🧵 1/ Presumed #covid19 reinfection (first cases mild, second cases more severe) in five elderly Kentucky nursing home residents w/ multiple co-morbidities, > three months apart.
2/ The patients were elderly with multiple chronic health conditions.
They had confirmed infections in a July outbreak at their nursing home- these were described as very mild, w/ only 2 having symptoms at all.
They had at least 4 negative PCR since their first pos tests.
3/ The second outbreak started at the same SNF on October 30th.
5 tested positive again, 3 with known roommate exposures.
7 who were previously infected did not test positive but further details about them (did they have more severe initial cases?) not included.
4/ So this was an observation in a small cohort of patients who were all >65 w/ multiple comorbidities who had mild infection initially & presumably were reinfected >3 months later. #covid19
🧵🧵1/ When people ask which mask is “good enough”, I often try to reframe it as better protection is better protection; everything we are doing is to reduce risk.
🧵 1/ So I read this @BostonGlobe story today about what is going to be reopening in Massachusetts on Monday - restaurants will have *no capacity limit* and can host *musical performances*(??)
Hmm interesting.
So I decided to check again what % we have vaccinated #covid19 ...
2/ So we are at 6.2% in terms of people who have received two doses; 16% for those who have received one dose
So...we aren’t even close to where we need to be for vaccinations, we got lucky to see a rapid decline in cases, but now we are rapid reopening
🧵1/ So CDC published a couple of outbreak investigations from gyms yesterday— heavy breathing, incomplete mask use, aerosols 🗣 —> superspreading #covid19
But we knew this was risky from a May 2020 outbreak in exercise classes in South Korea already...
2/ This was published in May 2020 in the @CDC_EIDjournal - they found that rigorous exercise was associated w/ transmission whereas low intensity (Pilates, yoga) was not.
🧵1/ Sometimes when you push for an idea for long enough (#BetterMasks) & when the logic makes sense to you- but you are continuously told by other “experts” (CDC leadership) that it’s not needed; you begin to wonder if you yourself are missing something. #covid19
2/ But- the other factors at play- the political ones- make me think otherwise.
If CDC said “yes better masks are better; yes they protect you more”, they are now on the hook for getting these to people.
But- if they don’t have the bandwidth or political backing to do it...
3/ Then they can’t acknowledge it.
But- because we (many of us) pushed for #BetterMasks incessantly, they probably had to do something.
So they did a study with two masks, which worked better than one mask; two masks is easy bc it’s still on the public to figure it out.
Another @CDCgov report today on #covid19 from unmasked exercise classes
The secondary attack rate of infection from instructors to class participants for classes taught within 1 day of symptom onset was 95% (20 of 21)!
And again here, we have CDC 🗣 about aerosol transmission
2/ Transmission despite 6 feet apart w/ instructors yelling during stationary cycling class #covid19
3/ One of the instructors was teaching kickboxing & personal training - two of the infected participants wore masks and were *still infected* #covid19 #BetterMasks
2/ Right in the abstract here under "implications for public health practice", CDC says:
"To reduce SARS-CoV-2 transmission in fitness facilities, attendees should wear a mask, including during high-intensity activities when ≥6 ft apart."
So the 6 foot rule has limits...why?
3/ Because of smaller particles- aerosols- that spread farther than six feet, & hang around for more than 15 minutes.
And CDC acknowledges that; but is still hesitant to send people #BetterMasks (announced today they are sending cloth masks)? C'mon man. What is going on?