Thread by @DrTomFrieden

Covid Epi Weekly: Immunizing Against Herd Stupidity

Bad week for fight against Covid. Reopening without sufficient care. Failure to isolate. Failure to communicate. Dangerously misguided theory on immunity. Cases increasing, hospitalizations following, more deaths to come. 1/15

Test positivity increased for first time in a month (to 5.4%), but positivity difficult to interpret. Antigen tests, lack of consistent definitions. bit.ly/30Fj11C Hospitalization data concerning tho in the crazy world of US health economics supply creates demand. 2/15

In the past 2 weeks, 21 states had their highest reported rates ever, including most of the midwest, much of the west. As predicted, we have surpassed 50,000 cases/day. White House cluster up to 40 known cases, hundreds not untested. Maine and Vermont still encouraging. 3/15

More information on long-haulers is emerging. We must better understand and care for people who are suffering. Excellent article by the incomparable Jane Brody. 4/15 nyti.ms/3nX974I

Great new data on self-reported mask-wearing. More masks→less illness. Shameful misrepresentation of CDC study which found restaurants, bars, and family members with Covid associated with illness. Masks are a low-cost, effective way to reduce spread. bit.ly/37csil0 5/15

Nowhere 90%+ mask wearing >20% know someone sick, and nowhere with <85% mask wearing <20% who know someone who is sick. How did masks become political? Masks are only against a virus, not against any party or person. We're in this together! Us against them. Them=virus! 6/15

Bad news 1. Remdesivir doesn’t appear to reduce death 2. US continues to fail at contact and source case tracing. Complex, important, high-skill, high-empathy work. 3. Dangerously misguided concept of herd immunity through natural infection spreading. 7/15 bit.ly/2IEG7P9

“We’re all connected” is reality. Infections in healthy people lead to infections in others. “Protect the vulnerable” requires reducing risk of infection in all. Altho the more people who are immune, the slower virus spreads, every infection is a setback, not a step forward. 8/15

Now three pieces of good news. At least 199/200 people with infection recover - Covid is NOT the Zombie Apocalypse. Dexamethasone and other steroids - cheap, available meds - reduce death rate by as much as a third. And lots of safer social and economic activity is possible. 9/15

With Halloween, Thanksgiving coming we CAN have some safer connections. Halloween ideas below. For Thanksgiving, suggest 2 weeks strict quarantine before any family get-together, and only if travel can be done safely. That’s what my family is doing. 10/15
bit.ly/31gAdtP

Let’s not get ahead of ourselves on vaccines. Our best tool, but just one of many. We don’t know if they will be effective, safe, accessible, and trusted. Even if all 4, they won’t end the pandemic, and rare, serious adverse reactions may occur. Underpromise, overdeliver. 11/15

Simple measures, such as ensuring paid sick leave, are also very important. Interesting new analysis suggesting “roughly 1 prevented COVID-19 case per day per 1300 workers who newly gained the option to take up to two weeks of paid sick leave.” 13/15 bit.ly/3nZ7N1q

Public health must do better understanding, empathizing with people experiencing social, economic pain of pandemic. It's the pandemic, not the response, that's killing jobs and people. In US, >30 people have lost jobs because of pandemic for every 1 who has lost their life. 14/15

“We know how to bring the economy back to life. What we do not know is how to bring people back to life.”
-Ghana President Nana Akufo-Addo

Covid is here to stay. We must live, fully, now.

“The present moment is the only moment available to us.”
-Thich Nhat Hanh

15/15/end