SCHOOL CLOSURES: Wow, think we should invest in emotional support for children instead of closing schools again after prolonged schools closures last year (that led to mental/emotional difficulty).
I gave talk in Pediatric Grand Rounds this am at UCSF which made me look more deeply at the history of school closures for infectious diseases in US. School closures were ALWAYS last resort & only happened for raging infections (esp those worse for kids than adults like measles)
In influenza pandemic of 1918 (encourage you to read this article), schools were not closed in NYC (& Chicago/ New Haven) because progressive cities (we really changed!) & out of 1 million children, 750K were not from affluent families; schools place for food, safety, learning
Despite opposition, public health officials in these progressive cities said, no, we are not going to close schools; children are better off in schools. This was in a pandemic that actually affected very young & older unlike COVID which has increasing severe disease with age
Would encourage reading this interesting article- well known that children needed school so ventilation was main strategy employed (open windows, outside) for a respiratory pathogen and schools either kept open whole time or opened soon.
There were some of the strategies employed; school nurses for the first time.
Since children "better off in school", strategies employed to keep them there
These were some of the strategies employed; school nurses in school for the first time
Topsy turvy pandemic response in the US
Oh I see we didn’t learn anything. Ok.
Detroit school district moves to virtual learning 3 Fridays in December freep.com/story/news/edu… via @freep
I and co-authors wrote a piece published last week (@sdbaral, @drklausner) that stressed the importance of keeping schools open, avoiding lockdowns/abandoning ineffective mitigation procedures, & vaccines (including global equity) to fight the pandemic
bmcpublichealth.biomedcentral.com/articles/10.11…

• • •

Missing some Tweet in this thread? You can try to force a refresh
 

Keep Current with Monica Gandhi MD, MPH

Monica Gandhi MD, MPH Profile picture

Stay in touch and get notified when new unrolls are available from this author!

Read all threads

This Thread may be Removed Anytime!

PDF

Twitter may remove this content at anytime! Save it as PDF for later use!

Try unrolling a thread yourself!

how to unroll video
  1. Follow @ThreadReaderApp to mention us!

  2. From a Twitter thread mention us with a keyword "unroll"
@threadreaderapp unroll

Practice here first or read more on our help page!

More from @MonicaGandhi9

16 Nov
Protective immunity after recovery from SARS-CoV-2 infection - an important review in Lancet ID about protection from repeat infection after prior infection vs vaccination. Immunologic review AND review of re-infection studies
thelancet.com/journals/lanin…
#1. Developing illness is what all doctors are sworn to prevent so there is rarely advocacy for natural infection but this is what happens if natural infection occurs. Strongest immunologic evidence for enduring immunity, T cells from Science study here:
science.org/doi/10.1126/sc…
And 2nd amazing paper showing that your B cells will adapt antibodies if they see a variant in the future to the variant in front of them is here (we have discussed this and the above paper in T & B cell threads if you search them)
science.org/doi/epdf/10.11…
Read 5 tweets
14 Nov
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
Read 8 tweets
12 Nov
We need to start thinking differently about COVID outbreaks- this is not really about this particular outbreak (we don't know all the details)- this is about thinking differently after vaccines:
sfchronicle.com/opinion/openfo…
Read 8 tweets
10 Nov
INDIA: True that cases rising in US during the winter (at least colder states) which happens with any respiratory virus (as people gather inside during colder months). But not rising in India (and COVID hospitalizations remaining low). This being taken to mean that natural
immunity more powerful than vaccination because India had such a terrible 2nd wave but would point to 2 things: 1) Natural immunity came at terrible price of suffering & death; most of our COVID deaths in US since delta among unvaccinated; 2) This study
jamanetwork.com/journals/jama/…
showed that vaccinated individuals with prior infection 6 months or more before (HYBRID IMMUNITY) had statistically significantly lower risk for breakthrough infection than those vaccinated less than 6 months before dose 1 (adjusted hazard ratio, 0.62). Hybrid immunity powerful
Read 12 tweets
9 Nov
Democrats Desperately Need Schools to Get Back to Normal- important article "Because America’s response to Covid was so politically polarized, school shutdowns longest in blue states..only 6 states had fewer in-person days last year" than VA (CA was 50/50)
nytimes.com/2021/11/08/opi…
May be difficult from parents in other states to understand but this is what it feels like to be a parent in a blue state right now- November 2021. @JVergales and I and so many others have written about how quarantine in 2021 is the new "school closure" from 2020
important thing about quarantine as a historical concept in infectious diseases is that the benefits of that practice were ALWAYS weighed against its risks of isolation, exclusion, lost opportunities, and educational loss if enacted @JVergales & I write
washingtonpost.com/outlook/2021/1…
Read 7 tweets
7 Nov
NYC Mayor (Democrat) said today "off ramp" for masking in schools (Jan now that 5-11 vaccine here). Whatever metric you choose (MA doing 80% vax in community + hospitalization rate), looks like @NYT piece below (local NYC paper) opened door to discussion forbes.com/sites/marisade…
Reason to discuss is that children have had more restrictions in our country (more in blue states) than adults though less at risk. Our group's research on masks show masks protect wearer; anyone can still mask after mandate lifted to protect themselves
cell.com/med/pdf/S2666-…
Finally although @sfchronicle @erinallday wrote piece on off-ramps for masking children in schools today, @NYT ("liberal" paper, opposite coast) wrote powerful piece supporting school openings in 8/21; they were right, heralded last week's election
nytimes.com/2021/08/21/opi…
Read 5 tweets

Did Thread Reader help you today?

Support us! We are indie developers!


This site is made by just two indie developers on a laptop doing marketing, support and development! Read more about the story.

Become a Premium Member ($3/month or $30/year) and get exclusive features!

Become Premium

Too expensive? Make a small donation by buying us coffee ($5) or help with server cost ($10)

Donate via Paypal

Thank you for your support!

Follow Us on Twitter!

:(