Thread by @MonicaGandhi9

I am interested in increasing trust in public health. 4 things we can address now to increase that trust:
1) Natural immunity: Real, don't know duration of immunity from either route; 1 dose only? Acknowledge natural immunity, our knowledge limits

https://twitter.com/monicagandhi9/status/1378768089601298434?lang=en

2) Vax in kids: Acknowledge that adult vax massively reducing community transmission in US, kids less at risk of getting sick. Acknowledge risks vs benefits of vax in kids under study. 1 dose, lower dose to reduce risk of myocarditis? If low rates, can kids have normal life?

3) PCR test: Acknowledge limits of PCR especially after vax. PCR picks up "dead virus" or low virus in nose because very sensitive (can tell if must cycle the machine a lot; CT >30 is low viral load). Don't isolate someone with high CT (use Ag; no asymptomatic testing after vax)

4) Acknowledge collateral damage: Poor have lost jobs; kids have been out of school & had mental health effects; loneliness & isolation of pandemic Will not hurt efforts to control virus to acknowledge this pain & work to address, normalize as many settings as possible when safe

Here is thread explaining why not to test asymptomatic individuals after vaccination:

https://twitter.com/MonicaGandhi9/status/1395572466949365761

& here is NYT article explaining reasoning why normal school need not be linked to child vax status while trials in young kids ongoing & while we try to figure out how to maximize safety of vax for 12-15 year olds (1 dose? reduced dose? increase spacing?)
nytimes.com/2021/06/08/opi…

And here is article with @LeslieBienen & @JeanneNoble18 explaining why it is okay to acknowledge risks vs benefits of our lockdown procedures &, with adult vax & lower rates, ok to turn our thoughts to minimizing collateral damage
wsj.com/articles/the-p…

And here is article relevant to first point regarding immunity - what we know about natural vs vaccine-induced from immunologic research.
leaps.org/booster-shot/

And here is thread explaining why variants unlikely to be able to evade T cell immunity. With 52 (lowest) to 87 to 100s of T cells lining up across spike protein, hard to evade T cell immunity even with 13 mutations of delta variant

https://twitter.com/MonicaGandhi9/status/1373506320154849282

So, 4 points to help increase trust in public health: 1) Discuss natural immunity; 2) Discuss risks vs benefits of vax in kids; we want to vax children but keep safety paramount with lower risk; 3) PCR, testing limitations before & after vax; 4) Collateral damage to vulnerable

This is my final tweet of this thread. I have been wondering if Infectious Diseases doctors who see patients should have larger role to play in response as this is an infection & we study 2) virology; 2) immunology; 3) impacts on patients because we see them; 4) #harmreduction