Caitlin Rivers Profile picture
Jul 9, 2020 4 tweets 1 min read Read on X
I want to gently point out that voices on twitter, even experts, usually do not have any affiliation to one another. If you follow a lot of different experts, you might get a lot of different opinions, particularly on issues where evidence is mixed or absent. 1/
It is institutions e.g. CDC that coordinate the messages of the people who speak on their behalf so that everything is clear, consistent and trusted. We haven’t been able to hear from them as much as we would all like, and that has left a gap. 2/
I don’t mean to suggest that those of us who are active on twitter and in the media don’t take our duty to communicate seriously or that there is no room to improve. I feel a lot of responsibility, and I know others do as well. 3/
But if you are feeling frustrated by mixed messages about masks back in spring, and beaches and protests more recently, it’s because there is no public health expert messaging alignment committee. We’re all just out here on our own doing our best. 4/4

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More from @cmyeaton

Feb 24, 2023
I disagree (in a way) with the idea that the details of the Cambodia cases matter a great deal. Just like it's very unlikely that the mink outbreak itself is *the* genesis for efficient mammal spread, this cluster is not independently meaningful. These events are allegorical. 1/
They are allegorical in that they prove that spillover events can and do happen all the time, especially given the footprint of this epidemic in birds. The overwhelming majority of those spillovers are unobserved. Each is a coin flip. 2/
I think it would be wrong, if we learn that the family cluster had a shared e.g. avian exposure, to rest easy. These events are signals. Warnings. 3/3
Read 4 tweets
Sep 2, 2022
I took a look at CDC's 2nd monkeypox technical report. Some interesting finds. The fraction of cases in people with no recent MSM contact has been growing over time. Either the virus is moving into new pops or case finding has improved.
caitlinrivers.substack.com/p/changing-tre…
At the national level, epidemic growth is beginning to slow (and so are vaccinations). At the state level, the picture changes. States hit early and hard (e.g., NY) are improving markedly, but other states are just picking up.
These technical reports are great. The full report is available here, along with other monkeypox data that is updated regularly. cdc.gov/poxvirus/monke…
Read 4 tweets
Sep 1, 2022
It's especially concerning that cases include healthcare workers and multiple pathogens have already been ruled out. One to watch.
"The Ministry of Health reports that a new patient linked to the cluster of pneumonia of unknown origin has been detected. Case #10 is an 81-year-old male patient with comorbidities hospitalized in serious condition, with ARM, in the public sector." msptucuman.gov.ar/comunicado-ofi…
Read 4 tweets
Aug 23, 2022
A roundup of new outbreak data that has caught my eye. First, disparities around monkeypox cases and vaccinations have come into focus. Multiple states report that Black men are disproportionately affected have received relatively few vaccines. caitlinrivers.substack.com/p/outbreak-dat…
One good piece of news is that monkeypox testing is up and test positivity is down. This may be the first sign that the US is rounding the bend, following on signs of improvement in UK and Europe. Image
Another piece of good news, but in a different outbreak. Pediatric acute hepatitis cases seemed to have peaked. Still not much clarity on whether the outbreak is "real" or what the causative pathogen is. Image
Read 4 tweets
Aug 22, 2022
I have some concerns about the rollout of the new monkeypox vaccine strategy. State and local public health authorities are receiving *less* supply following the move to intradermal administration. caitlinrivers.substack.com/p/concerns-abo…
One challenge is that getting 5 doses out of a vial is proving difficult. Multiple health officials told me that 3-4 doses per vial is more like it. (Low dead space syringes may help.) 2/
But the bigger frustration is that state and local health officials are not receiving as much product as they thought. A health department that ordered 1,000 vials thought they could stretch to 5,000 doses with intradermal. Not so. They are now only receiving 200 vials. 3/
Read 5 tweets
Aug 10, 2022
New blog post from me on data needed to manage the monkeypox response ⬇️ caitlinrivers.substack.com/p/data-needed-…
What gets measured, gets managed. We need metrics and targets to evaluate our progress toward containment and uncover areas in need of improvement I propose 3. 2/
The first is number of tests (and test positivity). We are only using a small fraction of our testing capacity, and test positivity has been 40-60%. This should be lower to have confidence we are finding most cases. 3/
Read 4 tweets

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