My 2-year-old loves swings. His favorite playground finally opened, but all the swings have been removed.
SF reopened indoor dining before playgrounds.
And indoor dining is limited to 2 hours, while playing at a playground is limited to 30 minutes. bit.ly/2IEDWeg 🧵
When considering the differential in risk of transmission, this is backwards.
As a parent of 2 toddlers who went through their snotty-nosed years, I get it. Kids in general-and playgrounds in particular-are often associated w/ germs. But #SARSCoV2 is different. (2)
While the risk of transmission outdoors isn’t always zero, it’s likely many orders of magnitude (~20) lower than the risk of transmission indoors, especially when combined w/ masks. (Oddly, it’s harder for me to get my kids to wear shoes than masks.) (3)
medrxiv.org/content/10.110…
Transmission due to fomites outdoors rarely, if ever, occurs.
How many infections have stemmed from outdoor playgrounds? None, to my knowledge. Playgrounds have remained open in many European countries w/o evidence that they’ve been significant sources of transmission. (4)
While it’s possible that SARSCoV2 transmission can occur at playgrounds, the risk is much lower than indoor dining.
In 1 investigation, adults w/ #COVID19 w/o a known close contact were 2.8 times as likely to have dined at a restaurant (vs controls). bit.ly/3m37Kj4 (5)
One might assume that if something has reopened, then it is safe. Conversely, one might assume that if it remains closed or restricted, then it is unsafe. There’s a multidimensional spectrum of risk, but the signal that policies send are often perceived as simply safe or unsafe.6
As @JuliaMarcus recently pointed out to me, “The public health strategy of being overly restrictive in low-risk settings is misguided and likely to be counterproductive.” (7)
Educating the public about transmission risk is complex, but public health policies should protect AND inform us. To have a 2 hour indoor limit in an adult setting and a 30 minute outdoor limit in a toddler setting makes no sense (end).
@SFGate @LondonBreed @GavinNewsom

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More from @jakescottMD

11 Oct
As an ID doc who regularly sees #COVID19 patients & is responsible for starting & discontinuing isolation, a few comments:

I understand why there’s distrust but Trump may actually no longer be infectious at this point.

Thread
(The fact that he wasn’t properly isolating before this evening is a different story.)

(2/n)
Most people are most infectious from 2 days before to 5 days after the onset of symptoms. This excellent thread by @mugecevik explains this much better than I could.

(3/n)
Read 11 tweets
9 Oct
Short 🧵
#COVID19 & post-acute/long-term care facilities:
-Facilities are often unfairly blamed for outbreaks
-As long as the virus continues to spread in communities it will likely make its way into these vulnerable populations, & once it gets in it’s very hard to control (1/4)
-There are specific things facilities can do to help keep infection out, like frequent testing, but resources are limited & they need much more support than they’re getting.
(2/4)
-Even if staff have proper PPE & are practicing perfect infection prevention measures, many of the residents are unable to comply w/ mask-wearing & physical distancing
(3/4)
Read 4 tweets
13 Jun
I wrote a letter to @nytimes, like many of you, after reading this problematic article, but I never heard back, so I figured I'd include it here. With thanks to: @eliowa @GermHunterMD @dan_diekema @mike_edmond nytimes.com/2020/06/01/hea…
As infectious diseases physicians, the specialists primarily responsible for controlling infection within hospitals, we strongly dispute the author’s interpretation of data referenced in the June 1st article, “Medical Workers Should Use Respirator Masks, Not Surgical Masks.”
The headline itself, phrased as an official recommendation, could cause innumerable problems. The author draws inaccurate conclusions from a study published in the Lancet, which is a review and meta-analysis that draws from 172 studies.
Read 10 tweets

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