Thread by @ClaraJeffery

1/ As someone dealing with a breakthrough infection, maybe my experience will help you process risk and encourage you to vaccinate if you haven't, and mask up regardless when around the unvaxxed, esp if they're in high density/close proximity:

https://twitter.com/ClaraJeffery/status/1421967361423327236

2/ So my ex and our son went to a long-planned family reunion in, alas, Florida, where all family members were vaxxed but two, one of whom is a doctor (🤬🤬🤬).

3/ As Delta started to surge, both Florida and the unvaxxed relatives—which learned about a week out—was concerning, to stay the least. The compromise we arrived at: no indoor events, masks in any outdoor crows, testing before they came to meet me in CT.

4/ I knew that since ex/kid were both vaxxed, the chances of them catching was low. Estimated at 1 in 100, or even considerably less (tho' I'll come back to that). I knew they'd be careful, because they have been for 18 months. But I knew there was some risk AND...

5/ We were going to meet up with a bunch of friends, all vaxxed, except two little kids, one of whom has had pediatric cancer. So that was/is the primary concern.

6/ I'd told them they had to test before joining us, which they did, but PCR; results didn't post till after they arrived. And given that they both arrived sniffly, I had them isolate in a room, only go inside when absolutely necessary, and only with masks. And get rapid tests.

7/ Rapid tests revealed ex was positive, Milo negative. Now a thing to understand about rapid aka "antigen" tests are that a positive is almost always a true positive. But a negative is like ~60% accurate (false - happen). So they left the house, got PCRs. Same split in results.

8/ So ex clearly has breakthrough COVID. And, esp sinnce they shared a room for two nights, Milo may develop.

So now what? Clearly ex must leave. Almost as clearly, given risk to little kids, Milo should also. But to where? And do I go with them?

9/ This is privilege is key: We have many friends in region; some are traveling and might have empty homes/apts. And even if we had to get 1-3 hotel rooms for two weeks it would be a big hit, but survivable.

But a lot of people trying to be responsible will not be able to be.

10/ Within a few hours, friends of friends had stepped up (massively) to loan us their Bklyn apt. An area I know well, a config that allows us to isolate from each other, with a garden we—esp ex—can use. Milo and I continue (knock wood) to test negative.

11/ Ok so what do we know about route of infection? So far, ex's relatives have tested negative (Refusniks have only done antigen; the doctor's TWO Chicago hospitals *now* require all staff be vaxxed.) Probably wasn't the flight down. So...outdoor exposure in Fla?

12/ Until I see negative PCR results, I believe the most likely route of transmission is the relatives.

And here's the thing: Had I not insisted that ex and Milo get PCR tests, we'd never would have known that one is infected (and the other could be).

13/ Ex had symptoms, but he has allergy and sinus issues, and the symptoms were of a piece. Milo had a runny nose for 36 hrs. Both are feeling better/fine (🙏). So re: what is the real rate of Delta breakthroughs that go totally stealth, this is troubling.

14/ GOOD news: The evidence that vaccines prevent the worst outcomes even in a breakthrough case is robust. We are most worried about whether we infected others before we knew, esp the little kids. Lesser worry is how we'd logistically handle rolling infections if that happens.

15/ That scenario is MUCH harder for people (traveling or no) who have fewer resources, options, ability to work from anywhere.

NYC has (had?) quarantine hotels, but only for NYers.

What if not near friends/family/resources? What if you just don't know about any programs.

16/ For example:

https://twitter.com/kenarchersf/status/142271143170786099216/

17/ So what are some takeaways:
a) Vaccinate and insist on knowing the vaccination status of anybody you plan to be around. Breakthroughs are very rare, very rare, but as I hope we've demonstrated, do happen, and not just in "partying for two weeks with hundreds" scenarios.

18/
b) ask if your medical providers, all of them, are vaxxed. Don't be fooled by the hygiene theater offered by the websites at, say CHICAGO'S TWO LEADING HOSPITALS.

19/
c) don't make excuses for or accommodate unvaxxed relatives. If they're willing to put you and the public at risk, that tells you what you need to know. And especially if they violate oaths, be it "protect and serve" (my fam) or "do no harm" (his).

20/
d) I personally would not travel to FL or TX or any state that has catastrophic rates of infection and political leadership that's far far far more interested in disinformation-fearmongering than the well-being of residents or visitors.

vote with your money.

21/
e) vax mandates from big employers will help.Refusniks in both our families are now being mandated, by hosptials by federal and LE agencies. I doubt any of them will quit. Far easier to rail against...whatever.

both hospitals and feds/LEA should have done this months ago

22/ Thus far, the burden of this pandemic is being shouldered largely by those unable to avoid it, and, in a far less deadly way, by those acting responsibly (sometimes agro-ly so) to prevent its spread.

23/ So long as burden falls on those with fewer options and those who are public minded we must now reduce the population of refusniks by mandates/incentives/whatever and mask up in situations where the virus is likely to fester.

That fucking sucks. It's enraging. But true.

24/ @CDCDirector should resume tracking breakthrough infections. As this piece from a Hopkins epidemiologist— one of 11 of 14 vaxxed friends who all got it from dinner party—shows. Is there a difference btw vaccines? Other guidance to be gleaned? baltimoresun.com/opinion/op-ed/…

25/ Also problematic is that public has little input as to what to do if they do become infected, breakthrough or no, except to isolate. I made ex call @Delta, Fla hotel, anyone else he knew how to contact.Those efforts were met with cheerful diffidence, at best.

26/ And now we come to the pity party/mental health part of this thread. Even if 🙏🙏🙏 ex recovers, Milo and I don't get, and we didn't infect any friends and their kids, the toll is really high.

27/ I haven't had a vacation in two+ years, in which time I've gone thru a divorce, death of a parent, enormous stress at work, journo burnout, etc etc. I've been holding on by my fingertips, waiting for this vacation to recharge. Now that not only gone, but a ton more stress.

28/ Like just now, the place where the dog is being boarded called to tell us that a key vaccine (!) runs out tomorrow (which we'd asked about before we left, but...) and now i gotta figure out how to get that done remotely.

29/ Point being, take the precautions ever-more seriously, or, even if you have more financial/support resources than most, watch your life just turn into a shitstorm of caregiving and favor begging.

Meanwhile, off to get more tests!

30/ The only exercise—really the only activity—of the past four days has been running food and supplies down the stairs to them, and dirty dishes back up, and brief walks to get tested yet again or get other supplies.

It could be faaaarrrr worse. Still sucks so hard.

31/ Update: Ex is feeling normal. Milo and I continue to test negative. So do the friends we were with and their unnvaxxed littles (one a cancer survivor).

So, fingers crossed, we've managed to stop the spread as soon as we knew he had it.

But...

32/ The advice/support that CDC and other health authorities have put out does not really address:
1) how to safely isolate if travelling
2) which authorities to inform about breakthrough case

and...

33/
3) what is the isolation/testing protocol for caregivers of a completely sealed off +positive person.

A week+ with regular PCR testing which coincides with end of his quarantine period is what we're going with.

34/ That's a lot to figure out and manage and pay for to be responsible. A lot of people just will not be able to do it.

Vax and mask up.

35/ Made it through quarantine. Ex flying home to SF. Milo and I are headed to Vermont. One of the friends we had to flee called this whole episode "a warning shot." Yes. Please vax and mask up.