Schools will open in weeks in the US with the Delta variant spreading rapidly. What does this mean for kids—especially those under 12 who aren’t eligible for vaccination? How can we keep them safe? These are important questions that require practical, thoughtful answers. 1/thread
The Delta variant is much more transmissible than the original virus and makes up at least 83% of sequenced cases in the US. Although most adults are now fully vaccinated, that’s not the case for adolescents, and kids under 12 can’t be vaccinated yet. 2/
Good news: Most kids who get Covid will have mild or no symptoms, and there’s no evidence that Covid caused by the Delta variant causes more severe illness among kids. 3/
Evidence from multiple contact tracing studies, household transmission studies, and population exposure studies suggests that children are less susceptible to Covid than adults. 4/
As of July 22, 2021, CDC has reported 494 deaths among children under 18 in the US, a small fraction of the millions of reported cases among kids. 5/
But some kids who get Covid do get very ill. Though it is very rare, MIS-C is a serious complication of Covid in children. Available evidence suggests kids can get long Covid too, though possibly not as frequently as adults. We need better data on this. 6/
The risk of death from Covid among kids is very low, but it isn’t zero. That’s why if your kid is 12 or above, it’s important they get vaccinated to protect themselves and people around them. Vaccination is proven safe and effective for adolescents. 7/
Vaccinated family members of unvaccinated kids may err on the side of caution, especially in areas with high rates of Covid: wear a mask in indoor public places, increase ventilation, practice physical distancing, and avoid large gatherings with many unmasked people. 8/
Safety measures work inside the house too: a new study shows kids can spread Covid to people in their households, but—importantly—that safety measures reduce this risk. Especially relevant to unvaccinated adults who spend a lot of time around kids. 9/
The best way to keep all kids safe from Covid is to get as many people vaccinated as possible and to use multiple layers of protection. So what does this mean for schools? 10/
In person schooling is essential. Our kids have suffered enough from missing in-person learning over the past 18 months. It’s possible to open schools safely if we do it carefully, as guidance from @CDCgov, @AmerAcadPeds, and @ResolveTSL has indicated. 11/
All of these safety measures should be implemented: Consistent and correct mask use, increased ventilation of indoor spaces, physical distancing of at least three feet, hand-washing, cleaning of school spaces, quick action to find and stop spread from cases in schools. 12/
For the small number of students and staff with very serious underlying health conditions that suppress immune response or increase vulnerability (e.g. organ transplantation, cystic fibrosis), reasonable accommodations would be...reasonable! 13/
When we know more about risk factors for breakthrough infection after vaccination, we can better target this type of reasonable accommodation. I hope we’ll learn a lot more about risk factors for serious and fatal breakthrough infections in the coming weeks. 14/
Horrifying to see some states block safety measures, such as masks requirements, in schools. Can’t we agree that we should work together to protect our kids? Masks in schools are a route to the new, safer normal as long as Covid is spreading widely. 15/
Measures that protect students also protect teachers and staff. Data shows that teachers aren’t at greater risk of Covid than other essential workers. Getting vaccinated and having strong safety measures in place will keep risk low. 16/
It’s inevitable that cases will emerge. Schools must encourage students and staff to stay home when sick, ensure testing to promptly identify cases, clusters and outbreaks as they emerge, and conduct contact tracing in combination with isolation and quarantine as needed. 17/
Protecting our kids means expanding vaccination, opening schools carefully with layered protection measures for our kids and school staff, and reducing community spread of Covid as much as we can. 18/end of thread, but near beginning of school year

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More from @DrTomFrieden

21 Jul
I’m hearing from vaccinated people who are frightened about breakthrough cases, the Delta variant, and new waves of Covid. But it’s not vaccinated people who should be most concerned. Here’s what I expect to happen over the coming weeks. 1/thread
Globally, we’re far from the end of the pandemic. Delta is at least two times more contagious than the original virus, which means it will infect and kill more people. 2/
Many countries have so far avoided big surges but haven’t had access to the vaccines needed to vaccinate their populations. Many of these countries will likely see explosive spread of Covid over the coming weeks and months. 3/
Read 20 tweets
9 Jul
How big of a threat does the Delta variant pose? New developments show that the challenges we face in controlling Covid are immense. Millions of lives are at stake globally. 1/
It’s now clear that Delta spreads more readily than initial strains of Covid. It’s at least two times as infectious. 2/
Delta may or may not be more deadly on a case-by-case basis, but because there are so many more cases, more people will get very sick, and more will die. 3/
Read 15 tweets
8 Jul
Vaccination gives you higher antibody levels and much stronger protection against Covid than natural infection, according to the best data we have today. If you recovered from Covid but still haven't been vaccinated, you may be vulnerable to reinfection—especially by Delta.
We're still learning about the duration and robustness of different types of immunity, but research suggests that people who've already had Covid are safer when they're vaccinated. Some examples:
In one study, antibody titers in people who received mRNA vaccines were up to 10 times higher than in people who recovered from natural infection.…
Read 7 tweets
2 Jul
Vaccines Stop Cases…If They’re Given

The Delta variant poses a huge threat—but not to vaccinated people. Unvaccinated people are still being hospitalized and killed by Covid, and we’re seeing worrying Delta-fueled outbreaks, particularly in places with low vaccination rates. 1/
Don’t get caught up in fears that Delta is evading vaccine immunity. Our vaccines are working. Evidence has shown that mRNA vaccines provide excellent protection, J&J announced that their vaccine is likely also effective against Delta. 2/
Good news: Getting vaccinated virtually eliminates your risk of being hospitalized or dying from Covid. 3/
Read 11 tweets
21 May
Taming the World’s Leading Killer

An article was published this week that has findings which could save millions of lives. Why did you miss it? Because there was zero media coverage of it. Zero! Tells you something. Tells you a lot, actually. So, here are the details. 1/thread
High blood pressure is the world’s leading killer – and will kill more people, including more young people, than COVID-19 this year. It can be prevented (mostly by lowering sodium) & treated, but, globally, only 1 in 10 people with high blood pressure have it controlled. 2/
Elegant studies by @SarahLewington2 prove for every 20-point increase in blood pressure, the death rate from cardiovascular disease DOUBLES. What’s more, this starts at a blood pressure of 115/75 – way below the usual level at which we treat, or toward which we aim treatment. 3/
Read 14 tweets
18 May
Estimated excess mortality during the pandemic far outstripped officially reported Covid deaths in most countries. However, many countries, and in particular low- and middle- income countries, don’t estimate excess deaths 1/
Statistical modelling by @TheEconomist suggests the Covid death toll is between 7.1m and 12.7m. That means the official death toll represents, at best, about half the true toll and, at worst, a quarter of it. 2/
Most uncounted Covid deaths occurred in LMICs. In OECD countries, the true death toll was estimated to be 1.2 times the official number; in parts of Africa, it was estimated to be 14 times the official number. 3/
Read 4 tweets

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