2/ In 2021 delta it was only 3.7 days (vs 5.6 days for 2020 outbreak).
This would have an impact on a key transmission dynamic factor we often look for: "serial interval periods" (time between symptom onset for index case vs subsequent case in a contact tracing investigation)
3/ What you are trying to estimate from observable symptom intervals is underlying mean generation time.
tangent: If you find negative serial intervals as in COVID, it's a sign of asymptomatic and presymptomatic spread.
4/ (A household transmission study in Singapore didn't find a difference between delta and wild type covid strains, but was so teeny in sample size that I don't think it really counts as evidence one way or another)
5/ Here's the quiz.
If Delta's incubation period is 34% shorter, and cycles through faster from generation to generation, what would that mean for our estimates of R0?
6/ A plurality of us (34%) got the right answer- If generation time is faster, than means that a lower Ro would explain the growth dynamics
It might seem like a distinction without a difference but it means that a smaller change in behavior (or vaccinations) would reverse trends
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TY @bijans for spotting the "full pdf" download button.
3/ what do we learn?
The mysterious "other data" for high viral load in breakthrough cases came from a 4th of July outbreak in Provincetown (Barnstable, Mass) where the “vast majority” of the new cases were among fully vaccinated individuals
2/ MACRA was a true milestone, and a concept that I still support- instead of artificially capping medical inflation (and then not having the guts to actually see doc pay cuts) lets create 2 paths- a "pay for performance" base and an incentivized alternative payment model track.
3/ But 3 seemingly technical details fundamentally sapped the potential impact of this huge bill.
classic behavioral economics- the impact of an incentive is not just proportional to its size, but also its cost, uncertainty, and delay
2/ in this article, Joseph Kannarkat and I break down all the tools that the Biden administration and @SecBecerra have to address competition beyond antitrust reviews
2/ Why do I think it's "The Question" of this moment for field epi to try to answer?
I'm going to be joining @Bob_Wachter@cmyeaton@inthebubblepod tomorrow in our continuing "Safe or Not Safe" series, and Variant vs Vaccine will make all the difference