Some thoughts on a lot of the news today - first, I’m grateful that we continue to evaluate vaccines throughout the changing nature of this pandemic (and have so many efficacious vaccines). It’s hard to address any of this w/out acknowledge the privilege of it all (1/n)
I entirely agree w/@IDSAInfo about this being a partnership with ensuring global vaccine access/distribution for low and middle-income countries. None of this can be done in a silo. (2/n).
We will need more data to drive vaccine decisions and while the US faces its 4th surge, it’s hard not to feel the pressure to do something. I worry though, the issue stems from earlier scicomm failures (3/n)
Early on we treated the COVID vaccines as this end-all, elimination tool. The messaging, the emphasis - all of it. They are a complimentary tool (one of the best) to our NPIs like masking. So in some ways it seems like we dropped the complimentary aspect of this (4/n).
I hope now more than ever, we see this as a reminder that COVID is not gone, we have a lot of privilege that requires serious responsibility globally, and that we fundamentally need to keep up (and sustain) pub health interventions (5/5)

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More from @SaskiaPopescu

23 Jun
One of the most important pieces of infection prevention is working with bed placement - we try to avoid shared rooms, but in emergent situations/overflow, the focus becomes on avoiding transmission of any infectious diseases (1/n)
For patients w/an ID, we try to pair like w/like - flu w/flu, MRSA w/MRSA, *if necessary*. Same with COVID. The assumption is never “they’re six feet apart, so we can mix it up” - we know patients may pass each other, move around, are in the room unmasked for a while, etc. (2/n)
Despite efforts to screen patients w/out infection for COVID-19 during the pandemic, it was still possible for some one to be incubating during hospitalization (but test neg on admission screening). This is the reality of an imperfect situation during a pandemic (3/n)
Read 6 tweets
10 Apr
Statements like “we can end the pandemic once X occurs”, present both a false dichotomy and a myopic inaccuracy in how pandemic response and public health functions. It takes a lot to truly get a pandemic under control (1/n).
Vaccines are easily one of the most valuable tools we have. To make this work though, we need equity and that’s a huge issue we’re facing here in the U.S. and abroad. This also requires us to address hesitancy. (Adding - get vaccinated once you’re able to! ) (2/n)
Non-pharmaceutical interventions are also immensely critical - masks, physical distancing, ventilation, hand hygiene, cleaning/disinfection, etc. Risk reduction is additive and well, we need to make sure people have access to all of these tools. (3/n)
Read 6 tweets
2 Apr
While grabbing coffee today, I couldn’t help but notice a large group of older gentlemen at the coffee counter (outside) w/out masks on. It wasn’t the weird look they gave me when I put mine on as I approached, but rather the stressed look the coffee shop employee had (1/2)
The shop is still requiring them despite AZ’s relaxation of restrictions. Yes we were outside, but after paying/while waiting, they all stayed huddled around the tiny counter & in her workspace. Even when vaccinated, you should still mask up in public.
Even w/more accessibility, people are still struggling to get vaccine appointments. Moreover, let’s not make assumptions about other’s vaccine status or comfort w/ unmasked interactions. Also -tip your service industry folks (legit saw them not..ffs). Rant over. Happy Friday, all
Read 5 tweets
3 Feb
Single Dose Vaccination in Healthcare Workers Previously Infected with SARS-CoV-2 medrxiv.org/content/10.110…
“At all time points tested, HCW with prior COVID-19 infection showed statistically significant higher antibody titers of binding and functional antibody compared to HCW without prior COVID-19 infection (p<.0001for each of the time points tested)."
“In times of vaccine shortage, and until correlates of protection are identified, our findings preliminarily suggest the following strategy as more evidence-based: a) a single dose of vaccine for patients already having had laboratory-confirmed COVID-19;.."
Read 4 tweets
31 Jan
Sharing some insight as some one who’s been doing contact tracing for 10+ years: it’s about empathy and privacy. It’s also about having a general exposure definition to help gauge potential exposure. Is this perfect? Nope. No one has ever said contact tracing is perfect. (1/3)
It *is* an important public health tool. Sure, it would be great to have a super complex algorithm to help narrow if an exposure occurred, but that’s just not feasible (from both the PH standpoint AND that of the person being interviewed). Trust me, this isn’t an easy task. (2/3)
So while I get it’s easy to argue the 15 min/6ft rule (and trust me, we’re all for revisions), we need a place to start. It’s also pretty easy to judge it when you’re not actually doing it. Shout out to the teams of CTers - it’s hard work and we depend it. (3/3)
Read 4 tweets
23 Jan
During a convo yesterday I realized that we really haven’t invested much communication or awareness into what recovery means for others. There's still fear/stigma about being around some one after their iso period is done. This is a complicated topic, but one we should focus on🧵
For example, CDC does not recommend using testing to end isolation. Moreover, during the 90 days after infection, PCR testing is not recommended as a + indicates viral RNA shedding since we know reinfection during that time is exceedingly rare. cdc.gov/coronavirus/20…
Meaning, that during this 90 days, a + PCR in an asymptomatic individual could be startling at first, but really signifies persistent viral shedding, so that’s why re-testing isn’t encouraged. This is also why quarantine isn’t necessary during the 90 days if asymptomatic
Read 5 tweets

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