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Infectious Diseases Profile picture
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20 Dec, 9 tweets, 4 min read
Pregnant women can be vaccinated against COVID.

Pregnant women were not specifically included in trials, but as supported by professional societies, including the
@acog
and
@mySFM,
they can choose to take the vaccine, particularly in consultation with their own doctor.

sogc.org/en/-COVID-19/e…
Above ^^ @MySMFM (Maternal Fetal Medicine, US) @acog (American College of OB/GYN) @SOGCorg (Society of OB/GYN of Canada)
(note @MySMFM is the correct handle)
Meanwhile in the UK
Israel also reports delayed vaccination for those who are pregnant
Singapore where cases are fewer is also intending to delay vaccination for pregnant women todayonline.com/singapore/covi…

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More from @InfectiousDz

Infectious Diseases Profile picture
20 Dec
The European CDC has a straightforward threat assessment on the new COVID strain reported in the UK:
ecdc.europa.eu/en/publication…
"preliminary analysis in the UK suggests that this variant is significantly more transmissible than previously circulating variants, with an estimated potential to increase the reproductive number (R) by 0.4 or greater with an estimated increased transmissibility of up to 70%."
Importantly, though:
"This new variant has emerged at a time of the year when there has traditionally been increased family and social mixing.

There is no indication at this point of increased infection severity associated with the new variant."
Read 8 tweets
Infectious Diseases Profile picture
20 Dec
Concerns over new UK COVID strain has led to travel limitations from the UK:

- Netherlands and Belgium suspended flights
- Trains to Belgium banned
- Italy, France, Germany planning similar action
- Even Scotland has extended travel ban with rest of UK
Add Israel to the list of countries banning travel from the UK
Italy now added to countries banning air travel from UK
Read 24 tweets
Infectious Diseases Profile picture
20 Dec
Sierra Leone reports poliovirus isolation from children w/weakness -acute flaccid paralysis (AFP)- in Kambia, Tonkolili, Western Area Rural

Awaiting results from South Africa
Type 2 is common in VDPVs (vaccine-derived poliovirus) and eradicated worldwide

reliefweb.int/report/sierra-…
Given COVID associated interruptions in vaccination, we may see more vaccine derived poliovirus circulating in communities as more do not have expected immunity.
From @ProMED_mail
cVDPV2(community vaccine derived polio virus 2)
WPV1(wildtype polio virus 1)
ES(Environmental samples)

- Afghanistan 54 cVDPV2
- Pakistan 3 WPV1,2 cVDPV2,ES
- Chad 2 cVDPV2
- DRC 2 cVDPV2 cases
- Nigeria 2 cVDPV2,1 ES
- South Sudan 6 cVDPV2
- Sudan 2 cVDPV2
Read 5 tweets
Infectious Diseases Profile picture
19 Dec
Equity in vaccinations will be an ongoing issue - first line healthcare vs other providers, older adults, teachers, who are essential. Those in more senior positions may be prioritized by age over those in more junior positions.

Hospitals are already grappling with these issues.
On paper prioritizing vaccination for those who are older can seem fair, but means those exposed to COVID the most may not be the first to be vaccinated (ie residents, younger ED/ICU staff).
Primary care also sees a lot of COVID before it is identified and when it is most infectious. A patient sick on day 20 of illness may not be producing any infectious virus. The mother accompanying her child to the pediatrician may be even more infectious but unaware.
Read 12 tweets
Infectious Diseases Profile picture
6 Dec
When all the dust settles, we realize we've lost azithromycin, right?
Doctors from DC to Kampala give azithromycin for COVID even though it's a virus, even though <4% on hospital admit have a superinfection
It's not helping patients but makes providers feel good to do something
In case it needs to be said, azithro doesn't have superpowers. Added to standard treatment, it doesn't help thelancet.com/article/S0140-…
Azithromycin, prescribed for every cold for the last couple of decades, was already faltering. It has already been removed from US IDSA/ATS first line treatment recs for community acquired pneumonia. Too much resistance thoracic.org/statements/res…
Read 7 tweets
Infectious Diseases Profile picture
21 Nov
Lines snake around the block for pre-Thanksgiving COVID testing

Not a good idea.

You can test negative on Saturday and be positive on Thursday, on Sunday, on Saturday night. The moment you switch from negative to positive you are at your most infectious and likely will not know
Of those who will develop symptoms, most will by 5 days after exposure. Many will start shedding 1-2 days before symptoms. Any exposure 5 days before Thanksgiving is incredibly risky and a negative test today doesn't mean you won't be maximally infectious on Thursday.
In fact, if you're positive today, you may not even be infectious by Thursday. 10 days after your initial symptom (or first positive test) you are considered non-contagious, as long as you have no fever and your symptoms are improving.
Read 5 tweets

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