct 36. Bad things happened when a highly contagious person shedding lots of virus gets into a setting where many people can be exposed 3/
Read 8 tweets

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