Spraying is not evidence-based and is potentially harmful.

School safety science is clear:
– masking
– vaccines for all 12+
– ventilation/filtration
– screening testing
– controlling community spread

@NYCSchools @DOEChancellor's plan is inadequate for *all* of these measures.
It's good there's a mask mandate, but @NYCSchools @DOEChancellor are not adequately:
– providing masks
– educating on or requiring masks of sufficient quality: medical grade at least, better to double mask or N95
– set up to monitor/ensure correct use
For vaccine mandates, unlike LA schools, @NYCSchools @DOEChancellor are failing to protect students, staff, families, and the community by mandating vaccination for all 12 or older.
For ventilation and filtration they are utterly failing in unsafe buildings, especially during lunch.

Highly recommend these videos here: gospeakupamerica.com/delta-schools-…
For screening testing, @NYCSchools @DOEChancellor are failing with substandard levels. Infrequent intervals and testing too few people means it's more like a survey than a tool to catch cases early and quarantine.
For controlling community spread, @NYCSchools @DOEChancellor should be more vocal but ultimately this one is on @NYCMayor...
... @NYCMayor is failing to implement common sense measures to stop spread:
– indoor mask mandates
– forced unnecessary return to in-person work for city employees who could work remote
– not limiting capacity for high risk venues

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More from @AndrewMakeTweet

16 Sep
Media reporting on boosters
Scientific discussions on boosters
Booster approval
Clinical and public health guidances on boosters

These are all being based on evidence of "waning immunity" which itself is predominantly based on reduced vaccine effectiveness.

🧵 Big problem is...
Vaccine effectiveness is contingent on many things.

Not just immunity.

So reductions to effectiveness can not be assumed to be due to waning immunity.
Viral dose affects likelihood of infection.

If typical viral dose exposures increase over time periods (e.g. due to waning behaviors or waning policies that prolong social interactions, reduce mask use, drive interactions indoors), then vaccine effectiveness will drop.
Read 5 tweets
16 Sep
Here's the NEJM study of the data. A few thoughts

1) Big risk rate differences but dataset appears to lack behavioral/social data that would help identify potential confounders related to differences in exposure/viral dose at exposure

2) Lacks safety outcome data, so hard to discuss risks vs. benefits
3) Use of time period to set lower bound of effect is questionable. Behavioral differences related to the time periods, and how they shift, are much more of an unknown and are historically contingent. Image
Read 5 tweets
15 Sep
🚨 FDA booster data up.

1) Surrogate marker trial data is not useful clinically or for public health.

2) Real-world data shows massive effect in terms of reducing infections (suggest big public health benefit in stopping spread) and severe COVID.

Link: fda.gov/media/152161/d… Image
The real-world data controlled for some confounders but no suggestion they controlled adequately for things that might make someone more likely to pursue a booster but also less likely to be exposed and/or exposed to high viral doses. E.g. community factors, mask use, etc.
People who care enough to get boosted might also have been more careful with masking or might be from communities less hard hit (social too, not just geographic).
Read 6 tweets
14 Sep
I would like to see a book on how careerism, personal brand-building, and book deals are harming public health.
Gottlieb clearly understood the underlying public health dynamics in the pandemic (chains of transmission, exponential growth, presympomatic spread).

Relative to so many (a very low bar), he called for needed policies.
But considering that unlike so many he has a deep understanding of public health, policy, and politics, it's actually worse that he did so little.
Read 5 tweets
12 Sep
Centrist Democrats, progressives, and the left should be ashamed.

Scott Gottlieb, corporate law firms, and McDonalds are leading more on public health than they are.

Sorry to be harsh but we need a reality check and a principles check.
Law firms lead on remote while anti-worker de Blasio and sycophantic unions force workers to return in-person needlessly, while parents aren’t given remote options for school. wsj.com/articles/covid…
McDonalds self-implements indoor dining closure while only Hawaii has capacity limits or closures for high risk venues. wsj.com/articles/delta…
Read 4 tweets
9 Sep
Cases are surging.
10,000+ people are dying each week.
Thousands of people are developing long COVID.
Schools and businesses disrupted.

We needed a course correction.

Instead it's another round of too little, too late from @POTUS @WhiteHouse @WHCOS @CDCDirector. 🧵
The vaccine-focused approach of the last 8 months has failed.

It overly focused on vaccines to control spread and stop severe illness. It ignored and relaxed NPI (non-pharmaceutical interventions) policies e.g. mask mandates, venue restrictions, and contact tracing.
Vaccine policy has been inadequate.

First inequitably delivered, then with wide availability with little attention to needed outreach and supports, and now with mandates that coerce and divide. This approach has not succeeded in reaching the 85-90% needed for herd immunity.
Read 24 tweets

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