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Monica Gandhi MD, MPH

15 Dec, 8 tweets, 3 min read

My 8 suggested changes for COVID policy 2022:
1) Boosters: risk stratify, do young males need? Space doses
2) Mask mandates based on hospitalization rates like Marin
3) CDC endorse test-to-stay. schools
4) Masks optional schools 8-12 weeks after availability of child vax (11/4)

5)Paxlovid asap
6)Acknowledge natural immunity more like Europe
7)CDC reporting: Better data on severe breakthroughs so can advise boosters, masks, etc.
8) Stop travel bans, harm reduction approach, global equity, acknowledge endemic, prevent illness
nytimes.com/2021/12/11/opi…

Guess not clear. Suggesting off ramps for masks for both adults and kids for top points. I said after AVAILABILITY of child vax; some adults deciding. And yes I recommend for immunocompromised like my dad -fit and filtered masks inside. Everytime I mention masks, both sides yell

In relevance to point #1, please see this piece from today in the Washington Post
washingtonpost.com/outlook/2021/1…

@j_g_allen

In relevance to point #2, please see @j_g_allen's piece in Washington Post yesterday about how masks protect YOU so immunocompromised & those who desire protection need N95s or similar but mask mandates for all not effective now washingtonpost.com/opinions/2021/…

@LeslieBienen

In reference to point #8 (how are still closing schools this late in the pandemic despite knowing mental health effects on children), please read our piece in TIME today with @LeslieBienen. We need a different strategy esp with Omicron
time.com/6129225/omicro…

https://twitter.com/MonicaGandhi9/status/1450276455280037888

And finally, to complete this thread, why so many countries suggest increasing the spacing between doses which is relevant for point #1 (safety and effectiveness)

https://twitter.com/MonicaGandhi9/status/1450276455280037888

So happy #3 of 8 happened today! CDC endorses test-to-stay! In terms of #2 on masks, 2 options: 1) Say all wear N95 inside (probably not realistic after vax); 2) Focused protection: Anyone at risk or who wants no risk: N95, KN95 or double mask inside
washingtonpost.com/education/2021…

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More from @MonicaGandhi9

Monica Gandhi MD, MPH

@MonicaGandhi9

14 Dec

https://twitter.com/MonicaGandhi9/status/1470839863284957184

There seems to be a lament on twitter today that COVID zero could have been possible (although many countries tried so hard & couldn't); it is actually the properties of the virus itself that make that impossible; lucky these amazing vaccines so effective against severe disease

https://twitter.com/MonicaGandhi9/status/1470839863284957184

https://twitter.com/MonicaGandhi9/status/1440698563051196425

This is a longer discussion on what makes a virus "eradicable" or not

https://twitter.com/MonicaGandhi9/status/1440698563051196425

When a virus is recognized to have properties that will make it endemic but have strategies to protect against severe disease (vaccines & therapeutics-Paxlovid- for those who decline), we track cases in health departments, policy formed on hospitalizations
nytimes.com/2021/12/11/opi…

Read 4 tweets

Monica Gandhi MD, MPH

@MonicaGandhi9

11 Dec

@COVID

1. WHY HOSPITALIZATIONS ARE NOW A BETTER INDICTOR OF COVID'S IMPACT: This is my 50th op-ed on @COVID this year, round number. Suggest with @LeslieBienen and @citizen_oregon how to shift US strategy on restrictions & policies at this stage in pandemic
nytimes.com/2021/12/11/opi…

2. New strategy likely even more important to institute (with our current tools) with the new #Omicron variant which - since likely more transmissible but more mild by accounts to date- can be in people's noses without disease. Public health sworn to protect us against illness

3. The US (and any other country) accepting that a highly transmissible virus with animal reservoirs will be endemic is not "giving up" & cases will still be tracked by health departments, but by focusing on disease, we can work harder to prevent iy

Read 11 tweets

Monica Gandhi MD, MPH

@MonicaGandhi9

11 Dec

@DLeonhardt

Covid Malaise - great article on what it feels like to be in a blue state at this point in the pandemic (@DLeonhardt has written plenty of red states having less vaccine uptake & more COVID hospitalizations since vax available). I call it "twilight zone"
nytimes.com/2021/12/10/bri…

@DLeonhardt

It is important to assess the collateral damage of any interventions we put into place in public health to combat one disease on other conditions and @DLeonhardt does so here, also commenting "And school operations are still not back to normal. Students are sometimes..

"forbidden to sit or talk with one another during lunch — or to eat indoors. Masks make communication harder, especially for students with learning disabilities. Positive Covid tests/worker shortages can cause schools to close temporarily". In blue states, other problems ignored

Read 4 tweets

Monica Gandhi MD, MPH

@MonicaGandhi9

10 Dec

@DrMarcSiegel

Why I don't think variant-specific boosters will be needed on Doctor Radio @DrMarcSiegel
siriusxm.com/clips/clip/e7a…

@DrMarcSiegel

Why I am excited about upcoming oral treatments for COVID-19 on Doctor Radio @DrMarcSiegel
siriusxm.com/clips/clip/e7a…

@DrMarcSiegel

And why to remember that protease inhibitors specifically were the turning point for HIV in 1996 & so particularly excited about Paxlovid. Doctor Radio @DrMarcSiegel
siriusxm.com/clips/clip/e7a…

Read 4 tweets

Monica Gandhi MD, MPH

@MonicaGandhi9

7 Dec

Epidemiological update: Omicron continued reporting from EU CDC equivalent as of 6 December. "All [Omicron] cases for which there is available information on severity were either asymptomatic or mild. No deaths". Immune system more than antibodies
ecdc.europa.eu/en/news-events…

Although some references need updating, this explains how the immune system is not just antibodies but cellular memory too
leaps.org/how-long-do-co…

If hybrid immunity strongest type of immunity at all (as shown by the Sigal lab), much better to be vaccinated first & then get benign infection on top than vice versa (not safe). Remains to be seen if boosters stimulate memory/antibodies enough (boosted people have mild Omicron)

Read 4 tweets