Thread by @MonicaGandhi9

SHIFT in CDC: Feel like was likely the biggest news of the week & the message may have been missed. With such a transmissible virus, shift away from herd immunity goal is prudent. Can no longer count cases as goal of US epidemic (e.g. get <10K etc.).
ktla.com/news/nationwor…

If we track cases as our main metric after vaccination, you will see this yo-yo effect. In late September, CA had lowest cases (yes people gather inside as it gets colder), now FL has lowest cases but tracking hospitalizations is the key after vax
abc7.com/california-cov…

And - during delta- a lot of natural immunity occurred in Florida, tragically in many cases but also a lot of natural immunity in younger healthier individuals too which brings up the IgA in the nose & brings down cases; this is chasing one's tail

https://twitter.com/MonicaGandhi9/status/1449453253687533570

If track hospitalizations are main metric, we will know who to boost (immunocompromised, J&J, older individuals >65) from data so far to protect against disease; we will see that giving young IgA boost from vax will decrease again; we can shift thinking
sfchronicle.com/opinion/openfo…

This shift in thinking is imperative to make now or the case metric states like CA using now will not allow reasonable public health policy decisions which are to do whatever it takes to prevent disease - that is what public health's mission is.

https://twitter.com/MonicaGandhi9/status/1459034440198356997

During delta surge in the US, cases became uncoupled from hospitalizations in areas of high vaccination like SF. Now during this surge of cases, imperative to figure out risk factors for hospitalizations with vax (>65, immunocompromise), boost aggressively
sfchronicle.com/health/article…

CDC's shift that we can't reach herd immunity with such a transmissible variant is not giving up- no one is giving up; ongoing vaccinations, deciding the best way to administer boosters, antivirals coming, child vaccines, all get us to control (not herd immunity but control)

Of note, details of football outbreak Cal emerging in terms of symptomatic/ asymptomatic infections (check local news sources for details) so points raised in this piece are not about football but shift in thinking reflected by the CDC this past week on control not herd immunity