What is the relative risk of indoor vs outdoor dining?
COVID-19 cases are falling and indoor dining has resumed in NYC & elsewhere.
It should be possible to quantify the relative risk of indoor vs outdoor dining.
Thread nytimes.com/2021/02/12/nyr…
Many people argue that indoor dining represents a high risk for transmission of SARS-CoV-2, b/c people can't wear masks while eating, people from multiple households often sit at 1 table & at least 2 case studies show cross-table transmission is possible. jkms.org/DOIx.php?id=10…
Outdoor dining is thought to be (much) safer, due to much higher ventilation. But we still don't know the relative risk of indoor vs outdoor dining, which would be extremely valuable in determining the relative risk of re-opening these activities.
Data to answer this question would be relatively easy to collect (& may already exist) in places where indoor & outdoor dining occur. One could simply test contacts of cases whose only contact was through an indoor or outdoor meal.
Including adjustments for auxiliary variables like duration of meal, additional exposures of contacts, etc. would help focus on differences in the setting itself (indoor vs outdoor).
Does this study already exist? (please give link!)
If not, do the data already exist from states that have indoor & outdoor dining? If so I hope they can be analyzed to address this important Q.
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Vaccine efficacy in blocking infection & transmission
(I think) We can now estimate the (minimum) reduction in transmission from the Moderna vaccine.
Thread
tl;dr Moderna vaccine blocks >90% (87-93%) of infections & 91% (89-94%) of transmission.
*Critiques welcome!
Background
By now, everyone knows there are 4 vaccines "approved for full use" (NY Times wording) in one or more countries: Pfizer, Moderna, Sputnik 5, Astrazeneca nytimes.com/interactive/20…
These 4 have shown moderate (Astrazeneca) to very high efficacy in reducing "symptomatic" infections. bbc.com/news/world-asi…
Viral loads (& age but not symptoms) influences transmission probability, incubation period & symptomatic/asymptomatic outcome.
Fantastic new study @dr_michaelmarks. Tons to learn & haven't seen any detailed thread yet, so here's one. thelancet.com/journals/lanin…
Background
We know that transmission of SARS-CoV-2 is highly heterogeneous, with most cases infecting no one & minority of cases infecting 1 to many. How much of this is due to variation in infectiousness vs... @_akiraendo@AdamJKucharski@sbfnk@seabbs doi.org/10.12688/wellc…
differences in # & type of contacts including setting & activity (indoors, singing, temp/RH, etc.), & susceptibility of contacts? We have evidence that all of these things likely matter, but evidence linking viral loads of index patient to infection of their contacts was missing.
Novavax has shared prelim efficacy data by press release: ir.novavax.com/news-releases/…
90% overall, 50% in S Africa (60%) in HIV-.
But there's more...
@carlzimmer has written a nice story about it here:
Article makes very provocative statement - that previous exposure doesn't protect against new variant B.1.351 found initially in S africa. But where are data to support this?
Press release is vague on this. It just says this.
Hundreds of nursing home residents are dying each day due to slow vaccine rollout in SNFs.
CDC vaccine tracking page shows this huge failure.
We are failing to vaccinate the population where most deaths have occurred: nursing homes.
Thread covid.cdc.gov/covid-data-tra…
As most know, ~40% of all deaths in US (& other countries like UK) have been in nursing homes. kff.org/policy-watch/c…
As a result, nursing home residents were put, w/ health care workers (HCW), in top priority tier for vaccination. Great! But allocating vaccines to this group did NOT magically result in shots in arms. That requires huge logistical plan. Unfortunately that plan has not gone well.
New SARS-CoV-2 variant will outrun best control US states achieved in 2020.
W/out rapid action we'll lose race b/w vaccination & virus by much more than we are now.
Much faster vaccine rollout & spacing doses as UK is doing is urgently needed.
Thread.
Background
New variant of SARS-CoV-2 was detected in UK in Sept & spread rapidly since. Estimates suggest it is more transmissible with reproductive number R (# of cases/case) ~50% higher (see tweets in thread for details)
Will vaccination reduce transmission or just disease?
Do 3 vaccines w interim or final phase 3 results (Pfizer, Astrazeneca, Moderna) reduce asymptomatic infections & does reduced symptomatic infection imply reduced infections?
Thread
Background
Developing a vaccine for COVID-19 has been a goal since the virus was 1st identified in Jan 2020.
But what is the purpose of vaccines? Many, it turns out!
They can reduce disease, reduce infection, or reduce infectiousness, or some combination. nymag.com/intelligencer/…
Why does it matter whether vaccine reduces disease, infection or infectiousness?
Because it changes who we vaccinate first & whether vaccination protects friends & family of vaccinated person (herd immunity!).