Wonderful article that puts 3 feet vs 6 feet issue to rest in schools (e.g. 3 ft fine for distancing if teachers not vaccinated, then likely less). WHO recommends 1 meter for distancing (3.28 ft), rumor is we miscalculated that to 6 feet! Study from MA academic.oup.com/cid/advance-ar…
that looked at public schools in the state that opened with any in-person learning in fall 2020. Data was from publicly available district infection control plans & variables of interest were school model type (full in-person or hybrid), physical distancing of ≥3 versus ≥6 ft,
masking policies, ventilation upgrades if done and (sigh) disinfection protocols even though this is spread by respiratory route and not surfaces. Because of practicality in public schools, minimum of ≥3 feet of distancing often put into infection control plans. SARS-CoV-2
positivity examined 9/24/20-1/27/2021 from school data; community incidence rates also known. Among 251 eligible school districts, 537,336 students & 99,390 staff attended in-person instruction during the 16-week study period. Student case rates with spacing of 3 vs 6 ft similar
even when adjusting for community incidence. Same with staff case rates. So, ≥3 feet distance can be easily adopted in public schools now if there is any remaining barrier there (≥ 6 ft not required) after this excellent study in this top ID journal. Write your city/state DPHs
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Still working on recording but highlights we all agreed upon
-@DrOnyemaOgbuagu and I agreed how amazing it was to work in a hospital as ID doctors and to see the plunging hospitalization rates from #covid19 (we had 1 admission last week) in real-time from vaccines
-We agreed with
@EricTopol on his coined term of "scariants" for variants and were reassured by falling numbers in S. Africa, despite the scary variant.
-We reviewed the accumulating data of viruses reducing asymptomatic infection and @DrOnyemaOgbuagu and I agreed the CID paper I tweeted this am
Taking break from @CROI to tell you one thing from @CROI regarding COVID-19 medication (since tweeting for me is only for COVID-19 and can't WAIT until this is over, which is soon). Med is molnupiravir and is general antiviral (makes virus mutate; btw, medscape.com/viewarticle/94…
viruses cannot mutate too much or they mutate themselves out of fitness; a key point when you worry about variants). In this phase 2a RCT, 202 adults with outpatient SARS-CoV-2 randomized (not 1:1:1 though) to 200 mg, 400 mg; or 800 mg of molnupiravir. Pill twice daily x 5 days
and then followed x 28 days with PCR swabbing at 3, 5, 7, 14, and 28, with sequencing and culture. 182 had swabs that could be evaluated, of which 78 had infection at baseline. By day 3, 28% of patients in the placebo arm had SARS-CoV-2 in their nasopharynx, compared to 20.4% of
Can't imagine a more pressing issue of the day as to get schools open full-time for children. This op-ed I wrote with the excellent @TracyBethHoeg and @doctortara stresses that the CDC misinterpreted their own MMWR-published study on WI schools in guidance usatoday.com/story/opinion/…
Four points: 1) Children are not at significant risk of poor outcomes from COVID-19. As of March 3, 2021, 286 children have died from COVID in the U.S. (similar to number who die of influenza) compared to >520,000 adults. MIS-C rare, treatable 2) Viral spread in schools
with appropriate mitigation rare. Dr. Hoeg led study of > 4,876 grade K-12 students & 654 staff members in Wisconsin school districts in the fall of 2020 during time of high community prevalence (up to 41.6% in the community). during the study. Despite majority of ventilation
How long will immunity from COVID-19 vaccine last? Let's remember from papers tweeted before, immunity from natural infection & vaccinations across viruses lasts long. Remember: survivors of 1918 flu: memory B cells can stimulate Abs to fight same strain nature.com/articles/natur…
Then immunity from pertussis, measles vaccinations lasts long long time - look at those T-cells (CD4 and CD8) from measles vaccination continue strong, measured out to 34 years after vaccination ncbi.nlm.nih.gov/pmc/articles/P…
Then let's turn to the RNA viruses that are coronaviruses (influenza, measles both RNA viruses too). There are coronaviruses that cause colds (229E, NL63, OC43, HKU1) for instance & coronaviruses (SARS-CoV-1, MERS) that - like SARS-CoV-2 cause more severe symptoms. Behooves us to
hi - will be posting thread on how long immunity should last to vaccine later today & then off twitter x 3 days due to huge HIV meeting! But wanted to make one plea to #covid19 experts. It behooves us to look at vaccine clinical trial data carefully and memorize every detail. BUT
let's incorporate data from real-world roll-out that is coming in droves when we discuss the vaccines on 2 points: 1) Transmission: Already tweeted all those papers/analyses from real-world (NEJM, Lancet no slouches!) that asymptomatic infection reduced after vaccines.
2) Real-world data since trials has shown repeatedly that severe disease/deaths plummeting in populations who are vaccinated. So, if one is concerned about sample sizes in the clinical trials for a secondary outcome, incorporate that data!
I see new debate is going to be whether the fact that the severe disease outcomes from #COVID19 occurred in the placebo arms (not vaccine) is notable or not, including biostatisticians on secondary outcomes & powering. You may see a bent on here from #MDs who are very happy
about this as they are the ones who worked in the hospital this year. But let's actually discuss for a minute why rolling out a vaccine in the middle of a pandemic is SO different than previous pandemics. You see on timeline above that 1st flu vaccine was introduced in 1936
18 years after the influenza pandemic. Vaccine not rolled out smack-dab in midst of pandemic before this! And look what is happening in UK with such fast roll-out of 2 mRNA vaccines AND an adenovirus/DNA vaccine (AstraZeneca) that also (like J&J) doesn't have the same efficacy