1/ “state authority handoff... to escape blame" nytimes.com/2020/07/18/us/… This administration is all about scapegoating.
2/ "States' rights"? If you believe in local, then why is it OK for state governors to preempt local leaders' public health measures? nymag.com/intelligencer/…
3/ “Only in Washington, D.C., do they think that they have the answer for all of America.” & states always know what's best in cities & small towns? Seems like a double-standard to me. If you really want to talk about policy based on local data, commit to LOCAL, not political.
4/ #DeborahBirx ranges from patronizing & condescending to cheerleader-ish. nytimes.com/2020/07/18/us/… "a constant source of upbeat news for the president and his aides, walking the halls with charts emphasizing that outbreaks were gradually easing"
5/ "Mr. Trump..." said "he alone had authority to decide when the economy would reopen to pushing that responsibility onto the states." nytimes.com/2020/07/18/us/… Our president is #NotALeader.
6/ "Mr. Trump began criticizing Democratic governors who did not 'liberate' their states." nytimes.com/2020/07/18/us/… Liberate? From what? You want liberation from the virus? Then you need to face reality.
6/ "Dr. Birx was more central than publicly known... her model-based assessment nonetheless failed to account for a vital variable" nytimes.com/2020/07/18/us/…
7/ What vital variable? "how Mr. Trump’s rush to urge a return to normal would help undercut the social distancing & other measures that were holding down the numbers." nytimes.com/2020/07/18/us/… Models are only as good as the underlying assumptions. They were wrong.
8/ "The president quickly came to feel trapped by his own reopening guidelines. States needed declining cases to reopen... But more testing meant overall cases were destined to go up... Mr. Trump’s remarkable public campaign against testing" nytimes.com/2020/07/18/us/…
9/ When the science is inconvenient to your political interests? Discount, dispute, deny the science.
10/ "Even now there are internal divisions over how far to go in having officials publicly acknowledge the reality of the situation." nytimes.com/2020/07/18/us/… LEADERSHIP IS ACKNOWLEDGING WHEN YOU'RE WRONG AND LEARNING FROM YOUR MISTAKES.
11/ "WH officials came to feel that they had in fact accomplished... giving governors the tools they needed to deal with remaining outbreaks as infections ebbed." Wait what? Do they have no understanding of state vs federal power to tax & make policy?
12/ "By June the president was regularly making nonsensical statements like, 'If we stop testing right now, we’d have very few cases, if any.'" nytimes.com/2020/07/18/us/… Right, because tests give you COVID, not viral transmission.
13/ "Mr. Trump declared... his role as something akin to a 'wartime president'" nytimes.com/2020/07/18/us/… Wartime presidents ask their countrymen to sacrifice on behalf of their nation.
14/ "it would be his decision about whether to reopen the country. ... 'the biggest decision I’ve ever had to make.'” nytimes.com/2020/07/18/us/… Our president blew it. And tens... hundreds of thousands will die as a result.
15/ "3 days later, he reiterated his responsibility. “When somebody is the president of the United States, the authority is total" nytimes.com/2020/07/18/us/… Total responsibility? Or total dictatorship? OUR PRESIDENT HAS A DUTY TO CARE FOR ALL AMERICANS.
15/ "Dr. Birx was the chief evangelist for idea that the threat from the virus was fading... a strong believer in models that forecast the course of an outbreak." nytimes.com/2020/07/18/us/… Models make poor forecasts when your assumptions are wrong. Garbage in, garbage out.
16/ "real-world outcomes depend on how people respond to calls for changes in behavior... sacrifices that required a sense of shared national responsibility" nytimes.com/2020/07/18/us/… OUR NATIONAL LEADERSHIP DOESN'T BELIEVE IN SHARED NATIONAL RESPONSIBILITY.
17/ "Among the models Dr. Birx relied on most... looking back on its predictions from 3 weeks earlier, it turned out to be hit or miss." nytimes.com/2020/07/18/us/… Hit or miss? That's how we're handling American lives.
18/ "Dr. Birx regularly delivered what the new team was hoping for. 'We’ve hit our peak,' she would say, & that message would find its way back to Mr. Trump." nytimes.com/2020/07/18/us/… Telling people what they want to hear when it's not true, that isn't leadership. It's cowardice.
19/ Dr #DeborahBirx insisted the US would follow Italy. nytimes.com/2020/07/18/us/… But "Italians had been almost entirely compliant with stay-at-home orders and social distancing... Americans, by contrast, began backing away by late April... egged on by Mr. Trump."
20/ Good public health isn't just about good biomedical science. It's also about understanding psychology, politics, anthropology, history, and so much more.

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More from @celinegounder

Apr 29
1/ H5N1 bird flu candidate vaccine viruses have been identified:
(jump to 1:33)
🔹2 are "well-matched" to H5N1 infecting dairy cattle
🔹but how "well-matched" are they really? this conclusion is based on ferret dataastho.org/education/hpai…Image
2/
🔹Candidate vaccine viruses are used to make antigen (i.e. the target you want the immune system to see) for vaccines.
🔹Adjuvant has also been stockpiled.
🔹Adjuvants help strengthen the immune response to antigen in vaccines. Image
3/
🔹100s of thousands of doses of candidate antigen + adjuvant have been manufactured for use in clinical studies.
🔹2 safety/immunogenicity studies are being conducted.
🔹@ASPRgov is working with @US_FDA & industry to figure out a regulatory pathway for the use of these doses.
Read 4 tweets
Apr 29
1/ There are still lots of unanswered questions re: H5N1 bird flu

🔹How quickly is the virus mutating and evolving?

A PB2 E627K mutation was found in the human case in Texas, but not seen in birds or cows.
(1:04:50)astho.org/education/hpai…
2/ The PB2 E627K mutation has been seen in other human cases of H5N1.

It is one step towards mammalian (but NOT human) adaptation in experimental studies. (h/t @RickABright)
3/ The PB2 E627K mutation may have developed in the human Texas case.

It has not been seen in Texas dairy cattle or birds, nor in wild birds or poultry.
Read 8 tweets
Apr 25
1/ Stemming the spread of H5N1 bird flu
🔹The federal government is ramping up testing of dairy cows
🔹Cows will now have to be tested before being transferred to another state
🔹H5N1 viral fragments detected in grocery store milk
🔹The risk to humans remains low at this time
2/ Remember PCR tests from COVID?

They can be positive even after you’ve recovered because they’re picking up dead virus.

Some PCR tests on pasteurized milk from grocery stores have come back positive for bird flu... but that could just be dead virus.
3/ Pasteurization has worked for over a hundred years to protect consumers from bacteria and viruses.

There’s no reason to think pasteurization won’t also work to kill the bird flu virus, but scientists are confirming that with testing anyway.
Read 16 tweets
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
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
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

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