Lazarus Long Profile picture
Sep 19, 2021 11 tweets 5 min read Read on X
Had the idea of fixing the contact tracing form.


But CDC isn't doing contact tracing - (thank you Ian!),


but their training feeds into the states, which feed the counties, etc))
Tried acccessing the website that all of the states/ local authorities use to develop their contact tracing forms:
cdcpartners.sharepoint.com/Sites/CSTLTS/C…

But it's locked down.

Poked around Washington State's website, and couldn't find any actual forms.
All good.

Let's a look at the CDC's contact tracing information (that feeds the states, etc), and see how it's letting us down.

cdc.gov/coronavirus/20… - literally says, "Contact Tracing slows the spread of CoVid-19"

Maybe. But since we are
literally the absolute worst at CoVid?

statista.com/statistics/110…

Clearly, we are not doing it, correctly.

So, what is our contact tracing based on?

Key information to collect during a case interview.
cdc.gov/coronavirus/20…

The most important part? Close Contacts.
And what is the definition of close contact?

Anyone within 6 feet for a cumulative of 15 minutes within 24 hours.

Except if they're a kid - and then they are excluded if 3 to 6 feet away and wearing a well-fitted mask.

Quick note - the kid exception is

cdc.gov/coronavirus/20…
really, really
Anyway, where does the close contact definition come from?

Per this:
cnn.com/2020/10/21/hea…

From this:
cdc.gov/mmwr/volumes/6…

Highlights:
July 28, 2020 - a prison guard had 22 brief encounters, for a total of 17 minutes with 6 prisoners.
July 29, 2020 - all 6 tested positive
The guard had 2 other contacts - those people did not test positive.
All interactions were on video.
The guard was in a microfiber cloth mask and goggles the entire time.

So, ocular infection in this case was eliminated.

Anyway - was he infected from repeated exposures?
Possibly, but not probably.

No, he was probably infected during only one of those interactions.

But is that the end of the story?

It shouldn't be.

Where, oh where, can we possibly find someone who could help us see if there's a better definition of close contact?
Would you believe - the CDC?

wwwnc.cdc.gov/eid/article/27…

People infected from 45 feet away, with Patient Zero actually facing away from those he/she infected.

Caught on video. Genomically confirmed.

So, that would seem to be good place for the @CDCDirector begin to change the
definition to:
"Shared space up to 45 feet away for any amount of time."

And then, we will be closer to actually having contact tracing slow down transmission.

Until then, we only have Contact Tracing Theater.

Enjoy the show - though I hope you enjoyed this thread more.

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More from @LazarusLong13

Jun 10
Please explain how a study measuring physical improvement in a Cognitive and Behavioral study can have unmeasured Graded Exercise Therapy - and be considered as well-controlled. Not confounded.

So, I emailed Dr. Ebell and asked how that was nitpicking. Image
Image
I also agreed with the comments at the bottom of the study, linked below.

If you change analysis protocols post hoc? That's not nitpicking in my book. But maybe that is nitpicking?

jamanetwork.com/journals/jaman…
Science is ALL about nitpicking. You ARE SUPPOSED to be very detailed, so you can be replicated, right? Alan is funny.

Anyway, amusing to spot the lobbying group for the Lightning Process on their advisory board.

Tch tch. Or is that nitpicking. ;) ? Image
Read 7 tweets
Jun 1
A thread on airborne Ebola - the rest is accurate.

Let me emphasize that I agree far more than disagree with her, in general.

Declaring a thing debunked without actually debunking it, with facts, is not debunking.

So, let me debunk this. Image
Dr. Kuppila has excellent credentials, and has earned her laurels.

If we accepted the debunking of airborne Ebola on the basis of credentials, we would have given into the fallacy of appeal to authority.

:) not today.

She worked in an Ebola Treatment Unit in Sierra Leone,
coming back in December 2014, and now resides in Dallas per her very interesting StatNews article:



She did not get infected. We could have survivorship bias here - fortunately.

This is a reference to possible surgical mask usage by her.

You see, the web.archive.org/web/2026052103…Image
Read 22 tweets
May 28
Ebola - it's not all about respiratory aerosols.

DYK that you, and me, and everybody are Pig Pen from Charlie Brown?

We shed our entire outer layer of skin every 2-4 weeks, about 500 million cells daily.

Your corneocytes (outermost cells) lift off of your body with the
gentlest of micro-air currents. Like a leaf picked up off the ground for the briefest of moments in fall.

They act like 12 micron aerosols in float time, but 25% of total skin flakes are sub 5 microns...and you know what that means. Deep deposition - or shallow as
sub 5 likes to also deposit in the nose.

It's funny...I embrace push-back in debate. Tightens up my game.

Imagine if those skin flakes now have Ebola on them?

Two studies show that Ebola literally oozes through the skin - both ways. In and out.

Not shown in vivo, but
Read 10 tweets
May 23
The WHO forbids contact tracers from masking or gloving up.

"Do not conduct home visits wearing personal protective equipment like masks, gloves, or
gowns."

It gets worse. Do not conduct home visits wearing personal protective equipment like masks, gloves, or  gowns.
They have a handy how to reduce risk of catching ebola at home.

It even has 5 masks listed on it.

But not for the other family members.

"7. If the patient has vomit, diarrhoea or bleeding, a mask or a dry towel wrapped around the face can be used to protect the nose and mouth Image
7. If the patient has vomit, diarrhoea or bleeding, a mask or a dry towel wrapped around the face can be used to protect the nose and mouth when touching the patient or items soiled with blood or body fluids. A waterproof gown, eye protection, gloves and rubber boots should also be worn in these circumstances.
Here are the 5 face masks. Image
Read 9 tweets
May 22
The "epidemiology" of Ebola tells us that it's not airborne. You've heard this over and over.

What drives it? The questions on the contact tracing form.

Quick 🧵. Image
COVID - the WHO and CDC said it wasn't airborne via aerosols, right?

The CDC said it was spread person to person via close contact - within about 6 feet.



And you remember it took FOREVER to get changed.

The contact tracing form was web.archive.org/web/2020032817…Image
Image
arranged around close contact. These are the questions driving the stats of how many and how are infected.



So, the CDC will only hear back what it's asking. This was the epidemiology of COVID - until it wasn't. web.archive.org/web/2020052514…Image
Read 16 tweets
May 20
Speaking of silly, can we agree that the WHO has Ebola experts?

Let's talk about PPE, and a bias towards "less PPE is better." Image
The WHO EBOLA IPC guidance:


Foreshadow on PPE

"...due to the desirability of an off-
the-face design, and not for protection from aerosols, respirators may be used instead of medical masks"who.int/publications/i…
If you can stay 3 feet away while screening? No medical mask needed. Image
Image
Read 12 tweets

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