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Céline Gounder, MD, ScM, FIDSA Profile picture
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3 Dec, 4 tweets, 2 min read
1/ We are in a very different place now than in March 2020.

We now know that SARS-CoV-2 is airborne.

We know how to prevent the spread of airborne viruses:


wnyc.org/story/what-new…
with @WNYC @MorningEdition host @MichaelHillNJ
2/ 3 key Qs we have re: Omicron

1⃣infectiousness/contagiousness/transmissibility

2⃣virulence (severity of disease in infected individuals)

3⃣immune-evasion (immunity from infection & vaxx)
3/ re: Omicron & immune-evasion
- boosters may overcome relative immune evasion (as was shown with Beta variant)
- don't count on "natural immunity" to protect you vs Omicron
4/ What should you be doing to protect yourself from Omicron?

The advice hasn't changed. We were already heading into a winter surge.

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More from @celinegounder

Céline Gounder, MD, ScM, FIDSA Profile picture
5 Dec
1/ Important, timely piece by @PeterHotez:

"Science tikkun: Science for humanity in an age of aggression"
faseb.onlinelibrary.wiley.com/doi/10.1096/fj… Image
2/ Image
3/ Image
Read 8 tweets
Céline Gounder, MD, ScM, FIDSA Profile picture
4 Dec
1/ It's not that people who reject vaccines are less scientifically literate than those who don't.

It's about "core beliefs about what we owe one another."

nytimes.com/2021/12/03/opi…
by @anita_sreedhar & @Anand_Gopal_
2/ To build trust in government institutions and the collective,
we need institutions that serve the public
and a society that values everyone,
including the most vulnerable and marginalized among us.

Service & Equity Image
3/ Is this because lower socioeconomic status correlates with not being served by government institutions?

Being left behind by society? Image
Read 15 tweets
Céline Gounder, MD, ScM, FIDSA Profile picture
3 Dec
1/ Not surprisingly, a longer delay between 1st & 2nd doses of mRNA COVID vaccines (i.e. 6-7 weeks rather than 3-4 weeks) results in better immune responses.

jamanetwork.com/journals/jama/…
2/ Did we do the right thing sticking to 3-4 weeks between doses earlier in the pandemic?

I'd argue yes. Early in 2021, we were facing the threat of the Alpha variant.

We were trying to fully protect as many as quickly as possible.
3/ And then, of course, the Delta variant came on its heels... even more infectious than Alpha.
Read 5 tweets
Céline Gounder, MD, ScM, FIDSA Profile picture
3 Dec
1/ There is tremendous confusion about what it means for SARS-CoV-2 to become endemic.

It will *eventually* become endemic, but we're still far from that point.

More on that in this thread:
2/ "Endemic" is the new "herd immunity."

"People come back to work because they're less scared."

1000 people are dying from COVID in the US per day.
These are not acceptable losses.
Of course people should be scared, especially when their lives aren't valued.
3/ When I say that WE need to learn to LIVE with COVID, the operative words are "WE" & "LIVE."

WE, not I.
WE need to adapt to keep ALL OF US safe.

LIVE means alive, NOT getting used to death.

The public health approach is about protecting POPULATIONS, the VULNERABLE & EQUITY.
Read 4 tweets
Céline Gounder, MD, ScM, FIDSA Profile picture
1 Dec
1/ The first case of Omicron has been detected in the US, in San Francisco.


Am I changing my behavior?
Other than getting a booster dose of vaccine, nope.
2/ I have been wearing KN95 masks in public.

I dine outdoors.

I have HEPA air filtration units in the home.

I will use rapid tests when visiting family over the holidays. They are all vaccinated except my 2-year-old niece.
3/ Already boosted people are asking when they can get an Omicron-specific booster.

This may not be necessary.
Read 4 tweets
Céline Gounder, MD, ScM, FIDSA Profile picture
29 Nov
1/ With the emergence of the Omicron variant, my stance on boosters is shifting.

If Omicron is truly immune-evading, we can likely overcome that immune evasion with boosters (similar to what was seen with Beta).
2/ Boosters would buy us time to develop 2nd generation COVID vaccines specific for Omicron.

But risks remain:
- FALSE SENSE OF SECURITY: your risk of SARS-CoV-2 infection is proportional to levels of transmission in the community, no matter how many boosters you get

➡️
3/
Other risks:
- COMPLACENCY: we need a multi-pronged approach; vaccinations alone will not control SARS-CoV-2, at least not in the short term

➡️
Read 10 tweets

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