1. Both MA and VT target 80% vaccination rate in schools to remove mask mandates. Let’s be clear that this isn’t about herd immunity. For one, 80% doesn’t get you there - if R0 = 6 for delta and vaccine efficacy is 90% (both generous assumptions), it would be 92.5%.
2. Also, a school isn’t a “herd” (though it sometimes feels like one). Students and staff go home and interact with people outside of school.
3. Pure speculation, but I would guess that 80% just felt like a reasonable target consistent with overall vaccination rates. And therefore unmasking is a “prize” for schools that hit the target.
4. We should be clear-eyed about this. The argument is not that unvaccinated or immunocompromised kids would be safe once a school hits 80%. It is that we are OK with their risk if it helps boost vaccination rates. And that assumes unmasking is actually a good incentive.
5. It’s logistically impossible to mandate masks for some kids and not others, and kids don’t want to broadcast their differences to their peers. So some unvaccinated kids will go unmasked. It will be better if 80% are vaccinated, but not necessarily safe.
6. Everyone wants an off-ramp. But one that ignores the state of the pandemic and just uses vaccination rate places that ramp on top of our most vulnerable students. #MAEdu#mapoli#vtedu
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1. I've been frustrated with how #COVID19 cases among the vaccinated have been reported, and I feel like it can be done better. I'm not an expert in this space, but I wanted to toss out some thoughts to #epitwitter and see if some collective wisdom could emerge. 🧵
2. First, to be clear, this is about public presentation of data in the media, not optimal study design to determine vaccine efficacy. My premise: Reporting just number of "breakthrough" cases lacks context, and "breakthrough" cases divided by number vaccinated lacks meaning.
3. So what is meaningful? Starting with cases, I'd argue that new cases per 100,000 vaccinated vs. new cases per 100,000 unvaccinated is a good starting point. CA does this - for the past week, it was 7 for vaccinated and 33 for unvaccinated.
Let me make sure I understand - with data (below) showing that #COVID19 is no longer declining in MA, with the more infectious variant increasing, and the goal to open schools in April, we are opening restaurants on Monday at full capacity with musical performances? #mapoli
Here are some recent studies (graphics borrowed from @EricTopol) which reinforce risks associated with in-person dining 👇
At least we prioritized vaccinating food service workers to make sure we protected this vulnerable population before reopening.
1. Just celebrated 20 yrs as a professor this week, so I’ve been thinking about life in academia.
I have only one piece of advice - know yourself, use that to figure out what success means to you, and find people who will help you achieve that success.
Let me explain... 🧵
2. You will meet a number of potential mentors along the way. Some will be lousy. Some will be good but will guide you toward their notion of success. The great ones will ask you first what you want to achieve, and strategize with you about how to get there.
3. There are so many dimensions of academia. Do you want to devote most time to teaching? Research? Administration? Why? And what would it mean TO YOU (even if not to others) be successful in each area?
1. There has never been more focus on ventilation in school buildings. This leads to the obvious question - what do we actually know about ventilation in schools, and how important it is?
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2. First, a primer. Many studies use indoor CO2 to characterize ventilation, because the primary source in a school building is people breathing, and the outdoor concentration is relatively stable.
3. A recent review article by Fisk reported that ALL studies in schools found average CO2 of over 1000 ppm, a sign of a poorly ventilated space (outdoor CO2 is roughly 400 ppm).
1. This has been a week of contentious meetings, angry online debates, and complex conversations about school re-opening.
One key topic: how risky is it to return to school? The literature on risk perception may help to increase understanding and improve communication.
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2. I think the brilliant work of Paul Slovic, as described in his article "Perception of Risk" in 1987, makes it clear how we are talking past each other when sifting through data on the health risks associated with returning to school.
3. Slovic found that there was a large gap between how risky people thought different activities were and what experts thought. But his key insight was this is not because the public was ignorant - it was because people saw risk as more than just expected number of fatalities.
1. I’ve been thinking a lot about our tendency for “bright line” decision making and what that means for how we approach school reopening decisions this fall...a little wonky, but indulge me, since I think it matters...
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2. Epidemiologists are quite familiar with this phenomenon, as p = 0.05 is treated as the magical bright line by some. If p = 0.049, it is significant and “real”. If p = 0.051, it is insignificant and “not real”. Many have written on this topic ⬇️
3. How does this connect to #COVID19? One place is the 6-foot “rule”. It is treated (by some) as a magical bright line. 5’11” - deep trouble. 6’1” - no risk, all is well.
The reality, of course, is that there is a continuum of exposure risk.