No we dont get an A grade on this. US failures so far w COVID19 response. Please feel free to add: 1) Delayed roll out of testing capacity 2) Held on to overly stringent case definition that delayed recognition of community transmission 3) Didn't federalize supply distribution e
4) Left too much of response architecture & reopening to states, who took widely different approaches 5) Didn't invoke DPA earlier or enough times to cover all needed supplies 6) Relied too much on tracking sympt cases even after role of asx was clear(not enough contact tracing)
7) Didn't mandate masks even after (or since) widely accepted as a critical tool in mitigation 8) Allowed politicization & downplaying of existence of pandemic by some politicians 9) Major missteps in EUA but also promoting txs w/o enough evidence based on political pressures
10) allowed manipulation of public facing public health documents by political appointees which eroded trust in public health authorities 11) Allowed politicians to state unrealistic vaccine timelines which forced people to let their guard down or get confused, distrustful
12) Pulled out of international collaborations/WHO in the middle of a pandemic, fracturing a unified global approach to pandemic 13) Allowed targeting of scientists and public health leaders
14) Did not take an earlier stronger, proactive approach against misinformation about pandemic by nefarious actors 15) allowed setting up false dichotomy between economic and public health measures, rather than simple true motto of "control cases to open markets"
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Lot of #H5N1 news this week: 🧵
-phylogenetic analysis suggests virus may have made single jump from bird to cows in Dec, & circulating in cows since
-virus is jumping back from cows in birds (no good, implies further opportunity for adaptation) 1/n
-H5N1 + reported in asymptomatic cows
-studies in milk show 1 in 5 (FDA data) to 40% of samples had H5N1 remnants on PCR, suggesting a much more widespread outbreak
-NIAID supported study showed no live virus in pasteurized milk, FDA results on larger national sample pending 2/n
-USDA reported virus found in a pulmonary tissue of a single cow (just one cow but concerning if virus adapting to lungs & possible changes in transmission capacity)
-USDA order asks lactating cows be tested before interstate movement 3/n
Dr @matthewjhepburn, Senior Advisor on Pandemic Preparedness, @WHOSTP, opens the Summit highlighting the importance of early detection both domestically and globally.
Dr @AlondraNelson46 reflects how @CDCgov Center for Forecasting and Outbreak Analytics should be a national asset with equity at its core, providing data from and to all our communities. And how important it is to link action to early warning.
The national security implications of pandemics are widespread. @JakeSullivan46 says these health issues aren’t adjacent to national security concerns but central to it.
Still opportunities to use infrastructure set up to give Regeneron/Lilly monoclonals (current versions don't work w omicron because of mutations). Administer: 1) Sotrovimab (this monoclonal still works w omicron) 2) Remdesivir (given w/in 7 days, ⬇️ hosp 87%)
Give what works.
Remdesivir is given as 3 day course, which means patients have to come back but dedicated infusion centers can provide good infrastructure. The data is very striking for early administration. nejm.org/doi/full/10.10…
The problem currently is that there are so many cases that there is a shortage of therapies that work- including oral antivirals. This is why it's not a good idea for everyone to get infected all at once right now.
And why vaccines are still your first and best line of defense.
To figure out if we have reached endemicity with a disease, we have to answer the question: Can our society function if current moment became status quo?
The surge of cases leading to worker shortages & still overwhelmed hospitals tells us for COVID, the answer currently is NO.
I think we need to think of the next few weeks of surge as phase onto itself that we have to manage and minimize damage from.
After the surge, we can ask that same question again and figure out the best metrics to follow in that new reality.
That question makes it obvious that endemicity is both a function of disease (virulence, prevalence) & society (demographics, immunity, resource/capacity, what society is willing to accept as ongoing cost.)
And that different communities will reach endemicity at different times.
I have news for people who are looking at the unfortunate loss of Colin Powell as a sign that covid-19 vaccines are not working: Almost no vaccines prevent ALL infections & deaths. Older & immunocompromised pts always depend on the rest of us to create population level immunity.
If you think it’s awful that lack of higher level population level to immunity to this virus is causing the vulnerable among us to suffer, wait till you see when the high anti-vax sentiment in some parts of this country makes us lose the same protection from other … contd
Vaccine preventable infectious diseases. If rates of immunizations go down more to measles, mumps, rubella etc… you are likely to see many more breakthrough infections related to those diseases as well.
What infectious diseases/epidemiology/global health topics in general or COVID-19 issues would you like more information on or are confused about?
What can scientists and public health folks do a better job of explaining?
A) honored you are sharing your questions & concerns here
B) because of the sheer number will try to group together in themes & respond to common ones
C) we are hoping to work on some web/social media resources down the road which maybe helpful
Re vaccine safety: in addition to existing post authorization vaccine adverse effects reporting system (VAERS), CDC instituted new initiatives includingV-SAFE text based, expanded acute & long term facilities & insurer databases reporting. More details: cdc.gov/coronavirus/20…