1/There are so many things going on with #COVID19 right now. In some respects, it seems like March 2020 again, even though it's not.

One reason COVID19 is bewildering right now is that no one is going the same speed on the highway.
2/On the highway, people driving faster than you are maniacs.

And people going slower than you are pokey.
3/Right now, in the face of Omicron, COVID is similar.

No two people conceive of their COVID risk in precisely the same way. That creates mismatches of perception, much like driving down a long stretch the highway.
4/People who approach Omicron more cautiously than you are overreacting worrywarts.

People who are more cavalier than you are unthinking COVID-deniers.

It's a (falsely) dichotomous world of speeders and slowpokes, and you are stuck in the conceptual middle.
5/It's understandable that no two people conceive of their COVID risk in precisely the same manner.

No two people have identical pre-existing health conditions that might portend worse COVID outcomes (and a more cautious approach).
6/Add to that the fact that immunity is not a binary phenomenon. It's a spectrum based on prior infection, the array of vaccines taken, when they were taken, etc.

The world is messy right now, and that makes it blurry, like being on a highway with only speeders and slowpokes.
7/Into that topsy-turvy world comes Omicron, which complicates the risk calculus.

We know little of the specifics around how contagious, severe, and immune evasive Omicron is. Nor do we know how effective the current armamentarium of drugs will be.
8/And some early studies on things like severity conflict with one another, given the speeders and the slowpokes support for their views.

Omicron is, in real time, changing the informal norms that many of us were just getting used to.
9/But another consequences of the world of speeders and slowpokes is that it's lonely.

Just as you can be alone on the highway because people either pass you or you pass them, it's easy to find yourself on a metaphorical lost highway when it comes to COVID risk tolerance.
10/Even within the same family, peoples' risk tolerances can vary, making the social and cognitive isolation even more pronounced.
11/Example: "Why am I the only one who really seems to understand what's going on with COVID? Why is no one in my family taking Omicron seriously? Also, my partner's family needs to lighten up: you can go outside without a mask on."

Being stuck in the middle is lonely.
12/What can we do about this? First, it's important to understand that not everyone has the same risk tolerance.

Second, recognize that we all come at uncertain situations with our own cognitive biases.
13/For some, the precautionary principle carries the day.

For others, it's "jump and the net will appear." Among the most pernicious bias from both speeders and slowpokes is confirmation bias. It allows zealots to always be right by cherry picking data they find compelling.
14/Social media exacerbates this confirmation bias, by allowing for the creation of virtual echo chambers.

Unless you seek it, it's easy to create a social media ecosystem that proves that all your preconceptions are right. (I see the irony of posting this on social media.)
15/Third, it's important to recognize that, for many, their views on COVID have become part of their identity. It's difficult to attempt to change views that are indissolubly intertwined with identity.
16/It's important to keep in mind that people will defend fiercely anything that challenges their identify. This is a common psychological defense mechanism. We can, however, understand those differing views and look for places where we agree and build on those.
17/The final thing I try to do is assume some degree of good, or at least benign, intention.

In real life (not social media) not many people are trying to be pernicious.
18/With respect to COVID19, they are coming at a messy, blurry world in their own lane and, much like the highway.

They are unlikely to be traveling at exactly the same speed as you at precisely the same time.

Maybe they'll slow down, maybe they'll speed up. Be patient.

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More from @nirav_mainecdc

18 Dec
1/There are numerous #COVID19 #vaccine and #booster opportunities this weekend.

The team from @NorthernLightH will be back at the former Pier 1 in SoPo from noon-5PM TODAY (368 Maine Mall Rd). All vaccines; no appt needed.
2/The @YorkCountyEMA vaccine clinic in Sanford (1364 Main St) is open TODAY until 4PM. All vaccines; no appt needed.
3/The community in Yarmouth is organizing a clinic on SUNDAY (12/19) at the Yarmouth HS gym from 2PM-4PM.

They are offering #COVID19 and flu shots for adults and kids 5+.

Read 4 tweets
17 Dec
1/This evening, @MEPublicHealth confirmed the first five cases of the #Omicron #COVID19 variant in #Maine.

This finding was not unexpected, given that 40 other states have already detected it. Nor was it welcome.
2/Based on what we know about #Omicron's increased contagiousness, it's more important than ever to get vaccinated.

Based on what we know about the potential for "immune escape", it's more important than ever to get a booster.
3/And based on what we know about its severity (perhaps equivalent to Delta), it's more important than ever to wear a mask in indoor public settings.

Of the three monoclonal antibodies available, one (sotrovimab) retains activity against #Omicron.
Read 5 tweets
30 Nov
1/You have no doubt heard much lately about the recently designated #COVID19 #variant, #omicron.

I would like to distill what we know, what we do not know, and what this all means for you right now.
2/On 11/26/21, the @WHO officially designated B.1.1.529 (#omicron) a "variant of concern."

It cited a "large number of mutations, some of which are concerning" and "preliminary evidence" of "an increased risk of reinfection with this variant.."

who.int/news/item/26-1…
3/In short, scientists are concerned because #omicron exhibits an unusual number of mutations across the #SARSCoV2 genome, with >30 on the spike protein.

The spike is the part of the virus that allows it to gain access to human cells and reproduce. (h/t @_nference)
Read 20 tweets
22 Nov
1/A recurring refrain I hear about #COVID19 #vaccines is, "Why should I get the shot since I can still get COVID after?"

I want to discuss why that isn't exactly an accurate assessment why it doesn't accord with the way that most of us think about risk in our daily lives.
2/Let's start with the core notion: that you can still get #COVID19 after being fully #vaccinated.

That is true. But the statement lacks critical context. While you can still get COVID after getting a vaccine, you are MUCH less likely to do so.

The relative risk matters.
3/At baseline, the #COVID19 vaccines have an effectiveness of around 80-90%.

Vaccine effectiveness is a measure derived from clinical trials and calculates the relative risk of being affected in a vaccinated population vs. an unvaccinated one.

cdc.gov/vaccines/covid…
Read 16 tweets
18 Nov
1/We are all tired of #COVID19. But the virus, sadly, is not done with us.

If you're looking to help your fellow Mainers through this difficult time, there's something you can do: volunteer with Maine Responds (maineresponds.org).
2/Maine Responds is our state's public health #volunteer network.

Hundreds of your neighbors are using their skills to help the entire state’s #publichealth system.

And it's an impressive, well-oiled machine. Some quick stats 👇🏾
3/Since March 2020, Maine Responds has built a #COVID19 response team of 519 activated #volunteers.

They've donated 38,917 hours during 6,474 shifts.

The #volunteers have carried out 34 distinct missions - both one-time as well as sustained, long-term efforts.
Read 5 tweets
9 Nov
1/Infection-induced (a/k/a 'natural') #COVID19 immunity and vaccine-induced immunity are again in the news.

This is a fascinating area of immunology, with numerous twists and turns.

cdc.gov/coronavirus/20…
2/It can be hard to digest the data and make sense of the various studies. Thankfully, the @CDCgov is out with a new Science Brief that does just that.

I recommend this Brief for anyone looking for an overview of the current scientific evidence.

cdc.gov/coronavirus/20…
3/Here are the key details from the review:

- Fully vaccinated individuals and those previously infected with SARS-CoV-2 each have a low risk of subsequent infection for at least 6 months.
Read 6 tweets

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