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Dr. Tom Frieden Profile picture
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5 Oct, 8 tweets, 1 min read
We still don't know key elements about the Covid outbreak affecting the White House. This is what needs to happen to assess the outbreak's impact and stop continued spread. 6 steps in an epidemiologic investigation:
Step 1: Establish the case definition: person, place, and time. For example, someone who had contact with anyone in the White House after September 18 and has a positive test for Covid (confirmed) or symptoms consistent with Covid (suspected).
Step 2: Find all who meet the case definition through active surveillance.
Step 3: Make an "epidemic curve" showing cases by time of onset. (Anyone have one for this cluster?)
Step 4: Analyze risk factors for infection and explore hypotheses regarding the people and places that may have resulted in spread of infection.
Step 5: Take action based on the most plausible hypothesis in order to limit further spread of the infection.
Step 6: Assess the impact of the intervention, reevaluate the data, and optimize interventions. Repeat.
Outbreak control works, if done quickly and well.

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More from @DrTomFrieden

Dr. Tom Frieden Profile picture
2 Oct
Epi Weekly. 40 million plus 1. And…NYC is on the brink of a precipice.

A minimal estimate is about 40 million infections in the United States with the virus that causes Covid. The infection of President Trump is the most prominent, and one of the most telling.

First of thread/
My thoughts are with the President, First Lady, family, and all others infected with and affected by Covid. The President’s infection is a reminder that Covid is an ongoing threat. No one is safe – not even heads of state – until everyone is safe. fxn.ws/3ioVuaG
2/16
Risk of severe illness and death increases with age. A 74-year-old has approximately 3% chance of death, higher in males and people who are obese, and much higher if hospitalization is required. 85-90% of those infected in their 70’s will have no, mild, or minor illness.
3/16
Read 16 tweets
Dr. Tom Frieden Profile picture
25 Sep
Covid Epi Weekly: People are tired of fighting the virus, but the virus isn’t tired of infecting people

As parts of Europe and the US show, turn your back on Covid and it will come back to bite you. Cases trending up again in many states, likely to hit 50,000/day in October.
1/9
2/9 Trends in positivity are getting harder to track. Per Covid Tracking Project, only 9 states documented to follow best practice of reporting antigen & PCR tests separately. (States should also report unduplicated people positive/tested, crossreferencing the two types of test.)
3/9 What starts in the young doesn’t stay in the young. @MMWR reports young adult infections were followed a week or two later by infections in people over 60. We are all connected. The sooner we recognize that, the sooner we can move forward more safely. bit.ly/369yrOu
Read 9 tweets
Dr. Tom Frieden Profile picture
22 Sep
Every one of the 200,000 Americans killed by Covid is a tragedy, and most of these deaths did not have to happen. The future is in our hands.
We can save lives and accelerate economic recovery by putting science and public health at the center of our response. As the global death toll passes one million, this also means collaborating to improve public health systems worldwide.
There is no fairy tale ending to this pandemic—not even a vaccine.
Read 5 tweets
Dr. Tom Frieden Profile picture
19 Sep
Epi Weekly Review: No Fairy-Tale Ending to The Covid Pandemic

Less testing, less information on tests, apparently less Covid. Positivity decreased 5.2 to 4.8% per CovidView. Testing decreased for multiple reasons, including antigen test results not being reliably tracked.
1/6
In the past week, most diagnosed cases in TX, CA, FL, IL, GA, MO, WI; these 6 states account for nearly half of diagnosed cases. But diagnosed cases only roughly a fifth of total infections. Virus spreading on campuses will spread to homes, parents, grandparents, and others.
2/6
3/6 @nytimes tracks counties with the highest rates. Here are top 28. They look pretty....red...to me. The virus doesn’t see red or blue states, only people it can infect. In too many places, the virus is still winning. If we work together but stay apart, we can stop the spread.
Read 6 tweets
Dr. Tom Frieden Profile picture
14 Sep
1/ I received a note the other day from an 18-year-old high school senior who's concerned and feels he may be getting depressed about the future. He asked, Will this be forever? Are we doomed? THREAD:
2/ He asked when he'll be able to attend a sports game or concert again, when he'll be able to visit his grandparents, and if we'll ever get back to normal life.
3/ Young people are facing a lot of stress and uncertainty right now. Schools in many places are closing almost as soon as they reopen. Sports, concerts, and large gatherings are either cancelled or risky. Recent college grads are entering a flagging economy.
Read 16 tweets
Dr. Tom Frieden Profile picture
12 Sep
1/9 Covid Epi Weekly: One Step Forward, One Step Back

Decreasing cases in much of country. But decreasing testing, less information, and impending explosions with schools, universities, and more.

Primary concern : “A single death is a tragedy, a million deaths is a statistic.”
2/9 Positivity rate decreased from 5.5 to 5.1% nationally. That’s good - it’s progress. But we’re losing the ability to track the virus - antigen tests, less testing, and still no reliable information on who is being tested. We should have better information each week, but don’t.
3/9 Most of U.S. still failing. Too many cases to test, trace, isolate. Even in places with fewer cases, very little tracking of actual outcomes:
*Days infectious before isolation
*% cases from quarantined contacts.
Tens of thousands of lives and millions of jobs depend on this.
Read 9 tweets

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