A #DeltaVariant outbreak in a Finnish hospital showed that fully vaccinated people can be infected by AND spread delta despite the use of surgical masks
It would have been MUCH worse without vaccines - only ~10% of vaccinated HCWs were infected
We need to learn from this
🧵1/7
It would have been MUCH worse without vaccines - only ~10% of vaccinated HCWs were infected
We need to learn from this
🧵1/7
https://twitter.com/IivoHetemaki/status/1421924954443030543
From a single index patient, infection of HCWs led to a chain of transmission throughout the hospital and to satellite hospitals, that led to 18 patient deaths (31% of the infected patients, median age 80, already hospitalized but COVID contributed to death in the majority).
2/7
2/7
There were 45 cases in health care workers (a little less than half of whom were fully vaxxed and the rest partially or unvaxxed), 58 patient infections, and at least 62 cases of secondary spread in the community
No HCWs died or were hospitalized.
3/7
No HCWs died or were hospitalized.
3/7
There was documented PRE-SYMPTOMATIC spread that made it difficult to contain transmission.
There were cases that were not able to be traced, likely due to HCWs with mild or no symptoms.
Incubation periods were variable, complicating the issue.
4/7
There were cases that were not able to be traced, likely due to HCWs with mild or no symptoms.
Incubation periods were variable, complicating the issue.
4/7
This outbreak makes me profoundly worried about the safety of schools and the ability to control delta with just the use of cloth or surgical masks.
Children have high rates of mild or no symptoms. Kids are often sent to school with a runny nose.
5/7
Children have high rates of mild or no symptoms. Kids are often sent to school with a runny nose.
5/7
We need to urgently do real transmission studies in a few school districts where delta is in the community, and make school virtual for the rest of the schools until we can determine a safe strategy to protect our children and communities.
Delta has changed everything.
6/7
Delta has changed everything.
6/7
We have been warned. Pediatric and adult hospitals are already overwhelmed in US communities hit by delta.
Adding school openings to this scenario, especially with low vaccination rates, will be a public health conflagration that will look like the West Coast wildfires.
7/7
Adding school openings to this scenario, especially with low vaccination rates, will be a public health conflagration that will look like the West Coast wildfires.
7/7
Addendum: my suspicion is that we will need to move to universal N95 masking in order to contain this variant.
Fit testing is needed to protect an individual, but "herd masking" without fit testing may be a viable population strategy, since most adults do fine with standard mask
Fit testing is needed to protect an individual, but "herd masking" without fit testing may be a viable population strategy, since most adults do fine with standard mask
However, N95 masks will be far more problematic for the pediatric population, since there are no pediatric N95 masks, and there would need to be multiple sizes.
Which means adults really need to do their part to protect children. Get vaccinated, and wear an N95 mask.
I don't see how we get out of this without taking the path of another lockdown, a strategy of vax+N95 masks, or mass deaths. I really don't.
I don't see how we get out of this without taking the path of another lockdown, a strategy of vax+N95 masks, or mass deaths. I really don't.
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