Quick update on state of pandemic in the US

National picture has turned mixed

Bad news: rapid declines in cases has plateaued

Over past 2 weeks, new infections flat at about 75K per day

The good news?

Early in November, we're flat

Could be much worse. Could be 2020

If we compare same two months to last year, we see a very different picture

Last year at this time, infection numbers were taking off!

Doubling every 3 weeks

We were on a steep acceleration

This year, we have the FAR more contagious Delta

Schools are open

And we're flat!
You all know why

Nearly 60% of Americans now fully vaccinated

So as the air gets cold and dry

The virus, spreading more efficiently, keeps running into walls of vaccinated people

And can't accelerate

If you look at the state picture, this becomes clearer
Nationally, you can the South has really cooled off

And its the Midwest and great plains states that have high infection rates

This really shows up when you look at individual state-level data
If you look at the 14 states with the highest new infections per capita

You can see that most are in the colder parts of the country

And the top 5 all have below average vaccination rates

And highly vaxxed states seeing outbreaks in less vaccinated communities of those states
So here's how to think about it:

The weather is getting colder

People heading indoors

Social interactions increasing

Last year, this meant the virus took off!

This year, we have a way worse variant (Delta)

But lots of folks vaxxed

And so we're in a stalemate

Over next couple of months, as we go into the holidays

Social interactions will push infections up more

But if we can get:

More adults vaccinated
Kids vaccinated
Folks boosted
Ubiquitous testing
Masking in high risk situations

We can definitely avoid another winter surge


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More from @ashishkjha

31 Oct
As a dad, I've thought a lot about the vaccines that will get authorized this week

And tried to think through the risk and benefits for my 9-year-old son

Based on data

I wrote out my thinking in a piece in @TIME

Here are some key points


A common misinformation refrain is kids are at lower risk than adults


Not the point

I don't think about my kids risk for COVID compared to my parents risk for COVID

I think about my kids risk for COVID compared to other risks my kids face

And what how to reduce them
The second issue is one of myocarditis or inflammation of the heart muscle

This is a real thing

But vaccine-induced myocarditis is rare and appears based on all the data to be relatively mild

COVID induced myocarditis is more common, and likely worse
Read 5 tweets
26 Oct
FDA expert advisors meeting on kids (5-11) and vaccines

I expect they'll follow the data and authorize vaccines for kids

And soon, I'm getting my 9 year-old vaccinated

Why am I so confident this is the right thing for my kid?

Because of the data

So lets review

First, the vaccine is very effective

In the trial, they reduced infections by 91%

That's during time when Delta variant was widespread

Safety data also compelling

You see standard stuff of course: sore arm, headache, low grade fever after the vaccine

But nothing serious

But lets look at the bigger picture

These vaccines have been given to half of all humanity (3.8 Billion folks)

They are among the most closely studied vaccine in history

15 million kids in the US have already been given the Pfizer vaccine

Side effects happen but are rare

Read 5 tweets
24 Oct
Good morning

Here's a quick update on the state of COVID in the US

5 points:

1. Infections are down 50% from September 1

Last year, infections rose 100% from September 1 to October 31

So we are, at least right now, on a pretty different trajectory

2. Deaths are down about 30% from the peak

This is good but not great

Why not more?

Deaths lag

But also, we are still seeing a lot of infections among vulnerable, high risk people

This is no time to be older, chronically ill and unvaccinated

3. Most new infections are in the northern half the US

And largely in Midwest, Great Plains states

7 states with the highest infection rates (AK, MT, WY, ID, ND, WV, UT)

They also have very low vaccination rates

In New England, cases flat despite weather getting colder

Read 6 tweets
18 Oct
Given the passing of General Powell who was fully vaccinated

A lot of misinformation spreading about breakthrough infections

So let's talk about breakthroughs

What are they about?

When are they a big deal?

Let's put on our public health and clinician hats on this

First, what is a “breakthrough” infection?

Its when someone who is fully vaccinated still gets infected

We know these vaccines prevent infection – but not 100%

So vaccinated people can still get infected

But then, your immune system, trained by vaccines, really kicks in

Within days of infection, a vaccinated person's immune system goes into high gear

Memory B cells make antibodies

T cells arrive to kill infected cells

And for most people, they don’t go on to have severe disease

A few days of symptoms, then they recover


Read 8 tweets
17 Oct
When folks think about highly vaccinated places in America

They think Vermont or CT or MA

Those places are good

But not the most vaccinated place in America

So who's #1?

Puerto Rico!

But PR has gotten way too little attention

Its worth reflecting on how they did it

So lets talk numbers

Proportion of population fully vaccinated

MA is 68.8%

CT and RI are both at 69.8%

VT is at 70.5%

PR? 72.0%

Among older folks (those >65) fully vaccinated

VT is highest state at 96.3%

Puerto Rico? 99.9%. Basically everyone

And its paying off

Since July 1, when the Delta wave started

VT has had 50% more cases than PR

And today, PR has one of the lowest infections rates in America

Here's data from @CovidActNow

You can see Puerto Rico has one of the lowest infection rate in the US (way lower than most states)
Read 6 tweets
13 Oct
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
Read 4 tweets

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