Don’t let @SWAtlasHoover fool you— the reason we have had to “lockdown” is because the administration has *no damn plan*; now they’re trying to push a “plan” where they *do nothing* but want to say it’s ok for you to get sick in the process. This is pure lunacy.
2/ Ask them why when they lost control of this epidemic months ago, they failed to implement working public health systems so that we could get our country up and running safely?
3/ Ask them why when we have 200k+ dead and numerous others *of all ages* suffering from long term effects, when the first surges pushed our hospitals to the limit, they are saying it’s a good idea to allow even more infections with fewer/no protections?
4/ Ask them why, when they are supposedly hard at work to get a safe vaccine out soon by which we work toward *vaccinating people toward herd immunity*, they are suddenly reframing it as “herd immunity through getting the actual infection”? Convenient timing and re-framing...
5/ Ask them why when other countries, both wealthy & impoverished, have successfully controlled their epidemics through implementation of actual public health principles, our administration *chose* to muzzle the CDC and its scientists?
6/ Ask them, when they say “herd immunity” and “age-based protections” if they have ever seen an actual patient or interacted w/ families— hiding grandma in a bunker for months doesn’t work. If the administration actually listened to experts, no one would have to “lockdown”.
7/ This administration wants to sell you snake-oil “cures”, & at the same time reframe the illness as “Democrats want to lock you down”— no one wants lockdowns, on either side of the political aisle. What we want is actual infectious disease experts leading our epidemic response.
8/ When I debated Dr. Kulldorff, I made the point that their team is also making — the vulnerable have been hit the hardest & are suffering the most. But my answer is not to send them (including young/healthy) back to the workforce without protections.…
9/ If you truly care about protecting the poor and vulnerable, the answer is you *protect them*— paid leave until safer working conditions, access to PPE, staggering work schedules, access to regular testing, access to safer isolation options if they can’t isolate at home.
10/ You don’t argue to send them back to work while hiding grandma & grandpa away for months until millions upon millions get sick; remember that “not dying” doesn’t mean you won’t need a hospital bed, or that you’ll be healthy enough to go back to work. That’s a false dichotomy
11/ Also remember— we don’t know if those infected will have robust long-lasting immunity; we are seeing some re-infections but may be undercounting these- even if those second ones are mild, if you can still transmit on to more vulnerable people, you run into the same issue.
12/ It’s unbelievably frustrating hearing a “plan” being pushed out by people who aren’t going to be treating the patients who will be getting sick from it.

It’s easy to suggest hypotheticals when the consequences of them going wrong don’t actually fall upon you directly.

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More from @AbraarKaran

19 Oct
1/ #Covid19 super-spreading event from a bar in Vietnam; this report is from a party for St Patrick's day in which one guest infected 12 others at a poorly ventilated crowded bar.

Genome sequencing analysis helped to confirm this.…
2/ They note that asymptomatic secondary spread occurred to people who were not at the bar as well.

Indoor, crowded, poorly ventilated spaces without masks are dangerous; these types of cluster spreading events are propagating this epidemic.
3/ While this may happen at bars, we have seen the same in others settings as well.

Sports games--> recent CDC report of an outbreak at a hockey game

Read 20 tweets
18 Oct
One of the most interesting parts of working on #covid19 has been as a contributor @NPR @NPRGoatsandSoda helping with their weekly FAQs for the last several months. Some of the questions might seem strange or “obvious”, but I appreciate every one of them.…
2/ As we say in medicine during our training, there is no such thing as a “stupid question”— I know this phrase gets thrown around but I really believe it. We need to create an atmosphere in which people aren’t meant to feel ridiculous or stigmatized for trying to learn.
3/ Elitism is, IMO, one of the reasons we are in this mess. As scientists, did we not do enough to connect w the public before COVID19? In creating that gap inadvertently, did we also create space for a demagogue President who people found more relatable; who they now listen to?
Read 6 tweets
18 Oct
1/ One of the biggest issues with #covid19 epidemic response work is that it’s easy enough to suggest tons of ideas but a whole different beast having to actually operationalize those ideas into a real plan that is carried out.
2/ The administration failed to operationalize any plan completely. No mask mandate. No coordinated national tracing initiative. No real implementation of digital tracing. No nationally supported/coordinated central isolation options for vulnerable. No adequate $$ protections
3/ So the conclusion of all that—> supporting a plan where they wouldn’t really have to do anything at all except shift the responsibility back onto us. Young go ahead & work again. “Old/vulnerable” stay at home. And then label it as “science” by calling it “herd immunity”
Read 7 tweets
17 Oct
It’s easy to propose a hypothetical plan when the consequences of that plan failing miserably don’t actually fall on you directly. If millions get sick over time, & thousands or more need hospital beds, @SWAtlasHoover @VP & crew won’t be the ones at your bedside. We will⬇️
Read 6 tweets
16 Oct
72 #covid19 cases linked to a spin studio; 2500 have been exposed & are being monitored; the indoor classes did not require masking, despite having limited capacity and 6 feet of distance. This outbreak (to me) suggests contributions of aerosols…
2/ Remember that all layers are important; not wearing masks during indoor exercise classes is a big red flag.

And, crowds that are indoors doing exercise are certainly at higher risk of aerosol-based transmission.

Concerning as we head into winter & indoor activity increases
3/ A reminder that aerosols don’t follow a 6 feet rule (this class is a great example of where 6 feet is unlikely sufficient- crowded indoors enclosed spaces).

Here is where we think ventilation could be very important in addition to other protections.
Read 6 tweets
14 Oct
#TheGreatBarringtonDeclaration calls for allowing #covid19 to spread openly while “protecting” the elderly/vulnerable.

While I actually believe the authors mean well, there are multiple reasons why I believe this is a seriously problematic proposition.

-With asymptomatic & presymptomatic spread, the virus will inevitably find its way beyond the first layer of “healthy” people, esp in crowded households & intergenerational households— & especially in our most vulnerable communities who are more likely to run this risk.
-Allowing millions of cases to spread unabashedly will absolutely mean at least several thousands of cases requiring hospitalizations. And those of us who are still working on the frontlines will be the ones — once again— fighting to care for patients w/o adequate supplies.
Read 14 tweets

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