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Michael Mina Profile picture
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6 Oct, 6 tweets, 2 min read
TRUMP is a DANGER to the US in a way that should be unfathomable for a sitting president

"Don't be afraid"... he downplays the virus that has killed >200,000 people on his watch---on the day he leaves the hospital. He is unfit.

His words will kill more
theguardian.com/us-news/live/2…
People may think I'm too outlandish with this tweet. I've bitten my tongue for 9 months watching this president act against all good public health policy... for what? To make a point? Politics? To seem strong? I don't know what. But it has harmed our country in massive ways

2/
The US has failed in incredible fashion to get this virus under control. There are innumerable things we could have done better - but unfortunately I'd say few have been aided by our president. He's advocated against public health policy and downplayed the virus since day 1

3/
All of the public health issues aside - most of all, he has failed to even attempt to send a message of unity - to bring the US together - which is absolutely the role of a leader and one of the few absolutes needed to control a pandemic that affects all of US.
Just imagine if the president said:

"My fellow American's. Today we start over. By each of us taking these few simple steps, together we can stop this virus. Please, wear a mask, social distance, and isolate and quarantine when needed."

Instead...

.@EricTopol

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More from @michaelmina_lab

Michael Mina Profile picture
7 Oct
Winter is coming!

If we do not get this virus under control now, we are in for a perfect and terrible storm

We are not taking the expected seasonality of this SEASONAL virus seriously!

Instead, we've assumed our efforts are responsible for decreased cases this summer...

1/x Image
I worry very much that people are confusing the fact that this virus has transmitted in the summer for it not being very seasonal.

This is a grave mistake and misinterpretation...

2/x
The 'force of infection' of this virus is massive! Think of it like the momentum that the virus has to transmit

The huge number of susceptible people is what is allowing the virus to maintain transmission through the summer months - when other coronaviruses go to near zero.

3/x
Read 8 tweets
Michael Mina Profile picture
6 Oct
Important (but not surprising) study

Rapid Antigen tests may be MORE, not less, accurate to detect VIABLE virus (i.e. transmissible virus) compared to the more sensitive PCR.

But how?

1/
medrxiv.org/content/10.110…
We continue to see the use of the word “accurate” but accuracy depends on the target of interest. If the goal is to detect any evidence of virus at all (i.e. RNA remnants), then PCR will be more sensitive, more specific and overall more accurate.

2/x
However if the target is to detect VIABLE and thus likely transmissible virus - then it is possible that PCR can “overcall” positive results when in fact the sample contains just RNA and no viable virus.

3/x
Read 17 tweets
Michael Mina Profile picture
3 Oct
For those thinking "look proof that frequent tests dont work"... a wrong interpretation

This is the 1st transmitting event despite 100s (1000s?) of ppl crossing paths w president or through the White House. Testing has since March helped keep the WH generally free of virus.

1/
It is far too easy when thinking about public health to see successes. The very nature of public health is that success is largely invisible. Reporting that no cases transmitted day after day is simply not a story. So we focus on where things go awry - its natural to do so.

2/
This is the same issue as vaccines and preventive healthcare, and public health in general. It does not get the funding it needs because its successes go unreported and undocumented... out of sight out of mind. But it is the daily undiscussed actions of public health that matter
Read 4 tweets
Michael Mina Profile picture
3 Oct
About frequent rapid testing and the TRUMP White House:

I agree with ppl that the WH cluster f%^* is a shining example of how throwing caution to the wind in response to neg tests is a terrible idea

But it does NOT mean frequent rapid tests don’t help stop outbreaks

1/x
No single protective layer is 💯% for this virus. We need to remain vigilant.

We’ve said all along that frequent rapid tests help to stop spread similar to how masks help and should be considered similar to masks in how they are considered as a tool to curb outbreaks..

2/x
A frequent rapid test can detect MANY people who are infectious, but not everyone - just a bad swab (potentially intentional) can cause a positive to look negative.

But the point is that if used frequently, they can catch ppl early in their infection...

3/x
Read 10 tweets
Michael Mina Profile picture
30 Sep
To detect #COVID19 before it spreads to others, we need frequent accessible testing.

We cannot detect pre/asymptomatic people before they spread if we do not test frequently.

A new article in @NEJM by ⁦@DanLarremore⁩, Roy Parker and Me

1/x nejm.org/doi/full/10.10…
An ideal screening test is one with high sensitivity.

During a pandemic of a fast moving virus that transmits asymptomatically, it is difficult to detect people before they transmit to others.

2/x
This far we have focused almost all of our screening efforts on the use of the very sensitive (and specific - a good thing) qPCR.

The qPCR meets the molecular needs of detecting this virus. It has an extraordinary sensitivity.

But it is extremely limited

3/x
Read 11 tweets
Michael Mina Profile picture
29 Sep
The load of virus detected in the #COVID19 PCR test is a powerful piece of information for medical and public health use

Unfortunately it is usually not considered and thrown away before being reported

@RobertFService discusses in
@ScienceInsider

1/x
sciencemag.org/news/2020/09/o…
Ct values aren’t perfect - but nor is listening to a heart or taking an X-ray. Nevertheless, these tests have their place when considered in context - as does the Ct value of the PCR

To discard is to throw out some of the most informative data we have about one’s infection

2/x
It can help determine whether a person is early or late in their course of infection. It can tell us about he direction of an epidemic. It holds immense value. We should consider its regular use as a crucial tool in this fight against COVID. Not toss it for its imperfections.
Read 5 tweets

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