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Céline Gounder, MD, ScM, FIDSA Profile picture
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11 Apr, 4 tweets, 1 min read
1/ Michigan is facing a surge in COVID cases due to
- the more infectious & virulent B.1.1.7 variant
- less masking, more indoor gatherings
- travel
Young adults hospitalized for severe COVID.
nytimes.com/2021/04/10/us/…
2/ But I'm not sure that surging vaccine supply to Michigan will help now.

People are misapplying the concept of ring vaccination, an important tool in smallpox eradication, to COVID.
3/ There's value in giving smallpox vaccination even AFTER exposure.

But the median incubation period for smallpox is 10-14 days.

The median incubation period for COVID is 4-5 days.
4/ It takes 14 days after vaccination before someone's immune to COVID.

We won't be able to vaccinate and get people immune quickly enough to flatten the COVID curve in Michigan.

Our best tools right now are masking, sticking to household bubbles, and socializing outdoors.

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More from @celinegounder

Céline Gounder, MD, ScM, FIDSA Profile picture
13 Apr
1/ Agree with @CDCDirector @RWalensky and former CDC Director @DrTomFrieden. You can't vaccinate yourself out of a COVID surge. Vaccination works well to PREVENT a surge.
nytimes.com/2021/04/12/us/… Image
2/ Can we predict where the next surge will be? It may be too late for Minnesota, Illinois, too. Should we send more vaxx to the NE, where transmission is also up? If there's a seasonality or geography to this, will the southern states be next (like last summer)?
3/ Unless we can predict and get ahead of a surge, it doesn't make sense to reallocate vaccine supply.
Read 4 tweets
Céline Gounder, MD, ScM, FIDSA Profile picture
8 Apr
1/ To delay 2nd doses of the Pfizer and Moderna COVID vaccines (like the UK, Germany, & Canada)?
usatoday.com/story/opinion/…
Or not to delay?
thinkglobalhealth.org/article/dont-b…
That is the question.
2/ Where there is this much disagreement among experts (BTW, some arguing for delaying 2nd doses are some of my favorite people!) and the stakes are this high, not only for individuals but also for populations, the only way to resolve the question is through empirical study.
3/ Agreed, though I think deaths will be blunted by our having vaccinated many of the highest risk (i.e. residents of long-term care facilities and people 65 and older).
Read 50 tweets
Céline Gounder, MD, ScM, FIDSA Profile picture
2 Apr
1/ And... I'm back off the fence.
One dose of Pfizer vaccine useless against B.1.351 and significantly less effective against B.1.1.7.
Two doses of Pfizer vs B.1.351 better.
pubmed.ncbi.nlm.nih.gov/33772244/
2/ I think I am more worried about B.1.351, P.1, and vaccine-evading variants.
3/ I think we have enough vaccine supply in the U.S. right now. 205M doses delivered and almost 158M doses administered. Delaying for 2nd doses is solving for the wrong problem if you're trying to speed up vaccination and get more of the population covered.
Read 4 tweets
Céline Gounder, MD, ScM, FIDSA Profile picture
2 Apr
1/ To be clear... I've only moved from being firmly against delaying 2nd doses to reconsidering / being on the fence.
statnews.com/2021/04/02/dem… -@levfacher
2/ As a scientist, I think it's really important to reevaluate your conclusions as more data comes in.

Models help us think through and weigh different scenarios, but are not the same as empirical evidence.
3/ This model finds that the strength of vaccine neutralizing antibody responses may be less critical than slowing the rate of viral transmission in preventing the emergence of mutant variants.
nature.com/articles/s4157…
Read 7 tweets
Céline Gounder, MD, ScM, FIDSA Profile picture
1 Apr
1/ My father came to the US from India in 1972. He changed his last name to his caste name because it was easier for Americans to pronounce. And yet, Americans still find a way to get it wrong... throwing in extra letters, etc. Names matter. They’re us. newyorker.com/culture/person…
2/ We shouldn't have to change our names because other people can't be bothered to learn how to pronounce our names or to "avoid the shame of the American gaze." We can't let people ruin our names for us.
3/ "My earliest memories of school include the tension of roll call, when I would try to volunteer my name to stop the teacher from attempting a pronunciation."

💯 identify with this experience.
Read 5 tweets
Céline Gounder, MD, ScM, FIDSA Profile picture
29 Mar
1/ In the aftermath of the Parkland shooting, my team at justhumanproductions.org and I produced season 3 of the @AmericanDxFM podcast: 36-episodes on gun violence in America.

Here are some important lessons that the media seems still not to have learned:
2/ We spend too much time focused on the shooter and not enough on the victims. Shooters want notoriety. We should never name them. justhumanproductions.org/podcasts/e25-g…
3/ The media focuses too much on the perpetrator's motive and not enough on evidence-based solutions.
nytimes.com/2021/03/27/bus…
Read 8 tweets

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