Indoor shared spaces, esp crowded ones w/ poor ventilation, are highest risk for transmission
Public health is local first; measures must be taken at the local level to stay ahead of larger surges
3/ Vaccinated individuals have a significantly lower chance of severe disease, hospitalization, or death.
They also have a lower risk of transmitting too. Get vaccinated.
But bigger point here is the large # of *unvaccinated*/partially vax- in LA County, over 5 million people
4/ Of course other variables here- incl that some unvaccinated here already have been infected/ hopefully have immunity, although still unclear to what extent now, months later
After what the county has been through, re-instituting indoor public masks is a low-hanging fruit
5/ As infectious disease doctors, we are still seeing cases; we see them now primarily among unvaccinated; some among vaccinated although usually w/ immunocompromising conditions.
The pandemic never ended for some people. Doctors, nurses, but most of all- patients. #covid19
Noting discrepancy here b/w CA DPH/ LA Times data saying 52% fully vaxx v LAC DPH saying 61% (on their website)
The rapid spread of new variants is a *symptom* of a deeper issue. We can continue to try & protect ourselves against variants--talking third doses in rich countries--OR, we can address one of the biggest underlying drivers: most of the world having little access to vaccines.
2/ I'm frankly disappointed- because 'global solidarity' has once again proven to be all talk.
Go to any global vaccine tracker website right now and look at the countries that are at the bottom. Are you surprised? I am not.
3/ We have to acknowledge that our global power structures are ones that even before #covid19 existed to propagate inequities; they exist to extract resources from impoverished places; they exist at the expense of entire populations who are now facing dangerous variants w/o vaxx
Another new study worth looking into-- Delta variant #covid19 outbreak in a London nursing home.
Many residents/staff were <14 days since receiving dose 2 of Astra Zeneca vaccine; secondary attack rate among partially vaxx residents was 81.3% (13/16)
2/ Table 1 has a break down by demographics and vaccination status
Unique situation here as most residents/staff were getting dose 2 right when the index case was diagnosed with #covid19
3/ Reassuring- hospitalization uncommon; no deaths here. And this was among a care home population where we know #covid19 has caused immense suffering/death this past year.
Index case here was described as getting dose 1 in January, but unclear whether they ever got dose 2.
2/ Some have commented previously on reasons that mRNA vaccines may be preferable to the J&J vaccine esp during non-surges; but at a population level, vaccines with ease of storage & single dose would be preferable in hard to reach groups
3/ The variable of interest here is vaccine efficacy against variants like Delta; two dose mRNA regimens seem to still hold up against this variant (unless there’s newer data I haven’t seen); I still have to take a closer look at J&J & Novavax results against Delta
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. @edyong209 theatlantic.com/health/archive…
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
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