Is it just me or did CDC go from "breakthrough infections are rare" to "we need boosters to prevent breakthrough infections" in like a week? And I'm not sure if the first talking point was rescinded.
And please take a moment to consider before you get mad at this
"What was previously uncertain is now revealed to be extra risky and we didn't prepare for it" is called not following the precautionary principle and that is a political stance
I'm not sure breakthrough infection was ever "rare" bc I don't know what rare means. Vaccine efficacy against any infection was in the 70-90% range pre-delta but that's a relative measure when people care about (absolute) cumulative risk.
Someone correct me if my thinking is wrong but even 90% VE implies that 10% of the vaccinated will get infected as the counterfactual probability of infection approaches 1, and we approach that when the virus is spreading unchecked and as time proceeds
Anyway we knew things could get worse and the messaging was meant to sell a vaccine-only strategy that was wrong then, even wronger now. Other countries were more precautionary at the same time with the same data. Now it's hard to put the toothpaste back in the tube.

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More from @jfeldman_epi

15 Sep
Okay this thing isn't going away so let's talk about why 1 in 5000 is actually meaningless and, despite vaccines' relatively powerful protection against hospitalization, breakthrough infections aren't "rare" when community spread is high.

Short thread
The figure comes from the NYT newsletter (reported as the individual *daily* risk of infection among the vaccinated). It was cited by Biden in his new covid response plan (somehow reported as a *weekly* infection risk) and has been otherwise making the rounds.
Where does the number come from? NYT guy David Leonhart apparently looked at data from a few arbitrary jurisdictions that track breakthrough infections (UT, VA, King County WA) and decided the numbers were trustworthy and could be applied nationally.
Read 16 tweets
24 Aug
Until pretty recently it was hard to find a political message about addressing climate change in the US that went beyond consumer choice (or worse, overpopulation). Now it's much easier to come across messages, even campaigns that call for regulation, planning, policy change...
That shift reflects years of organizing and education. With covid, the pandemic hit much faster than the left's ability to organize around it, and that first step of internal education is still far from complete.
I was naive bc I assumed that commited leftists would look at the pandemic response through lens of class power, structural racism, intertwined fates. But maybe most people need to be specifically organized around each new issue
Read 4 tweets
6 Aug
Black and Indigenous people are being hit hardest by delta, with 2.4 and 1.8x the hospitalization rate of whites in the US, respectively.

These figures actually understate the inequalities because populations of color are younger than the white population.
Screenshot from CDC's COVIDnet gis.cdc.gov/grasp/covidnet…
COVID-net only covers 10 states, and some states that are being hit particularly hard right now like Florida are excluded
Read 5 tweets
22 Jun
1/ I'm gonna use this to lay out a messy, preliminary version of an argument here. The question I'm trying to answer:

Why did US public health experts generally not push for the kinds of broad shutdowns that our counterparts advocated in many other countries?
2/ The answer is manifold, but I want to focus on one particular aspect here.
3/ Shutdowns are big, blunt instruments of the sort US scientists are socialized to eschew in favor of lightweight, targeted, local intervention. We're told to be pragmatic, that only micro-interventions will actually get adopted bc they’re palatable to politicians and the public
Read 21 tweets
5 Apr
The unstated US pandemic strategy:
- Strongly disfavor policies that interfere with business
- Favor individual behavior change
- Tolerate an unlimited number of deaths
- Intervene more strongly to avoid exceeding ICU capacity (sometimes)
- Rely nearly exclusively on vaccination
Most social distancing in the US has been voluntary. In Jan 2021, you could've eaten indoors in 46 states.

Social distancing has been about individuals choosing to avoid risk to themselves and others. This is far less effective than govt policy and not everyone has a choice
Despite the lax government response, we see a weird type of 'inventing a guy to get mad about' response, wherein people (mainly elites) are upset about social distancing and still want to blame government for doing *too much*.
Read 5 tweets
19 Mar
On Jan 21, Biden signed an executive order stating OSHA would issue an emergency covid regulation by March 15 "if such standards are determined to be necessary". Guess that's not happening.
Apparently they've opted instead to focus inspections on the highest-risk covid sites. But that leaves the vast majority of workplaces unprotected. And without a regulation, it's easier to fight citations under the less specific "general duty clause" osha.gov/enforcement/di…
Can a worker who refuses unsafe conditions then collect unemployment? Biden promised this, but details are still unclear (please let me know if you know something I don't) archive.is/M9RUT
Read 9 tweets

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