THREAD:

New Poll from @RWJF & @HarvardChanSPH

71% of adults want substantial increases in federal spending to improve the nation’s public health programs.

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2/x

A large majority of the public (72%) believes the activities of public health agencies are extremely or very important to the health of the nation.
3/x

The American public has higher trust in health care professionals than in public health institutions and agencies.

A particularly concerning though not surprising finding is a Particularly low level of trust in the @CDCgov (51%), the @NIH (37%) and the @US_FDA (37%)
4/4

In light of the very high fraction of US adults (71%) feeling we need to increase funding to improve US public health agencies, The above metrics regarding low trust in those agencies means we have a lot of work to do, and the public support to do it.

We should act on it.

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More from @michaelmina_lab

19 May
Now that we are seeing vax'd ppl turn up PCR pos, only now will public health leaders FINALLY understand why #rapidtests have always been the appropriate **public health** test.

When the question is "Am I infectious", PCR is overly sensitive to reliably answer this.
For too long this critical piece has been avoided

Comparing rapid Ag tests to lab PCR made it *look* like rapid tests have low sensitivity...

Real issue is PCR stays pos for wks after ppl are no longer infectious

PCR is badly NOT specific for identifying ppl needing to isolate
Rapid antigen tests are highly sensitive AND specific to be able to answer the question "Am I Infectious"

PCR is highly sensitive but NOT specific for this question. Pretending like it was led to millions of ppl being put in isolation and the wrong ppl quarantined
Read 4 tweets
11 May
Just on w @RTE_PrimeTime about rapid tests

Surprised at lack of trust the government has in the Irish ppl

Instead of supporting access to simple at-home tests to tell if u r infectious, position appears to be to limit access bc they don't trust ppl to handle a negative test

1/
We do not defeat a pandemic without properly engaging & trusting in the public

To actively advocate against an asymptomatic person to be able to access a rapid test that has a very high sensitivity to tell you if you are spreading the virus doesn't make sense.

2/
Similarly to actively want to force symptomatic ppl to NOT have access to at-home tests bc u want ensure they get a much less accessible PCR test isn't good policy. Do we want symptomatic ppl leaving home to get PCR tests?? A rapid test is accessible and fast.

3/
Read 6 tweets
11 May
FAQ: Why is a lab test w a 12-48hr delay not as useful for screening?

Simple

Even super high sensitivity lab tests have 0% sensitivity while awaiting results

So you can be @ peak viral load & superspreading virus and not be detected by a lab test while spreading for 2 days

1/
For evaluating a tests “Effective sensitivity” to help stop transmission, this 0% sensitivity while awaiting results must be taken into account since ppl live their lives while waiting on results

If a test takes 2 days to return it’s effectiveness is already reduced by 33%

2/
So w a 2 day delay, a theoretical 100% sensitivity PCR test may already be maxing out at 67% effective sensitivity to slow spread... which is what we are trying to do w screening test programs.

3/
Read 7 tweets
10 May
This is exactly why we need rapid tests and why they must be done frequently.

Viral load is not static.

At any given time, 2% of ppl carry 90% of the viral load. Who those people are changes day to day as the virus grows and falls inside ppl.

1/x
This is also why lower analytical sensitivity tests, when performed frequently, are MUCH more sensitive than very high sensitivity tests performed infrequently or w slow return of results

If infectious, you will be detected by rapid Ag tests. And that’s what matters.

2/
But if you aren’t testing frequently, you are VERY likely to miss getting a swab in your nose before or when you are at peak infectivity (bc peak is reached VERY fast and diminishes fast).

So a test that takes a long time to return or is infrequent, simply doesn’t help much.

3/
Read 4 tweets
9 May
@President_MU For an advisor to your government - you don’t appear to know what you are talking about @President_MU wrt rapid tests.

The comment adds nothing of benefit and further sows confusion.

You should be ashamed of your demeanor here.
@President_MU .@President_MU

I recognize youve heard things like “50% sensitivity”

In light of your comments it’s clear there are key pieces youve missed

Sensitivity nears 100% to catch potential superspreaders and others currently transmitting, for example.

See 👇
thelancet.com/journals/lance…
@President_MU 50% sensitivity is vs PCR. But as CDC (and hopefully you) know, PCR remains pos long after isolation & contagiousness end

Rapid Ag tests don’t stay positive past the infectious stage.

50% isn’t a lack of sensitivity of Ag... it’s a lack of specificity of PCR for infectiousness
Read 5 tweets
3 May
This is how progress is made:

A new study about to start in UK.

Can rapid tests each morning following contact w a #COVID19 positive individual be used instead of a 14 day quarantine.

I’ve been pushing for this type of study/policy for a year.

gov.uk/government/new…

1/
Why is this important??

Quarantines take a major toll on individuals. Physical and emotional. Most contacts in quarantine never become positive and there are multiple contacts for each positive.

2/
A quarantine of an uninfected individual should be considered with the same concern as false positives - and false positives sure have gotten a LOT of attention. But unlike a false positive, you currently can’t really get a “confirmatory test” to help get out of quarantine.

3/
Read 7 tweets

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