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
4/ Is this who we in wealthy countries are? Have we learned nothing? We are talking about the #Delta variant in terms of how we can protect ourselves; while paying little attention to how many of the key #covid19 variants emerged, and from where, and *why*
5/ The media coverage in the US is part of the problem; our coverage, relatively speaking, fails to dive into the deeper structural problems behind global inequity & what role wealthy countries like USA have played in it.
Instead, they fear monger around variants spreading here

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More from @AbraarKaran

17 Jul
Our op-ed summarizing the findings of our recent study in CID @IDSAInfo from @BrighamWomens looking at risk of #SARSCoV2 transmission from index cases to their hospital roommates. ~40% secondary attack rate; and beds are 7 feet apart w/ curtain in between

medpagetoday.com/opinion/second… Image
2/ We felt that short-range aerosol transmission most likely explains our key finding. Better ventilation & #betterMasks are essential in addition to vaccine rollout.

Cc @kprather88 @j_g_allen @linseymarr @DFisman @carlzimmer @jljcolorado @RanuDhillon @sri_srikrishna @zeynep
3/ Important to note that over several months, the incidence of roommate transmission was exceptionally low- 0.1%; the key takeaway is that IF you end up roomed w/ someone that has a #covid19 infection w/ a low CT value (high viral load, infectious)- very high risk of spread.
Read 4 tweets
15 Jul
Los Angeles County to mandate indoor masking in public spaces, regardless of vaccination status

Only 52% of residents in the county are fully vaccinated

261% increase in new daily #covid19 cases compared to two weeks ago, driven by Delta variant

latimes.com/california/sto…
2/ 1,537 additional new cases reported Thursday

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
Read 6 tweets
12 Jul
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)

eurosurveillance.org/content/10.280… Image
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.
Read 6 tweets
11 Jul
1/ New CDC report on #covid19 outbreak caused by Delta variant in Oklahoma gym, causing 47 cases.

Notably- over 90% of cases were among *unvaccinated or partially vaccinated* people.

Very high household secondary attack rate (53%)

cdc.gov/mmwr/volumes/7…
2/ Risk factors here:
-larger groups
-inconsistent mask use
-poor ventilation
-low vaccination rates

#covid19
Read 7 tweets
28 Jun
As #covid19 variants spread— the basics of how the virus transmits, & how to protect ourselves remains largely the same

Unfortunately, these basics/essentials are largely out of reach in many countries; &, this is exactly what many expected would happen.

nytimes.com/2021/03/03/opi…
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

blogs.jwatch.org/hiv-id-observa…
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
Read 5 tweets
9 Jun
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. ⁦@edyong209theatlantic.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
Read 9 tweets

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