This piece is on point— but also not surprising. Individualism has plagued public health for a long time; it is a byproduct of our society & American culture at large. At the center of this is a *disregard* for equity. This is not new. ⁦…
2/ That an institution like @CDCgov would make statements that refocus on individual responsibility is not surprising. This is a great way to shift blame and accountability to the public and away from the institution. This is the same as the “stay home” rhetoric
3/ The type of messaging referenced here telling individual to take matters into “their own hands”— that speaks to people who view the world through their lens of privilege & view others who aren’t living to their standard as being worthy of blame rather than in need of resources
4/ Doctors know this all too well— it’s the same blame put on patients who are re-hospitalized over & over because they are failed by the public health & social systems; yet, many are still seen as being blameworthy, lazy, exploitative of the system etc

Nothing has changed
5/ The new version of this will be those who are “vaccine hesitant”; those who continue to get infected in workplaces & crowded housing/ poor communities—> they will be blamed, prob by the wealthy/ privileged classes; they will be cast as “the problem” & why we have resurgences
6/ They will continue to disproportionately bear the burden of disease— because pandemics are less biological than they are social. This was always the case, throughout history.

& this will extend to the globe as well— immigrants & foreigners who never got access to vaccines...
7/ Will blamed for introducing disease & variants— they will be cast off as vectors of disease rather than human beings who were deprived life saving vaccines; they will be viewed as threatening the safety of American teenagers when their own country’s health workers are dying
8/ I appreciate @edyong209 for bringing light to this again— but at a point, when history repeats and repeats, we should get real about the immense, deadly privilege shared across American institutions of public health & medicine for whom equity is not a central goal.

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More from @AbraarKaran

24 May
1/ Nice column by @DLeonhardt this morning

Removing barriers for vaxx is our next big task to close inequities

Part of that is information, but I think a bigger part is overcoming pragmatic challenges:
•paid time off to get 💉/recover
•on-site vaxx in workplaces
2/ For the past year, I rarely had any #covid19 patients who worked from home

The inequities of who got sick were baked right into the way our society was already set up

We are seeing vaxx inequity play out the same — being able to get the vaxx is a big privilege (time,$ etc)
3/ While attitudes don’t explain the whole story, there is an interesting reduction in the % of “definitely not” getting 💉 group when you subdivide it into “college grads” v “non-grads” seen across categories

source @KFF /graphics @nytimes
Read 10 tweets
19 May
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…
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

Read 4 tweets
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
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
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:…
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
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

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