I welcome a more nuanced assessment, but @GaDPH Jan. suspension of an Elbert County provider for vaccinating teachers sent a clear message: local authorities must follow the will of @GovKemp, even as top-down control slows local decision making.

Short 🧵

dph.georgia.gov/press-releases…
The suspension was recently relaxed, see @AJC:

ajc.com/education/ga-s…
But, what is the incentive to move faster to help a local community from an informed, public health perspective when @GADPH will penalize/suspend a center:

dph.georgia.gov/document/docum…
Top-line warning via @GaDPH

"At the discretion of the Commissioner, DPH may assess penalties and/or require corrective action for the
following:

• Administering COVID-19 vaccine to recipients outside of the current phase, as those phases are
identified on DPH’s website."

!!!
So, providers are on notice that moving out of phase is not allowed and will be penalized.

Raising questions of the extent to which absence of bottom-up discretion is one of the underlying drivers of state's lowest-ranked vaccination delivery program.

/end 🧵

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More from @joshuasweitz

17 Feb
Am concerned that implicit use of uninformed priors has severely limited pandemic responses:

(i) Inaction is favored over action.

(ii) Information void is soon filled by misinformation.

From masks to immunity to vaccines; let's not keep making the same class of mistake. 🧵
Ex 1: No evidence of being airborne, despite this being a respiratory illness.

Just because airborne spread wasn't fully vetted does not mean it wasn't likely. Mask use delays are a consequence of remaining 'uninformed' about routes despite many examples (choir/etc.).
Ex 2: No evidence of protection from reinfection, despite the nearly universal absence of reinfections.

Without looking to SARS-1/MERS, then proactive steps to leverage and expand sero testing and interventions were missed (including surveys for missed infections).
Read 8 tweets
15 Feb
Hard to reconcile aspired branding with institutional values expressed through budgets, see Governor proposal that "the Department of Public Health would receive $7 million less in total state funds" when comparing FY22 to FY21 (see @GaBudget analysis)

gbpi.org/overview-of-ge…
For thoughtful analysis of this issue (and many others), see @AmberSchmidtke Daily Digest, in particular, the concern on @GaDPH funding from Jan 20:

amberschmidtkephd.substack.com/p/the-daily-di… Image
Via @AmberSchmidtke

"Instead, the Commissioner’s presentation indicated that the state’s pandemic response in its entirety would be funded solely by federal dollars. It signals that this pandemic is not Georgia’s problem and public health more broadly is not Georgia’s problem."
Read 4 tweets
1 Feb
Announcing: brief report for Fall 2020 intervention surveillance @GeorgiaTech represents the work of many, released to help inform, guide, and improve efforts to use viral testing as part of integrative mitigation.

A thread follows...

medrxiv.org/content/10.110…
Key messages:

Viral testing can mitigate outbreaks, when used at scale.

Expect outbreaks to be heterogeneous (both 'good' and 'bad' news with respect to control).

Passive testing is not enough, we recommend using infectious data to reinforce testing/control.

...
Key metapoint: models helped inform the scale and frequency of testing, but the point of intervention was not to score theoretical points (e.g., post-hoc matching of models and data don't help stop cases here and now).

...
Read 22 tweets
16 Jul 20
This thread is on #Covid19, heterogeneity, herd immunity, and the roots of SIR models; why mathematical choices we often take for granted have profound effects on interpreting unfolding epidemics.

@arxiv manuscript: arxiv.org/abs/2005.04704
Code: github.com/aapeterson/pow…

1/n
Key take-away: our mathematical analysis of the *joint* dynamics of heterogeneity and infection reveals that the force of infection can reduce to a simple form: I x S x S (or variants thereof) rather than I x S.
This nonlinear change in epidemic models may have significant consequences to long-term predictions and lead to super-slowing down of epidemics (including reduced herd immunity thresholds).
Read 23 tweets
14 Jun 20
A challenge for college/university re-opening plans.

Assume there are approximately the same # of circulating cases in August as there are now, a reasonable assumption given plateaus.

If so, how many expected positive #COVID19 cases will there be when classes begin?

A thread
First, although answers differ by state, let's start with a national metric... ~270K cases in the past 14 days reported via @COVID19Tracking, which given 10:1 under-reporting could mean 2.7M new cases in the past 2 weeks (or more).
Not all will be infectious at the same period, so we might get to ~1M active circulating case (conservatively, assuming 4-5 days of typical infectiousness).

Answers will vary based on geographic and socioeconomic profile of students.
Read 15 tweets
1 May 20
One more COVID-19 related modeling update for the week; this time more conceptual in scope, but something that has been on my mind for weeks: peaks - whether they are ahead of us, behind us, or whether they here at all.
To start -- a perusal of any number of sites suggests that fatalities have gone up rapidly in many places, but then have lingered, via plateaus and long shoulders, here is a subset of country-curves from @FT

ft.com/coronavirus-la…
The y-axis is key insofar that large impacts of #COVID19 with over 200,000 reported global fatalities still means that the vast majority of individuals remain susceptible.
Read 16 tweets

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