Dear @POTUS (& @PressSec)

An ambitious, but simple plan to convert holidays into an time to REDUCE #COVID19

1) Give every American 4 #RapidTests

2) Ask every American to test on Dec 25, 28, 31, Jan 3

3) Simultaneous mass severing of transmission chains can collapse outbreaks
@POTUS @PressSec I'm suggesting that US literally gives tests to all Americans & do so WITH A STRATEGY

No Insurance Reimbursements (this is public health, not medicine!)

Have a plan (I suggested a useful and doable one above) and get the tests out.

It will help curb spread

2/
And Before ppl say "Not enough supply, impossible"

It's not true.

We CAN have the supply
There are billions of rapid tests across the world.
A small fraction come to the US. Why? Bc our FDA places massive barriers, foregoing millions of data points collected globally.

3/
And, it doesn't have to be by Xmas

If you need more time, do it Mid-January. That's good too!!

The Virus cares about whether it's a holiday just about as much as tests care about symptoms (they don't... )

4/

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More from @michaelmina_lab

18 Dec
IMPORTANT:

RAPID TESTS DO WORK WITH OMICRON

"But why are some people staying negative in the first days they have symptoms??"

This is expected. Symptoms don't = contagious virus
This is literally a reflection of the fact that vaccines are doing their job!

PLEASE READ Image
Rapid Tests work w Omicron

Omicron is mutated mostly in Spike
Rapid Tests don't detect Spike

They detect nucleocapsid (N)

Omicron has 4 mutations in N

2 were in alpha/delta and were fine

2 are in NTD - a non-immunogenic site - unlikely to impact rapid tests

2/
We can use this “new” relationship between symptom onset and infectiousness to our advantage!

It’s a feature, not a bug. Now that the world has pre-existing immunity, we have to adjust our thinking.

Newly Symptomatic and Ag neg?
Probably not infectious now… test again tmrw

3/
Read 16 tweets
14 Dec
I’m going back and forth about this @TheAtlantic piece

It is SO difficult to read

As @jabarocas wrote - it insults & dismisses so many sacrifices made

But it also represents a hard truth of how millions of Americans view & have dealt w COVID

1/

theatlantic.com/ideas/archive/…
Should @TheAtlantic have published it?

It conveys what I consider deadly beliefs. But it’s so representative of the thinking of very many citizens that I also think it’s good for many people to read - to gain understanding of how people are thinking - regardless of the data

2/
So I’m really on the fence. Perhaps it should be published w a warning on top. But that is a very slippery slope of censorship and Reenforcing divisions and information bubbles on both sides

3/
Read 4 tweets
14 Dec
3 day wait for COVID Testing is unacceptable

MOST dont quarantine while waiting

In fact asking everyone to quarantine while waiting days is poor public health -> Every 4 negatives is equal to 1 false positive in person-days

2 years in all should have rapid results

1/
We have to be thinking of tests used for public health with population metrics:

If delay is 3 days to get results:

Then for every 2 infectious ppl detected, the wait time alone (6 person days of the person spreading while waiting) is equal to missing 1 full infection

2/
So the EFFECTIVE SENSITIVITY of a 3 day delayed PCR approaches only 50-60%

You miss ~half of the infectious days - even if you ultimately diagnose nearly everyone. But it is the infectious days averted that is important for public health. Not identifying ppl afterwards

3/
Read 5 tweets
12 Dec
How Far We’ve come!

@nytimes editorial board recommendations for how Americans can live with COVID in our midst

#1 suggestion:

Ubiquitous accessible #RapidTests

To empower us to breakthrough uncertainty and sever transmission

Smart public Health.

nytimes.com/2021/12/11/opi…
Here is a screenshot of their first couple of recommendations:

(Click the picture to see the full thing)
Read 4 tweets
12 Dec
This study is important

For unscientific reasons we in scientific/academic community downplayed impact of Covid infections in effort to get more ppl vax’d

We publicly project that infections don’t offer much immunity -stating only Vax does -> but this goes against evolution

1/
My goal is to say simply -
Focus on the science and the data and what we know of biology. Then message and create policy off that.

Yes we want everyone vax’d. But really we want everyone protected. With >50% of Americans exposed/infected… we should at least consider this…

2:
We absolutely do not want ppl to intentionally go out and get infected. But we also can’t reverse time. We know a majority of Americans have been infected. Given that protection is derived from infection - assuming you do OK through it - we should leverage that, not ignore it

3:
Read 7 tweets
11 Dec
I am 1000% for vaccinations for all

I’m very distressed by the inequities in vaccination (including owing to low uptake due to misinformation, even by our own leaders)

But this was never a pandemic of the unvaccinated - It’s always a pandemic of a virus

theatlantic.com/health/archive…
I’ve been working w vax hesitant and anti vax groups for years BEFORE the pandemic

Blame and Shame has never, ever, been the appropriate tactic to change minds. This is a pandemic of a virus

Ppl are either scared or misinformed,

First thing is GAINING TRUST

1/
Shaming and blaming does the exact opposite of gaining trust.

We cannot overlook that we had and still have leaders who have confused the shit out of ppl. Scared them of vaccines. Told them over and over that the virus is not bad.

We don’t undo this by shaming

2/
Read 5 tweets

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