1/ New #covid19 executive orders in #Massachusetts today from Gov Baker + team in setting of #covid19 hospitalizations being up 145% since Labor Day. While there is now a mask mandate & curfews, I want to focus attention on *private indoor gatherings* (limit 10 people right now)
2/ We need to do multiple things right now— *one* of those is to make people realize this is getting serious again; cases & hospitalizations are going up. We are heading in the wrong direction. Executive orders may help do that in part.
3/ But additionally, we need to stop transmission. Now- restricting people from being out after 10 pm; I don’t think many people are out after that time anyways esp as the weather gets much worse. But— they still very well may be congregating at home, possibly w/ friends etc
4/ Ten people is NOT a magic number; even with 10 people, if one of those people is infectious with #covid19, you can very well have spread to many others. And in most indoor private socializing scenarios, masks are not worn. Eating, drinking etc not conducive to masking
5/ Now we aren’t going to be able to efficiently regulate what people do in private.

In theory, there is a $500 fine for people that break the indoor gatherings limit that can be enforced by public health & police departments, per state website.
6/ But to stop the epidemic & stop transmission, we aren’t going to be able to police our way out of this.

We need to support people but we also need people to avoid unnecessary indoor crowded socialization in private gatherings.

Halloween didn’t help that cause here.
7/ Do more restrictions on outdoor activities lead to more private indoor socialization + more viral spread? I don’t know for sure but this is an important policy question & reminds me of when Los Angeles shut down beaches during July 4th weekend, which made little sense.
7.5/ Given the weather here, I don’t think the current executive order will necessarily push that outdoor needle one way or another; my bigger concern again is around indoor spread— I would not advise eating at indoor restaurants right now. Pay for take-out, support businesses
8/ In terms of the face coverings mandatory order...again— while this is for public places, we are most concerned about indoor transmission without masks, & this certainly seems to be happening in private indoor places. This is a tough issue!
8.5/ Does mandatory outdoor masking lead to more indoor private unmasking (if people are tired from having their mask on all day?) Or possibly the latter happens anyways and mandatory masking prevents public transmission, making private socialization safer. Hard to know
9/ I think this is a complex issue; there is some level of underestimation of #COVID19 risk, esp within one’s home or w/ close friends; I have seen it happen around me multiple times; also believe there is some level of pandemic fatigue + denial
10/ Recent friend had a new cough; I pointed it out & they initially were in denial about it, claiming they didn’t have a fever so they were alright— this person knows that you can have #covid19 w/o a fever but couldn’t believe they could have it.
11/ They eventually agreed, got tested; they were negative. That’s great— but the point is that even people who understand the science have some level of “can’t happen to me” mentality which can be detrimental.

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More from @AbraarKaran

4 Nov
THREAD
1/ Wasn’t able to sleep a wink last night. It’s a strange feeling when change feels so close, yet so far all at once. This year has been an eternity; headed into yet another huge wave of #covid19 infections, hospitalizations, & deaths, it’s exhausting fighting...
2/ Exhausting fighting against a viral pandemic- yes. But also exhausting fighting forces within our own country; political, cultural & more. Still, giving up is not an option. Not now, not tomorrow; regardless of who is in the White House, the onus will still be on us
3/ “Us” as the public; as individuals, as families, as communities, as counties, as states— neither Biden nor Trump can single handedly stop this epidemic.

It’s just not the way it works.

There will always need to be a certain level of public participation & cohesion.
Read 6 tweets
29 Oct
1/ One of the big failures in our epidemic response is expertise that is rightfully concerned with all the nuances and details but fails to see the bigger picture— so many people in this country are still unclear on even the basic aspects of #covid19 transmission. #covid19
2/ Honestly I see this as a big disconnect between academia & every day people; I would be willing to bet the average person in this country doesn’t give a shit about how much contribution is from aerosols v droplets as much as they care about *what they need to do to stay safe*
3/ If even we as “experts” are unclear on the relative contributions of aerosols and droplets and we are recommending the same safety measures— let’s focus our energies hammering those home in more accessible and clever ways. We are at over 80k cases a day right now.
Read 4 tweets
29 Oct
THREAD
1/ Have seen comments floating around re whether the numbers used in this article are exactly correct or completely fit the epidemiology of spread etc; the footnotes clearly state these limitations, but beyond that, I think these folks are **missing the bigger picture**
2/ There are hundreds of thousands of people (if not more) in this country *right now* who don’t have a strong grasp of how this virus transmits at all.

It has been a failure of science communication at a time when we need it to work most. #covid19
2.5/ I think that *in part*, although not completely, explains the hesitancy & confusion re masking (when to mask, why to mask etc)

If people grasped transmission better, there would likely be fewer questions about the value of wearing masks & in which situations.
Read 9 tweets
28 Oct
The graphics in this article are excellent— this is a huge part of communications that has been missing. If you want to understand how layered interventions reduce #covid19 spread— why masks are indispensable but not always “enough” — read this.

english.elpais.com/society/2020-1…
2/ These graphics are *excellent*— and really hit on a MAJOR gap in our sci-comm for #covid19. Why are we relying on tweet threads to convey safety measures when we can have actual visuals/ audio etc?

Where are all the companies that work on this?
3/ If anyone is working on this type of graphic communication — including simple & digestible videos for the general public, please share your work or reach out to me — I’m personally happy to get involved to help with this. It’s so critical right now to get these messages out.
Read 7 tweets
26 Oct
There are many who have argued against mask mandates, citing that we don’t need masks in every single situation, esp outdoors. While this is true, leaving it up to people to interpret when to mask has also not worked out so well— to no fault of theirs- our messaging has failed
2/ Our messaging hasn’t been nuanced enough to help people understand viral transmission well enough that they always know when to mask v when not to mask.

And that behavior change takes time; unfortunately, we are once again out of time.
3/ At this point, the benefits of masking consistently will outweigh the costs. And as we hit winter, we will mostly be indoors where masking is most important anyways.

The one place that we will get hit hard I predict is *home based* transmission, where people aren’t masked.
Read 5 tweets
25 Oct
The coverage at the hospital is slim on the weekend meaning we have to double up shifts.

I spent the entire day caring for patients—just got home at 10 pm.

Watching Trump claim he can better determine the cause of death of patients that we actually watch die— vote him out.
2/ During #covid19 surges, many of us who were not supposed to even be on service at that time had been called back to the hospital bc that is where we needed to be. We put on whatever PPE we had access to, & we stuck by our oath to be there for our patients no matter what.
3/ We showed up & we’ll do it again if we need to. That’s not a question, or a hesitation— that’s a commitment. That’s a promise. Watching this man degrade us, accuse us of falsifying the causes of patient deaths— he has no respect for what doctors, nurses & patients went through
Read 8 tweets

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