1/ SARS-CoV-2 is spread through the air.
nytimes.com/2021/02/17/hea…
2/ A combination of administrative (e.g. screening & testing), environmental (e.g. ventilation), and personal protective equipment (e.g. masks) can control the spread of airborne infections. cdc.gov/tb/publication…
3/ Some workplaces (e.g. schools) have very low levels of risk. Some workplaces (e.g. hospitals) have especially good ventilation to reduce risk. Other workplaces (e.g. meat-packing, prisons/jails) have minimal protections in place. nytimes.com/2021/02/17/hea…
4/ Does everyone need to be wearing an N95 all the time? No. But healthcare workers should not have to be reusing and decontaminating their N95s. nytimes.com/2021/02/17/hea…
5/ But we CDC needs to update guidance to allow OSHA to protect workers (e.g. people working in meatpacking, food processing, jails/prisons) against the risk of SARS-CoV-2 transmission in their workplaces. OSHA is issuing emergency temporary standards by March 15th.
6/ In the healthcare setting, I think we need to move away from "aerosol-generating procedures" as the threshold for wearing an N95 or equivalent. We know that intubation/extubation are lower risk than a volitional cough, for example. jwatch.org/na52621/2020/1…
7/ My biggest gripe with the healthcare setting is that many healthcare workers are still having to reuse & decontaminate their N95s. But I'm much more worried about other frontline workers, who don't have the ventilation & other protections we enjoy in healthcare settings:

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More from @celinegounder

17 Feb
1/ Former Biden-Harris Transition COVID-19 Advisory Board members @ZekeEmanuel @RickABright @llborio @Atul_Gawande @mtosterholm @drdavidmichaels & Jill Jim in the @nytimes today.
nytimes.com/2021/02/17/opi… We're in for a tough spring if we don't act now.
2/ We all want a break from the pandemic, but now is not the time to let up. By late March, the more transmissible B.1.1.7 UK variant will be the dominant strain in the U.S. This variant spreads more easily from person-to-person and is more virulent. justhumanproductions.org/podcasts/s1e61…
3/ What can we do?
- Every American needs to wear a high-quality mask, and wear it correctly. Snugly, over your nose & mouth. No air leak on the sides.
- Stay in your household bubble.
- Get vaccinated. usatoday.com/story/opinion/…
Read 6 tweets
7 Feb
1/ Should we give as many people one dose of the Pfizer and Moderna vaccines as possible? Or half as many people two doses of vaccine? It’s a data-free zone.
2/ Here’s the Pfizer COVID vaccine clinical trial data. Study participants got their 2nd dose at 21 days. We only have data on how well one dose of the Pfizer vaccine was at protecting against COVID during that 21 day / 3 week period after the first dose. nejm.org/doi/full/10.10…
3/ We don’t know how good or how long that protection would last if someone did NOT get that 2nd dose at 21 days.
Read 17 tweets
5 Feb
1/ On @CBSNews this evening with 3 of my favorite epidemiologists: @ashishkjha @mtosterholm @DrTomFrieden. The editing of my interview is a bit misleading. For clarification:
2/ The UK B.1.1.7 variant is more contagious and *may* be more virulent. If someone is infected with a more virulent strain, that means their risk of more severe disease and death is higher.
3/ The UK B.1.1.7 variant is definitely more contagious / transmissible / infections, which means that if you're exposed, you're more likely to get infected. That means more cases, which equals more disease, hospitalizations, and death.
Read 5 tweets
3 Feb
1/ “When I say ‘experts’ in air quotes, it sounds like I’m saying I don’t really trust the experts,” @NYGovCuomo said of pandemic policies. “Because I don’t.”
nytimes.com/2021/02/01/nyr…
But he does trust lobbyists, big private hospital systems, and paid consultants like Deloitte.
2/ Because we should trust consultants like Deloitte? Who charged the US government $44M to build a dysfunctional IT system to track COVID vaccination? technologyreview.com/2021/01/30/101…
3/ Why is @NYGovCuomo opening restaurants now? Monied interests. nytimes.com/interactive/20… If he really cared about people working in restaurants, he'd be focused on providing them with the economic and social supports to weather the pandemic safely. justhumanproductions.org/podcasts/ep-51…
Read 8 tweets
2 Feb
1/ We need to do better on equity in vaccine rollout. But that means (a) we've got to solve the right problem, and (b) we need the people and tools to solve the problem.
2/ Is it access or is it hesitancy that's led to less vaccination among communities of color? How do the demographics of healthcare workers and the residents of long-term care facilities, who had earliest access, compare with those of the same age in the community at large?
3/ Among healthcare workers who had access to vaccination in their workplace (note that home health aides, out-patient healthcare workers, and others may not have had access at work), were the demographics of those getting vaccinated skewed relative to the total population?
Read 8 tweets
1 Feb
1/ Thanks, @UnivisionNews for helping get good information out about the COVID pandemic.
2/ Translation here:
"This came to my attention. For me, this is an erroneous message for the citizens of Mexico and for the players, young people are doing anything and everything. The doctor Celine Gounder, who was assigned by the incoming @WhiteHouse in November,
3/ "...the new @POTUS, she had the opportunity to write to answer us:
'We cannot rely on natural immunity. We have seen reinfections following natural infection. Positive antibody tests demonstrate prior infection, NOT robust, long-term immunity.'
Read 6 tweets

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