Thread by @DrTomFrieden

Covid Epi Weekly: Keep your mask and guard up!

Are we near the new normal? By May we'll be much safer—but we're not there yet. Vaccine rollout gaining momentum, saving lives. Cases trending down. But transmission still high and variants could derail progress. Hang in there! 1/16

HUGE thank you to Covid Tracking Project, winding down this week. Last weekly metrics below – still not completely replicable @CDCGov but getting there. Blip last week seems to have been mostly weather-related, with cases trending down, but we’re not out of the woods. 2/

For bookmarking (I did): Where to find and how to use Covid data. Thanks to all who worked on the Covid Tracking Project. Hope we never need something like this again – that the Federal government never again abdicates its fundamental responsibility. bit.ly/3rgR4Yx 3/

Look at orange case graph. I’ve drawn black line–most likely both weather effects (less testing so less diagnosis leading to dip) and slowing of decline. And most likely slowing of decline (black line slope more gradual than orange) from both more exposures & variant spread. 4/

Now REALLY good news. As I’ve predicted for the past few months, rapidly decreasing case fatality ratio, with big decreases in nursing homes. Direct impact of vaccination: Saving lives. Within a month or less, deaths will be <1000/day. Still horribly high, but much lower. 4/

Perspective: Nationally >50,000 diagnosed cases/d, ~15 diagnosed cases/100,000 ppl/d = 1/6500 people infected/day. Infectious for ~7 days (10 w variant, maybe). Say 1/1000 people infectious. In a month, if you have contact with 100 people, 1/10 chance of exposure. Not small. 5/

Still raining Covid pretty hard out there. Twice the testing of Sept w similar case counts, so real progress. But don’t put away your umbrella. NYC still 3,000 cases/d, ~10x more than manageable w outbreak investigation/control, which we’ll need if we have dangerous variants. 6/

Next week: 100 million and, possibly, as many as 1 billion. These are the two numbers for best estimate of total infections in the United States and globally, respectively. Stay tuned. 7/

Brazil variant concerning. Increased spread (but no increase in severe illness) in kids concerning, but doesn’t change policy to open schools. More infectious variants will become much more prevalent in US, but if we’re careful won’t drive 4th Surge. 8/ nyti.ms/3kPThrl

More good news on vaccines. More vaccinations, more options, more soon. After vaccination what more can you do safely? Haircut, dentist, ride subway, hug grandkids, take vacation. But: mask up, don’t assume perfect protection, test if ill. If older, careful about gatherings. 9/

CDC data suggests vast majority of people who got first dose are getting second dose. Encouraging and surprising. These vaccines astonishingly effective, safe and increasingly available–in US. National and global inequities are unethical and dangerous. politi.co/2MTInEE 10/

Many routes to vaccine efficacy. Interesting data that vectored vaccines (J&J, AZ/Oxford, Sputnik) may give better immunity 1-2 months after vaccination. How long single dose vaccines will last to be determined. Great vaccines, much still to be learned. 11/

How do you solve a Governor like Abbot? (Or others.) If OSHA enforces worker safety standards for private business, business might ask governors to do the right thing and enact or at least not prevent mask mandates. Great CDC data. Science saves lives. bit.ly/2Ort7Py 12/

Cool it public health. Reopening– but avoiding superspreader events–as cases fall and vaccines make Covid much less deadly may be wrong but defensible. Relaxing mask mandates is NOT defensible. The only freedom masks inhibit is freedom of the virus to spread and kill people. 13/

After repeal of Florida's motorcycle helmet law, helmet use dropped from nearly 100% to ~50%; reduction in helmet compliance was at least partially responsible for an increase in motorcycle fatalities. Costs more than doubled, from $21 to $50 million. bit.ly/3c8pndV 14/

What will change as we tame Covid? Less travel. More (but less than now) Zoom. We may never see birthday candles in the same way. The virus adapts. Unless we adapt, it will continue to control us. The more we adapt, the more we can control it. Masks help – who wants flu? 15/

“Throwing out preclearance [mask mandates] when it has worked and is continuing to work to stop discriminatory changes [infections and deaths] is like throwing away your umbrella in a rainstorm because you are not getting wet.”

The Notorious RBG

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