2/ And yet, half-way across the world-- I am in contact with my relatives in India daily. My cousin, uncle, and aunt all were sick with the virus. We tried to manage my uncle at home for days; eventually got him a hospital bed.
We will continue to see this dichotomy globally.
3/ While it may feel like we are out of the woods here, the surges in South Asia are reminders that inequity- primarily but not solely vaccination inequity- will haunt us all.
#Covid19 will be an endemic disease; unvaccinated places will likely suffer epidemic surges.
4/ Vaccinated places will likely need to administer booster shots, possibly annually. The benefits of masking on reduction of not only #covid19 but also influenza & other respiratory viruses suggests that we will be seeing more of this- whether mandated or not- later this year.
• • •
Missing some Tweet in this thread? You can try to
force a refresh
2/ no mandated mask use*; and says many did not wear a mask; after this outbreak, the article reports that Hong Kong mandated mask use in exercise facilities.
Again- March 2021; but, with low vaccination rates, the epidemic will continue to spread.
3/ It seems from the report that many of these patients were younger/healthy (average age 38); none were reported to have any severe outcomes and a number were asymptomatic.
Big takeaway: large susceptible unmasked/unvaxxed populations are still vulnerable
1/ Three Cs from Japan- avoid crowds, prolonged close contact, & closed spaces (poor ventilation)
These fundamental principles must be the core of reducing transmission during #covid19 surges in large unvaccinated populations
Adhering to these requires serious social supports
2/ There will still be a number of essential activities that must be done for survival.
The safest way to do these is with the best personal protective equipment available: namely, high filtration masks, whether N95 or reusable eN95 respirators, or equivalents KF94, KN95, FFP2
3/ Beyond these, rapid at-home POC diagnostics (cc @RanuDhillon@sri_srikrishna) at scale could be key; ideally, these should be available universally before surges happen--> these can quickly remove highly-infectious people from the pool daily before they become superspreaders
2/ @zeynep - one of the best pieces you’ve written on this IMO. & some of the best in infection prevention- the team I am researching & writing w/ now from Brigham & Women’s similarly have shifted toward short range aerosols likely being dominant mode of transmission. Big shift
3/ From perspective of @RanuDhillon@sri_srikrishna and myself- we focused on the worst case scenario as it related to precautionary principle & PPE which is where #bettermasks came from
& we were criticized first by academics who held on to dogma of droplets as rationale
2/ This is the reality of trade offs. No one said there were going to be easy decisions. And with limited vaccine supply, & monopolization of that supply— these are the moral dilemmas that the world must grapple with. Extremely low risk children here v high risk adults elsewhere
3/ Yes, there are high risk kids here & they should be vaccinated. Yes, global vaccine monopolies are not the fault of American parents- no one is saying they are. Nonetheless, vaccine inequity is real. And it’s going to cost us all big time. #covid19
2/ With high-grade mask protection, you can functionally stop transmission both ways. This means that if you’re infected, you can stop spreading to others; and if you’re not yet infected, you can be better protected while doing daily essential activities that can’t be stopped
3/ this is of course with the goal of getting vaccinated; but as is known, immunity post-vaccination is not immediate; during a surge like the one in India, better PPE is the most immediate solution
1/ One of the biggest reasons why we had been pushing for #BetterMasks was because when you have a catastrophic surge like we are seeing in India-- you need the best personal protection you can get, *immediately* #covid19
2/ This was *always* about staying prepared.
Yes, we will have government leadership to blame. Yes, we need support from the state. Yes, epidemics are complex social, man-made disasters.
But at the end of it, if you can't breathe and you can't access a hospital bed- that's it.
3/ I'm a physician. Even now, in Boston, I have sent #covid19 patients to the ICU.
Every physician remembers the surges here. Every doctor and nurse knows what it is like to be at the bedside during times like this.
Watching videos out of India are frankly triggering for many