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12 Oct, 5 tweets, 2 min read
Wuhan implemented the #SwissCheeseModel model using multi-faceted interventions to suppress the outbreak by dropping the R value from 3.5 before intervention=> 0.1 in 6 wks => zero confirmed cases in 7.5 wks. Effective implementation & high compliance(1/)

The multi-faceted intervention Swiss cheese slices used in Wuhan include: mask wearing, social distancing(lockdown), testing, tracing, isolation and quarantine, and universal screening. They were implemented with high compliance. Students have been back to school since September
The tweet in April about multi-faceted interventions.

Find and effectively implement a path to zero. Different countries have different situations and cultures. An effective implementation of a path to zero is likely to be country-specific and requires multi-faceted coordinated efforts and leadership.
A great description of the effective leadership attributes for combatting #COVID-19: truthfulness, empathy, respect, humility, solidarity, resolve and hope.

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More from @XihongLin

Xihong Lin Profile picture
1 Sep
We published @howwefeel COVID-19 findings in @NatureHumBehav from 500K US participants in April-May on (1) factors for who got tested; (2) symptoms & factors for PCR+ tests; (3) pred models for + tests; (4) social distancing & mask wearing behaviors (1/).
nature.com/articles/s4156…
Big thanks go to @weallen1, Han Altae-Tran, James Briggs, @xinnie, Glen McGee, @andyshi_stats, @bitdrift, Dave Cheng, @8en, @zhangf and many members of the @howwefeel team (howwefeel.org), all HWF participants, and partnership with the state of CT. (2/)
Using the self-reported @howwefeel app data from general public across 50 states, we investigated COVID-19-related symptoms, exposure, demographic and behavioral factors, preexisting comorbidities, and the degree of asymptomatic and mildly symptomatic cases. (3/)
Read 19 tweets
Xihong Lin Profile picture
26 Aug
Our STAAR paper just appeared in @NatureGenet. STAAR performs scalable, powerful rare variant associations tests for Whole Genome Sequencing studies by using multiple in-silico functional annotations, applied to lipids in @nih_nhlbi TOPMed 30K genomes (1/)
nature.com/articles/s4158…
Thanks go to the co-first authors (@xihaoli and Zilin Li), @zhouhufeng, @sheilamgaynor, @sunryan(on twitter), many TOPMed colleagues, including @pnatarajanmd, Gina Peloso, @cristenw, Jerry Rotter, Harvard Analysis Center colleagues of @NHGRI_GSP @bmneale and Shamil Sunyaev(2/)
WGS association analysis is challenged by a massive number of rare variants. For TOPMed Freeze 5 data of 54K genomes, 47% of variants are singletons and 16% are doubletons, <3% are common variants (with MAF>1%). >95% variants are non-coding variants (3/)
Read 24 tweets
Xihong Lin Profile picture
17 Jul
Our paper “Reconstruction of full transmission dynamics of COVID-19 in Wuhan” is online in Nature. We showed two key features of COVID: High transmissibility (R0=3.5) & high covertness(up to 87% undetected cases), estimated the chance of resurgence(1/n)
nature.com/articles/s4158…
It was a great pleasure to work with @chaolongwang. This paper is built upon our March 8 MedRxiv preprint. The first part of this preprint (epidemiology focus) was published in JAMA in April (Pan, et al, 2020). This is the second part (modeling focus)(2/n)
medrxiv.org/content/10.110…
High transmissibility means the virus is very infectious in the absence of interventions. High covertness means infections are hard to detect because many of infected cases are asymptomatic and mildly symptomatic. (3/n)
Read 19 tweets
Xihong Lin Profile picture
9 Jun
There is some confusion about asymptomatic & pre-symptomatic spreading. Clear definition of terminology & clear scientific communication are important. Here are some thoughts on symptomatic,pre-symptomatic,truly asymptomatic cases,PRC test sensitivity, their risk assessment (1/n)
"Asymptomatic" is a vague term. Asymptomatic cases include pre-symptomatic and truly symptomatic cases. The COVID-19 symptoms have been evolving over time as we understand the disease better and better (2/n)
The pre-symptomatic period starts about 3 days on average after being infected. Viral shredding starts & pre-symptomatic subjects are likely to be infectious. The time between pre-symptomatic onset and symptomatic onset is about 2-3 days (3/n)
nature.com/articles/s4159…
Read 13 tweets
Xihong Lin Profile picture
17 Apr
Very pleased to report that our JAMA paper on public health interventions with the epidemiology of the COVID-19 outbreak in Wuhan based on analysis of 32,000+ lab-confirmed COVID-19 cases in Wuhan till Mar 8 appeared on April 10. See below for a summary.
jamanetwork.com/journals/jama/…
This is an updated analysis of that reported in the MedRxiv pre-print posted on March 6 by including 32K cases until March 8 and adding a fifth period after a universal symptom screening that was implemented on February 17-18.
Multi-faceted public health interventions using both social distancing AND centralized isolation and quarantine crushed the curve! These findings may help other countries and regions to combat the global pandemic.
Read 32 tweets
Xihong Lin Profile picture
6 Mar
Analysis results of 25,000+ lab-confirmed COVID-19 cases in Wuhan till Feb 18: epidemiological characteristics and non-pharmaceutical Intervention effects. The key results are summarized below and hope they are useful for the strategies in US and others medrxiv.org/content/10.110…
1. In the absence of intervention (before 1/23), the effective reproductive number R=3.8>>1, and dropped to R=0.3 after the massive intervention on Feb 1(centralized quarantine and treatment of all confirmed and suspected cases). This intervention worked.
2. Various sensitivity analyses were done and the conclusion holds.
Read 24 tweets

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