Tweet

Jeffrey Duchin, MD

14 May, 13 tweets, 4 min read

1/ A few thoughts on CDC’s new mask guidance, vaccination & CoV-19 risk.

Vaccinated people have a VERY high level of protection vs CoV-19 compared to unvaccinated with a MUCH LOWER chance of getting sick if exposed or spreading CoV-19 to others.

2/ When unvaccinated people gather indoors, they are at risk of both getting CoV-19 themselves as well as spreading it to others, especially if masks are not worn.

3/ CDC recommends vaccinated people no longer need to wear masks for most activities indoors or out, while unvaccinated people should continue to do so, especially indoors.

However, it’s not easy to know who is/is not vaccinated in public spaces!

4/ If unvaccinated people don't wear masks indoors, expect CoV-19 spread may increase. And, because no vaccine is 100% effective, when more CoV-19 is spreading in the community among unvaccinated, the risk of being exposed and infected is higher for everyone.

5/ At higher community CoV-19 rates, more infections occur than when rates are low, including in some vaccinated people even though their relative protection remains high & and most infections will be mild. This is why getting CoV-19 rates as low as possible is important for all.

6/ In King Co as of 5/12/21, we have 71% of people 16 yrs & older with 1 or more doses & 53% with completed series, but coverage rates vary significantly by age, race, ethnicity and geography. Would be best to have higher degree of vaccination & protection for all groups.

7/ King Co has a high level of CoV-19 (>200/100K/14d) currently, w/ highest rates in unvaccinated, young-middle aged adults & teens, in S & SE King Co, & among Native Hawaiian/Pacific Islander, Hispanic, Black, & Native American/Alaska Native communities.
kingcounty.gov/depts/health/c…

8/ When considering whether to wear a mask indoors in public spaces, understanding your risk based on local CoV-19 activity can help you make a decision based on your personal risk tolerance.

9/ Other things that increase risk are crowded indoor spaces with unvaccinated people, poor ventilation, & indoor activities among unvaccinated people that can increase the amount of virus in the air such as singing, shouting & aerobic exercise.

10/ Steps to improve ventilation & air quality are especially important now to reduce the risk in all indoor settings for workers, customers & the public.
kingcounty.gov/depts/health/c…

11/ Everyone should continue to wear a well-fitted mask in correctional facilities, homeless shelters, schools, public transportation, long-term care, and hospital settings and adhere to workplace guidance.

12/ Vaccinated people w/ weakened immune systems & all who want to reduce their risk to the greatest extent possible, even for mild infection, should consider continuing to wear masks indoors when around unvaccinated people, esp. where local CoV-19 activity is at high levels.

13/13 The more of us that are vaccinated, the more effectively we will decrease the risk from CoV-19 long term & the more protection we all will have.

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More from @DocJeffD

Jeffrey Duchin, MD

@DocJeffD

12 Apr

1/ What does remaining in Phase 3 of the Governor’s Healthy Washington Roadmap to Recovery mean for King County?

⚠️ Don’t let your guard down! ⚠️ This is definitely not an “all clear” signal. We don’t stop wearing seatbelts just because we haven’t had a crash recently...

2/ We are MUCH closer to putting the worst of the pandemic behind us, but not quite out of danger yet. The potential for a severe surge in cases & hospitalizations remains real until more of us are vaccinated.

3/ For the time being, we all need to continue taking COVID-19 precautions seriously. This will protect us, our family members, friends, co-workers, our community & our economy as vaccinations increase.

Read 8 tweets

Jeffrey Duchin, MD

@DocJeffD

22 Feb

Why are COVID-19 cases falling and what does it tell us about where the pandemic is heading? A few thoughts:
1/

Factors contributing to recent surge(s) are decreasing. These include holiday travel/get togethers, more activities & socializing, & general increase in indoor time during fall & winter that facilitate CoV-19 transmission through airborne spread & effects of low humidity. 2/

Restrictions on indoor and other activities (Governor’s directives in WA state: travel advisory, mask use, distancing) work and helped decreased spread. 3/

Read 20 tweets

Jeffrey Duchin, MD

@DocJeffD

29 Jan

With more dangerous CoV-19 variants, we must improve CoV-19 prevention in all aspects of our lives, incl. mask quality & fit, limiting time w/others, avoiding crowded indoor spaces, increasing distance from others, & getting vaccinated when it’s your turn. On masks: 1/

Cloth masks are recommended by CDC for use by the public. Cloth face masks were initially recommended to prevent someone w/CoV-19 from spreading the virus to others. This is especially important because people can spread the infection to others before they appear or feel ill. 2/

Recent studies suggest cloth face masks can also provide protection to the wearer. How well it protects depends on how well it's made & fits (e.g. the type & # layers of fabric). At this time, CDC only recommends N95 masks & surgical masks for health care workers (HCW) 3/

Read 17 tweets

Jeffrey Duchin, MD

@DocJeffD

12 Jan

In 2010, I noted lessons from the 2009 H1N1 influenza pandemic, incl. epi/surveillance, healthcare system response, communication, mitigation strategies, & the vaccination program. Regrettably, most are just as relevant today, many opportunities missed. 1/
nap.edu/read/12799/cha…

In 2010, I described racial & ethnic disparities, inadequate public health resources/funding; value of enhanced surveillance methods; hospital overload & PPE shortages; drug distribution problems & perhaps most noteworthy at the moment, challenges w/ the vaccination program. 2/

A few key points on vaccination follow. "The need to rapidly plan and implement a large-scale vaccine distribution & administration system severely taxed local public health capacity..." 3/

Read 11 tweets

Jeffrey Duchin, MD

@DocJeffD

10 Jan

What went wrong in SoCal? "Part of the reason for the new surge appears to be the Thanksgiving effect. Many Californians, particularly those in & near LA, held small gatherings for Thanksgiving with family & friends, despite warnings from officials." 1/ nytimes.com/2021/01/09/us/…

"...the state’s early success in the pandemic may have given Californians a false sense of security...The very successes that we had built in a potential complacency from the part of people thinking it’s maybe not that severe.” 2/

"Young people who had isolated themselves gathered in large groups & stretched the limits of what constituted outdoor dining to include rooms with large windows. The taboos of the first months of the pandemic, like meeting friends inside their homes, fell away." 3/

Read 4 tweets

Jeffrey Duchin, MD

@DocJeffD

3 Jan

Straight Talk About the New Variant COVID-19 Strain. As much as I regret saying it just when so many need & deserve a break, the new variant COVID-19 strain is a serious problem. It’s likely a matter of time before it arrives here & we need to beware & prepare. Here’s why. 1/

All viruses mutate resulting in new strains that vary from their ancestors. These are called variant strains. Most coronavirus mutations don’t fundamentally change how the virus behaves or affects us. 2/

However, at least one newly recognized strain, often called B.1.1.7., “SARS-CoV-2 VOC 202012/01” or an "N501Y" strain, has been shown to have multiple mutations that are changing the way the virus behaves in important ways. 3/

Read 21 tweets

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