From giving advice recently to a friend who was symptomatic, got tested and was told to expect a 3-5d delay, I've come to realize a gap in our prevention approach. The advice on preventing transmission if you are infected is mainly provided through contact tracing.
That's good but it's not enough. Especially with these kinds of delays, it could be almost a week from the time someone feels the need to get tested (symptoms, poss contact, whatever) until they might get a call from contact tracers if positive.
In the interim, if they were truly a SARS-CoV-2 infection, they would likely have passed through their peak period of infectiousness, the 4-6 days or so immediately before and after symptom onset we believe.
If they don't know what to do in the time between symptom onset and test results, they may miss opportunities to prevent transmission. High numbers of household clusters (by far the most common KNOWN source of clustered cases, partly ascertainment) suggest that's happening.
So what should people do if they feel ill but have no test result? The goal should be to reduce spread in household and beyond. Symptoms should prompt behavior similar to that prompted by a positive test. Reduce risk in the home:
1) sleep solo in separate room if at all possible. Sharing sleeping quarters/bed a well documented (and understandable) risk for trasmission. 2) mask in the house while infection status unknown. Ideally others in house should do same 3) ventilate & use air purifiers if available
And prevent transmission outside the house -- stay home from work/school/shopping. This is all obvious but in my experience it's really not being communicated to those who need it -- those who feel sick or have an "unofficial" exposure and are waiting for test results
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24h update. They don't know what is going on. On the upside, I have learned the fascinating details of @FedEx corporate structure, that the people at @FedExHelp are helpless if you are trying to deliver to a home. Obviously it is my job to route the problem to the right person.
Since for them to do it is quite challenging. Probably requires computers and stuff, and who would expect them to be good at that?
Their customer service rep wrote: I have advised the management team on the Express side that is responsible for the pick up and the Home Delivery side that is responsible for transporting and delivering the package of the issue so it can be handled as quickly as possible.
The @aier, the Libertarian think tank on an estate in Massachusetts that offered @MartinKulldorff@SunetraGupta and Jay Bhattacharya a comfy country retreat to write the Great Barrington Declaration clearly states the contents of same:
It advocates MAXIMIZING infection among the allegedly low-risk. aier.org/article/lockdo…. They should ask for their money back from Dr. Bhattacharya who argued today that it recommends trying to slow the spread. It advocates trying to speed it, as is clear from GBD's text.
This is just simply saying one thing when trying to influence policy and the opposite when trying to deflect criticism from scientists.
I think @realDonaldTrump and @SWAtlasHoover were committed to a policy with no scientific basis and would have dragged the country there regardless. But GBD provided a veneer of respectability for this deliberate subversion of public health
This thread by @AlexBerenson distorts my work in a way that can only be willful, given that others have made the same arguments in the past on twitter and I have clearly refuted them. threadreaderapp.com/thread/1318176…
He takes a commentary I wrote with @ted_h_cohen about Listeria -- a bacterial disease we get typically from food -- that suggested (citing another paper -- this was not original research) that a lack of herd immunity to listeria could be leading to increased case numbers.
(of symptomatic Listeria infection). It also mentioned the idea that rubella vaccines used in the wrong way could increase severe (congenital) rubella through modest amounts of herd immunity that delay but do not prevent infection, increasing its incidence in pregnant women.
This is just crazy. Mainstream experts have been trying to get through with almost no success. But take an out-there position and you get access. Of course take extra precautions for the most vulnerable. But don't relax everything else before evidence these precautions work.
The argument is incoherent if you don't do low-cost low-inconvenience things like universal masking. Surely any rational strategy uses low-downside strategies to reduce transmission in the whole population while shielding the vulnerable.
Two of these scientists, @SunetraGupta and @MartinKulldorff, have long been my friends. But I think they are dead wrong without a demonstrated plan for how such shielding would work. There is no good example in a dense western country.
New chart reveals military’s vast involvement in Operation Warp Speed. Fascinating article. statnews.com/2020/09/28/ope…
Don’t quite understand how source thinks “foot on the neck to make them go go go” is ok to say in 2020 or even, insensitivity aside, makes sense.
Also don’t know how @HHSGov Spox Mango can say with certainty what the vax trial results will be when they are still not unblinded. Every time someone corporate or govt says something like that they should be asked how they know.