1/ A short 🧵about risk. Might be helpful to recall that risk for CoV-19 is not only about vaccines & masks/respirators, but the nature & duration of exposure, underlying health status, behaviors of individuals, & characteristics of the virus.

But vaccine = most important...
2/ Exposure-related factors that can increase risk include close proximity to infected people (crowding), longer duration of contact, indoors vs. outdoors, poor ventilation, lower quality & fit of mask/respirator...
3/ Underlying health conditions also effect risk, especially severe immunocompromise but also other conditions, & older age... (cdc.gov/coronavirus/20…)
4/ Behaviors that can increase risk include loud talking/shouting, singing, aerobic exercise (& close/prolonged contact, as above). The more often someone does things that increase their risk, the more likely they will be infected.
5/ CoV-19 variants that are more transmissible (contagious), &/or cause more severe illness, &/or evade protection from vaccines, can also increase risk.
6/ Taking more risks increases the chances of getting CoV-19 (& severe CoV-19) PRIMARILY for UNVACCINATED people, BUT, also, to a much-lower-but-not-zero degree for the vaccinated, too.
7/ Recently, across the country, CoV-19 prevention measures have been lifted & vaccinated + unvaccinated people are doing lots of things together without taking adequate (or sometimes, any) precautions. Delta, unanticipated, increased the risk of this situation for everyone...
8/ What does all this mean?
- VACCINES REMAIN the BEST way to reduce risk (for CoV-19, including severe CoV-19) but are not 100% protection.
- Multiple strategies/LAYERS of protection REDUCE RISK for both unvaccinated & vaccinated where CoV-19 rates are rising/substantial/high.
9/ In addition to GETTING VAXXED, strategies to reduce risk include:
- a well-made, well-fitting respirator or mask
- ensuring adequate indoor ventilation/air quality
- minimizing high-risk exposures, settings, & behaviors

These are most important for unvaccinated people.
10/ Vaccinated people, especially if in a high-risk group for severe CoV-19, or who are a close contact of a high-risk person, should also take steps to further reduce their risk based on local CoV-19 rates, their personal situation/risk assessment/tolerance.
11/11 Layered protection = the best protection (graphic credit: @MackayIM)

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More from @DocJeffD

1 Aug
1/ Breaking down breakthrough infections: a short 🧵.
As more people are vaccinated w/CoV-19 vaccines, we hear more about so-called breakthrough infections being reported among vaccinated people, which can be confusing.
2/ The MAIN PURPOSE and value of the CoV-19 vaccine is to PREVENT SERIOUS INFECTIONS, not any infection or milder infections.
3/ Breakthrough cases for any vaccine are expected as more people are vaccinated because no vaccine is 100% protective. And the more people that are vaccinated, the more mild "breakthrough" cases we would expect.
Read 10 tweets
23 Jun
1/ CDC's vaccine safety team finds a likely association between mRNA vaccines & myocarditis in adolescents & young adults. Onset usually within 7 days after dose 2, males >> females. But, risk is low compared with benefits of vaccination...
2/ Benefits of vaccination in preventing CoV-19 cases, hospitalizations & deaths are great compared w/ low risk of myocarditis, & vary w/ age/gender.

Since pandemic began, 2,767 CoV-19 deaths were reported in 12-29 year olds w/ 316 deaths reported since April 1, 2021.
3/ Additional benefits of vaccination not mentioned above include protection against multi-system inflammatory syndrome in children & adults (MIS-C, MIS-A), long-term symptoms (long Covid) from CoV-19 infections, & against new, more dangerous variants of concern.
Read 6 tweets
14 May
1/ A few thoughts on CDC’s new mask guidance, vaccination & CoV-19 risk.

Vaccinated people have a VERY high level of protection vs CoV-19 compared to unvaccinated with a MUCH LOWER chance of getting sick if exposed or spreading CoV-19 to others.
2/ When unvaccinated people gather indoors, they are at risk of both getting CoV-19 themselves as well as spreading it to others, especially if masks are not worn.
3/ CDC recommends vaccinated people no longer need to wear masks for most activities indoors or out, while unvaccinated people should continue to do so, especially indoors.

However, it’s not easy to know who is/is not vaccinated in public spaces!
Read 13 tweets
12 Apr
1/ What does remaining in Phase 3 of the Governor’s Healthy Washington Roadmap to Recovery mean for King County?

⚠️ Don’t let your guard down! ⚠️ This is definitely not an “all clear” signal. We don’t stop wearing seatbelts just because we haven’t had a crash recently...
2/ We are MUCH closer to putting the worst of the pandemic behind us, but not quite out of danger yet. The potential for a severe surge in cases & hospitalizations remains real until more of us are vaccinated.
3/ For the time being, we all need to continue taking COVID-19 precautions seriously. This will protect us, our family members, friends, co-workers, our community & our economy as vaccinations increase.
Read 8 tweets
22 Feb
Why are COVID-19 cases falling and what does it tell us about where the pandemic is heading? A few thoughts:
1/
Factors contributing to recent surge(s) are decreasing. These include holiday travel/get togethers, more activities & socializing, & general increase in indoor time during fall & winter that facilitate CoV-19 transmission through airborne spread & effects of low humidity. 2/
Restrictions on indoor and other activities (Governor’s directives in WA state: travel advisory, mask use, distancing) work and helped decreased spread. 3/
Read 20 tweets
29 Jan
With more dangerous CoV-19 variants, we must improve CoV-19 prevention in all aspects of our lives, incl. mask quality & fit, limiting time w/others, avoiding crowded indoor spaces, increasing distance from others, & getting vaccinated when it’s your turn. On masks: 1/
Cloth masks are recommended by CDC for use by the public. Cloth face masks were initially recommended to prevent someone w/CoV-19 from spreading the virus to others. This is especially important because people can spread the infection to others before they appear or feel ill. 2/
Recent studies suggest cloth face masks can also provide protection to the wearer. How well it protects depends on how well it's made & fits (e.g. the type & # layers of fabric). At this time, CDC only recommends N95 masks & surgical masks for health care workers (HCW) 3/
Read 17 tweets

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