🧵 When ppl give anecdotes about public health efforts not working - please proceed cautiously

It is rare that public health success makes headlines or goes viral Bc success in public health almost always represents the absence of anything interesting.

Bias is tough to spot

Imagine for example if a vax failure in a single person was the only times vaccines made headlines. We’d think they didn’t work. But this is why we have trials - to ensure that we put any Vax failures into proper perspective and measure rates of success vs failure

The same goes for anecdotes around tests, for example:

The White House Rose Garden outbreak made headlines and made everyone think that tests don’t work.

What was not discussed were the hundreds of WH events w no outbreaks owing exclusively in that WH to testing.

Outbreak prevention is always imperfect & control in public health is always a probability

So there will always be room for failures to be highlighted in media

We can do better than this and use data to understand rates of success, rather letting headlines carry us astray


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More from @michaelmina_lab

21 Nov
🧵 I want to comment on what I was referring to👇

When we say “pandemic of the unvaccinated”, it is stigmatizing & inaccurate - this is a pandemic of a virus that is disproportionately afflicting unvaccinated

I urge us to consider root causes of why so many are unvaccinated

I have spent many years speaking w vaccine hesitant ppl and not once have I found someone choosing to not vaccinate out of spite

It is nearly always out of a combination of love and fear and confusion about who to trust.

In this pandemic, we have lost the trust of many…

The US has bungled the response to this virus in nearly every way pre-vax.

There have been many times when the public health decisions have had to be walked back. “We” have made many mistakes.

Yet we assume that everyone should auto-trust public health decisions

Read 9 tweets
6 Nov
Confused about the new OSHA testing rules for unvaccinated?


A few options but if using Rapid Tests, the tests must be:

- Observed by the employer OR

- via a Certified Telehealth Proctored session (There are a few companies enabling this)


The rule applies to any companies with 100 or more people…

In these companies, employees must be vaccinated or test weekly.

A hefty fine of $14,000 can be placed upon companies out of compliance

So here are the testing options and pros/cons

First off, that $14k fine is PER individual out of compliance, and possibly per infraction (though Im not positive about the per infraction part).

Read 15 tweets
1 Nov
I truly dislike the term "Natural Immunity"

There is no such thing as artificial immunity

A vaccine drives a NATURAL immune response

The question is simply "how do you want to start building that immunity?" Through a risky infection or via a safe vaccine

Me? I choose vaccine.
Vaccines are one of the most holistic interventions we have in medicine and public health.

Vaccines utilize our natural evolved processes to provide our immune system with an Education.

They aren't a pill that kills pathogens by distributing to all our tissues...

Vaccines are perhaps the most natural thing we do in medicine to protect ppl from infections

Vaccines are small proteins that get taken up naturally by our immune cells.

The immune cells do exactly what they evolved to do naturally. Vaccines don't force anything.

Read 7 tweets
1 Nov
“I will plan to return to work in person at the conclusion of the ten day quarantine following a negative rapid test..."

Great use of a rapid test!

Importantly she’s not using a PCR test bc she’d still remain PCR pos, potentially for weeks.


Why is this important?

Bc imagine that she did not test early and isolate and got a PCR positive AFTER the day her isolation would have ended.

SHE would have to START an isolation that day, for ten days, even though she was NO LONGER INFECTIOUS


Let’s say in this scenario that @PressSec was not in contact w @POTUS when she was actually infectious bc Biden was in Europe.

But then they were in contact AFTER the infectious period, and just before she got the 1st (in this scenario) positive PCR test

Read 7 tweets
31 Oct
Kids will now get vaccinated

Millions have unfortunately already been infected - we can’t undo that

Let’s not ignore it but use it to our benefit

Data shows Infxn + 1 dose Is as good as 2 dose in uninfected

Here’s a simple strategy to conserve vax and reduce burden

When kids show up to get their first dose of a vaccine, they are simultaneously offered an antibody test. The sample for the antibody test can be a simple mouth swab of the gums (or a blood draw - but I prefer a swab of gums personally since it’s painless and easy.

Now that the kid has their first vaccine AND a sample for antibody test, there will be 3-4 weeks to confirm if the child has antibodies to COVID.

This long period of time offers tons of flexibility to ensure a highly accurate result is obtained - I’ll give examples below

Read 14 tweets
30 Oct
Recognizing a need for boosters in vulnerable when it comes to Delta & recognizing their benefit - which thus far seems high (even if turns out to be temporary)…

Why are we still vaccinating w mRNA sequence of the now obsolete Wuhan strain when we know the sequence for Delta.
This is only half sarcastic as a question.

Is it purely bc full trials haven’t been completed? Is it bc we don’t agree w an added benefit of using a sequence matching the most common and destructive variant?

My opinion is there would be benefit (or at least equivalency)
If we continue to Reenforce a response to the 1st virus, we may find ourselves stuck in that version of a response when we do want to make an update to the vaccine later on. Better to stay current.

Also, we know Delta has evasive mutations vs original immune response
Read 4 tweets

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