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19 May, 4 tweets, 2 min read
New from CDC EID-->

Large #SARSCoV2 outbreak at fitness center in Hong Kong, March 2021

~300 tested w/ 102 cases confirmed

All unvaccinated

No mask use

Poor ventilation

wwwnc.cdc.gov/eid/article/27…
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

#covid19
4/ I understand that these younger/healthy people 'did fine'--> but the concern is that these types of super spreading events can spiral into larger outbreaks when there are many susceptible hosts around.

This is why vaccine equity is so critical.

#covid19

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More from @AbraarKaran

Abraar Karan Profile picture
19 May
Just walked down the sidewalk in Boston where summer has undoubtedly arrived.

Two folks walked out from my apartment building w/ their masks on; both pulled them off once they were outside.

Times are changing. #covid19
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.
Read 4 tweets
Abraar Karan Profile picture
8 May
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
Read 11 tweets
Abraar Karan Profile picture
7 May
The whole time I was reading this piece, this was the thought that was on my mind — & then @zeynep literally had it written out right here:

nytimes.com/2021/05/07/opi…
#covid19
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
Read 7 tweets
Abraar Karan Profile picture
4 May
FDA is getting ready to clear Pfizer vaccinations for children in the US.

High risk unvaccinated adults are dying in surges in India.

This is not what equity looks like. #covid19
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
Read 4 tweets
Abraar Karan Profile picture
2 May
1/ In speaking with multiple NGOs on the ground in India just this morning:

“the government has abandoned us”

The capacity to quickly scale up high grade surgical + N95 masks is there; why isn’t it being utilized?

#IndiaCovidCrisis #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
Read 5 tweets
Abraar Karan Profile picture
24 Apr
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
Read 8 tweets

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