NEW: People with Covid-19 are most infectious one to two days before symptoms begin and for five days afterward, according to a new analysis. So should isolation periods be shorter? 1/6

nytimes.com/2020/11/29/hea…
The results are based on a new meta-analysis, comparing the kinetics of the new coronavirus with SARS and MERS, and led by @mugecevik et al. They offer an intriguing possibility: People could isolate as soon as symptoms start, and get a test *after* the 5 days of isolation. 2/6
Right now, most people get tested a day or two after symptoms begin and get results 2-3 days later if they're lucky--so after they're pretty much done being infectious. They also can't often complete the 10 day isolation the CDC recommends. 3/6
Isolating before a test and with just symptoms is also tricky--how would they know it was Covid and not something else? Some people shed for as long as 8-9 days, and a few seriously ill and immunocompromised people can shed for up to 20 days. 4/6
But would the tradeoff -- getting most people to comply and missing a few -- be worth it? France has dropped isolation to 7 days, Germany is considering 5, and the CDC is also considering changes to its isolation period, sources told me. 5/6
This is a complicated issue, and some very smart people helped me think it through in this article. 6/6

feat. @mugecevik @meganranney @angie_rasmussen @michaelmina_lab @TaisonBell @sdbaral

nytimes.com/2020/11/29/hea…

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More from @apoorva_nyc

23 Nov
NEW: It's been said often and it sounds true: Small social gatherings -- people getting together with family and friends -- is driving the current surge.

But is it, really? I looked at the data, and they do not support this claim. 1/x

nytimes.com/2020/11/23/hea…
Let's be very clear upfront: This doesn't mean social gatherings are safe. Given community rates in most places, nothing is truly safe, and social gatherings undoubtedly do contribute to the spread. This is NOT an excuse for anyone to keep or make big Thanksgiving plans. 2/x
The question I asked was: Is there data to suggest that social gatherings are the "engine" of the surge, as officials keep saying? The answer is no. 3/x
Read 10 tweets
20 Nov
If anyone needed reminding that peer review is not proof of quality and preprint does not mean sketchy, just look at the two studies I wrote about this week.

I would rank the immunity preprint by @profshanecrotty and @SetteLab over the Danish mask study any day of the week
@profshanecrotty @SetteLab A better approach is to look at each study on its own merits. Read the paper, talk to experts, ask tough questions. I wish people would stop treating peer review like an infallible seal of approval
@profshanecrotty @SetteLab Over the course of my career, I've had to read thousands upon thousands of peer reviewed papers. And I would say maybe 400 were excellent. The rest... a waste of time, paper and effort
Read 5 tweets
19 Nov
MORE GOOD NEWS: Deaths related to H.I.V. in the United States fell by almost half from 2010 through 2017, regardless of sex, age, race or region. 1/4

nytimes.com/2020/11/19/hea…
But as with all good news, there are caveats. Women, Black people and those of multiple races showed much smaller gains in survival rates. And death rate in the south is twice that in the northeast. 2/4
Also, how will the pandemic change these trends? And what about access to testing, preventive therapy, treatment and care? No one knows quite yet, but there are troubling signs of declines in all of those metrics. 3/4
Read 4 tweets
19 Nov
You may have already moved on from yesterday's controversy over masks. But given the surge pretty much everywhere, it's important for us all to understand what we know about masks' usefulness, and what we don't.

Here we go: 1/7

nytimes.com/article/corona…
First of all, among public health experts, there is near-unanimous endorsement of universal mask mandates to shield people from the virus and slow the pandemic. That's not in question. 2/7
But let's be precise about what we mean by masks, because they're not all equal. N95s are best, surgical masks are great, but the avg person doesn't need either. In fact, in some studies, well-made cloth masks did as well as surgical. Plus cloth masks are green/recyclable 3/7
Read 7 tweets
17 Nov
THE GOOD NEWS: Immunity to the coronavirus might last years, maybe even decades, according to a new study — the most hopeful look yet at this issue. 1/x

nytimes.com/2020/11/17/hea…
What this means: Most people have been infected (more than 90% or so) will be protected from reinfections for a very long time. And vaccines — which generally provide stronger, longer-lasting protection — may do even better. 2/x
What it also means: We probably will not need to vaccinate people every year as we had feared, giving us a fighting chance to contain this pandemic once vaccines are distributed. 3/x
Read 8 tweets
13 Nov
NEW: Have you been wondering if the CDC has, in recent weeks, seemed to reclaim some measure of its independence?

You weren't wrong.

1/x
nytimes.com/2020/11/13/hea…
The CDC has been sidelined and silenced almost since the beginning of the pandemic. But something changed in the fall: The big fight about the administration's meddling in the prestigious MMWR reports, the election, and the dangerously rising case numbers 2/x
“We couldn’t allow ourselves to be politicized at this moment in time,” one senior CDC scientist told me. “We weren’t going to spend time licking wounds and worrying about the past." 3/x
Read 5 tweets

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