5 weeks ago, our public schools returned to full-time in-person classes

To keep schools safe, we implemented:

Indoor masking
Ventilation upgrades
Weekly testing
Encouraging vaccinations

We didn't push hard for distancing

So how's it going?

Pretty well actually

Short thread
We've seen essentially no spread within schools

Across the nearly 13,000 students who attend

There have been, on average, 10 cases per week

Number of kids getting infected likely has gone down since school began

But are schools driving community transmission?


Daily incidence down 10% since schools re-opened

And test positivity down nearly half in last month


No, just use of simple data-driven policies

And the few kids that are positive?

They aren't triggering quarantines

Because with "test and stay" - kids stay in school
The point is

We know how to keep schools safe

No plan is perfect

And we may yet have an outbreak

But with kids vaccines around the corner

And with good mitigation in place

I'm hopeful we'll get through this fall/winter with our kids healthy and in school


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More from @ashishkjha

10 Oct
Quick update on state of the pandemic in the US in 4 graphs

First, nationally

We have clearly turned the corner on the delta surge

Now down 40% since peak a month ago

Still at high levels of infections and deaths

But good to be heading down as we head into fall and winter
Next, lets look at the big 4 states

CA, TX, FL, and NY

Geographically diverse

All of them are low and generally declining

Given 1 in 3 Americans live in these 4 states, they matter a lot to the national picture

This is good

So are there troubling areas?


If we look at the national map

We see that deep south is done with its horrible summer surge

But great plains, Alaska are concerning

Here in New England, MA, CT, and RI have low levels of infection and declining!

Driven by high vaccination rates and public health measures
Read 5 tweets
4 Oct
Its time for vaccine mandate for air travel

Lack of one is becoming an issue

So here's my story from last night that confirmed why we need it

Basically, we can't expect mitigation measures to be enforced well enough to prevent transmission on airplanes forever

Short thread
Last night I took an overnight from LAX to Boston

I got to the gate, found myself next to a person whose mask barely covered her mouth

Mask was nowhere near her nose let alone covering it

I walked away

My flight boarded and I sat down in a window seat

She soon sat next to me
Sitting next to someone who is essentially maskless wasn't great

Truth is, if your nose isn't covered, you really aren't wearing a mask

She then started singing to a video on her phone


Her flimsy cloth mask wasn't doing much at that point

Read 8 tweets
1 Oct
Great piece by @matthewherper

molnupiravir cut hospitalizations by 50% in among high-risk folks (older, obese, those with cardiovascular disease)

Despite the fact that we only have a press release

I am optimistic this will pan out


Short thread

This result feels a lot more believable than many others we have seen


First, molnupiravir is a nucleoside-analog, a type of anti-viral that has been effective against other viruses

So the mechanism here makes sense

Second, this is not just a Merck press release

A group of independent experts saw the data and said "we've seen enough"

And stopped the trial because the drug was clearly working

That's important verification

It also makes me far more optimistic about other similar therapies being studies for COVID will pan out

Read 4 tweets
26 Sep
The southern surge is slowing

And cases in some Northern states rising

So it is all seasonal? Are vaccines working?

Let's look at data

Today the 10 LEAST vaccinated states had

2X the cases
3X the hospitalizations
5X the deaths

compared to 10 most vaccinated states

A lot of folks have been arguing the summer surge was "seasonal"

And now, the northern half of US poised to get hit

And if you look at states with biggest outbreaks today

Alaska, ID, WY, WV, MT, KY, ND

Largely not in the deep south

So should all northern states worry?

While we see cases rising in northern states

There are two distinct patterns here:

1. States with low vax rates getting slammed, having to ration hospital beds

2. States with high vax rates rising slowly with lots of hospital capacity

And the most interesting part?
Read 4 tweets
17 Sep
People concerned if we give 3rd shots (booster) to Americans

it'll mean fewer shots for the many unvaccinated folks in the world

Sounds right

But reality is more complicated

In the short run, I think we can boost the elderly largely with vaccines we can't send abroad

As of today, we have 80 million doses distributed to states

They are sitting in pharmacies, doctors' offices, hospitals

It is not possible to go collect those doses, pack them up, and ship them to another nation

No country would accept them

So we have to use them here

They all have limited shelf life

We are using about 0.77M doses/day

And at current pace, it'd take 104 days to use up doses already distributed

Many of these doses will expire before then

Does that mean we should start boosting to avoid wasting doses?

Of course not

Read 6 tweets
15 Sep
President Biden quoted @DLeonhardt

Suggesting daily risk of breakthrough infection among vaccinated folks about 1 in 5,000

Is that a lot?

Well, that would be 36,000 breakthrough infections daily

Seems bad!

So if you're vaccinated, should you worry?

Not really

Short thread
What does 36K infections mean in terms of hospitalizations, deaths?

Among UNvaccinated, about 1 in 20 infections lead to hospitalization and 1 in 200 lead to death

Vaccines cut risk of each by 90%

Which means daily, 180 vaccinated folks getting hospitalized and about 18 dying
Instead of IFR, what if we applied CFR?

That's 1.2% for unvaxxed, about 0.12% for vaxxed

Would mean 40 deaths a day

So how bad is 18 (or even 40) deaths a day?

After accounting for proportion of population vaccinated

Its lower than daily deaths in an avg flu season

Read 6 tweets

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