NEW: The CDC is acknowledging evidence that the virus can be "airborne" and travel further than 6 feet, especially when "the infected person was breathing heavily, for example while singing or exercising.” 1/x

nytimes.com/2020/10/05/hea…
This is why the presidential debate could be risky to Joe Biden. Even 12 feet may not be enough when you have an infected person, possibly at the height of their infectiousness (jibes with timing), talking loudly and at length for 90 minutes. 2/x
The CDC's definition of close contact --- 6 feet for 15 minutes -- is a minimum that doesn't account for this sort of high-risk scenario. But every public health expert I talked to has said Mr. Biden may have very well have been exposed and should probably quarantine. 3/x
This is among the many, many frustrations of a CDC that has been slow to update its guidance, and unclear on how to interpret. Many people have taken the 6 feet/15 mins to be an ironclad rule and if you're beyond 6 ft, then you're just fine, regardless of exposure time 4/x
In fact, the CDC has always been clear on at least that point. If the distance is shorter than 6 ft, or the duration is longer, your risk goes up. There is the letter of the law (or, in this case, guidance), and then there is the spirit of the law 5/x
The article gets into some important distinctions between old and new CDC guidance. Thanks to @SaskiaPopescu and @linseymarr for their comments. 6/6

nytimes.com/2020/10/05/hea…

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More from @apoorva_nyc

5 Oct
SCOOP: The White House has decided not to trace the contacts of guests and staff members at the Sept. 26 Rose Garden celebration for Judge Amy Coney Barrett, where at least eight people, including the president, may have become infected

nytimes.com/2020/10/05/hea…
Because no one tested positive within 48 hrs of the event, it's technically not required to be part of contact tracing, is the stance, and also doesn't represent a super-spreader event. 2/x
That, by the way, is the opposite of what public health experts told me. There are at least 8 people directly connected to the event, but several more secondary cases seem to be popping up 3/x
Read 6 tweets
5 Oct
With President Trump certain to be infected and infectious Tuesday night, Joe Biden (and VP Pence) should, per CDC guidelines, quarantine. But his campaign has been cagey about some details. 1/x

nytimes.com/2020/10/04/us/…
Technically, Mr. Biden and the president were about 12 feet apart. But remember this was indoors, and the president was talking loudly and often for much of the 90 minutes 2/x
We know that the 6 feet rule does not hold indoors. In fact, in August, scientists isolated infectious virus at a distance of 7 and 16 ft from a Covid patient in a hospital (where ventilation is arguably excellent). 3/x

nytimes.com/2020/08/11/hea…
Read 6 tweets
3 Oct
President Trump is getting the Regeneron antibody cocktail and remdesevir--two therapies with a lot of good press around them--and is at an excellent medical center. But his age, weight and sex put him at high risk.

nytimes.com/2020/10/03/hea…
As @CarlosdelRio7 and @jeremyfaust told me, the president's age and general health means he is exactly the kind of patient docs worry most about. 2/x
@CarlosdelRio7 @jeremyfaust Given that, the docs and the meds are probably as good as he can get. They're both experimental, altho remdesevir is now considered standard of care for most Covid patients and the Regeneron cocktail is probably safe if not yet proven to be effective 3/x
Read 7 tweets
3 Oct
It’s becoming increasingly clear that there was a super spreader event on Saturday. Not in the Rose Garden (although it probably didn’t help) but during the indoor discussions. At some point, they may figure out who the source was. I worry for that person’s safety
We know several people, including some needed for Judge Barrett’s confirmation to SCOTUS, were infected and were at the WH that day.

nytimes.com/live/2020/10/0…
And we also know that the test the WH used to screen people and assume they were safe is not reliable for that purpose. It was only authorized for confirming symptomatic cases.

nytimes.com/live/2020/10/0…
Read 4 tweets
2 Oct
This is how President Trump often meets people: indoors, without a mask on, and talking loudly. In other words, all of the ingredients for a superspreader event. Did the president--or whoever infected him--seed one? 1/x

nytimes.com/2020/10/02/hea…
Here's what we know about the virus. People are most infectious a day or two before symptoms and the virus can travel far when an infected person spends a lot of time indoors talking and shouting--which spreads aerosols. Tuesday night, anyone? 2/x
We know President Trump seemed sleepy/tired/lethargic as early as Wednesday night, so the timing works. Given the virus takes 2-14 days to incubate, but most often about 5 days, Saturday is looking very likely for when he was infected 3/x
Read 6 tweets
30 Sep
BREAKING: Massive new study out of #India is the first of the scale in a low or middle income country.

Key insights: shorter median hospital stay before death; kids of all ages can get infected and spread; confirms "superspreading" 1/x

nytimes.com/2020/09/30/hea…
First: Covid patients in India have a median stay of just 5 days in a hospital before death, vs 2-8 wks elsewhere. Important insight for outbreak planning, but also perhaps a sad statement on how late into their illness people get care. 2/x
They see the same increase in mortality among men and with age, but weirdly, the age risk goes down after 65 (and not just because of population distribution). Maybe because people who get past that age in India tend to be well off and have good health care 3/x
Read 9 tweets

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