Dr Ellie Murray, ScD Profile picture
Dec 22, 2021 15 tweets 6 min read Read on X
THINK LIKE AN EPIDEMIOLOGIST, Part 2.

In today’s 1st thread, I discussed the math of infections to help you understand what #TinyWiseDecisions you can make to be #COVIDSafer this winter.

In this 2nd thread, I want to give some concrete ideas for making your risk a little lower.
Omicron is very contagious & ideally, we would all be taking STRONG precautions.

But risk is additive & a spectrum, so #TinyWiseDecisions will help.

Choose something from this thread or share an idea of your own, so that we can all be just that much safer this holiday season.
Idea 1: If you are planning to attend more than one holiday event, choose one of them to decline.

Attending even one less gathering makes everyone safer.
Idea 2: If you are hosting a gathering, invite one less household.

Infection transmits easily within households, so having many different households together is more risky than fewer households.
Idea 3: If you’re going to a gathering, take a rapid test right before heading out of the house.

If the test is positive, or if you have any symptoms, stay home!
Idea 4: Wear a mask if you weren’t planning on wearing one. If you were already planning to wear a mask, choose a better mask.

KN95s or N95s are good. If you’re already wearing those, make them better by ensuring a nice snug fit.
Idea 5: If you are attending a holiday gathering, open up the windows to let some fresh air in, even if it’s a bit frosty.

If you were already going to do that, consider spending some of the time in the garden or on the balcony (if you have either—I dont!).
Idea 6: If you were going to visit more than one household, add an additional day or two between your planned visits.

Just a couple extra days will give you time to detect if you or anyone at the first household was infected.
Idea 7: If you were planning a holiday outing to the movies or theater or a restaurant or similar, choose a less crowded time or place, an outdoor seating option if available, or wait a few days before seeing family.
Idea 8: If you’ve been delaying getting vaccinated, make an appointment today! Accept whichever vaccine is available soonest.

The best vaccine is the one in your arm!
Idea 9: If your religious community is offering virtual services, choose those instead of in person. If you dont have that option, choose a less busy service (7am maybe?).

Mask up, spread out, dont shake hands or hug, dont linger too long chatting, ask to keep doors open.
Idea 10: If your gathering has a meal, consider having people plan to bring the food home rather than eating all together. Eating requires unmasking & unmasking means more chance of transmission.

Alternative: have different households eat in different rooms at the gathering.
Okay, there are surely many many many other ways to make your holiday safer & to choose #TinyWiseDecisions, but I’m running out of steam right now.

Share with us what you are planning to keep yourself & your loved ones #COVIDSafer this holiday season.
An important caveat to Idea #6.

Waiting gives time for symptoms to manifest but waiting for less time could just make you asymptomatic & infectious at your visit! Be careful out there, friends 💜
For all you “no one would do this” folks….

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More from @EpiEllie

Jan 13
PUBLIC HEALTH MINUTE:

Honey is sweet and sticky and wonderful and everyone loves it, and babies are sweet and sticky and wonderful and everyone loves them.

But you should NEVER ever give honey to babies.

Why?

The short answer is: botulism.

The longer answer: a 🧵
What is botulism?

Botulism is the general name we give to several different diseases caused by the bacteria Clostridium botulinum.

This includes foodborne botulism, wound botulism, ‘iatrogenic’ (aka cosmetic) botulism and *infant* botulism.
Foodborne botulism, wound botulism, and iatrogenic botulism differ in what body part is affected but otherwise follow the same basic process.
Read 22 tweets
Jan 9
If everyone you know is suddenly getting “food poisoning”, just FYI that it is probably not actually food poisoning but is instead norovirus.

Norovirus (sometimes called “stomach flu” but not actually flu) is seasonal, and right now in the US it is norovirus season.
Norovirus symptoms are mostly vomiting, diarrhea, and cramps. But some people also have headache and fever.

Typically, symptoms last only a couple days, but for very young kids, very old people, or people who have weakened immune systems for any reason can be sick for longer.
Norovirus spreads by when uninfected people accidentally ingest the poop or vomit of an infected person (eww!).

This happens when teeny tiny bits of poop or vomit get onto other people, shared surfaces, or into shared food.
Read 13 tweets
Jan 6
I am a methodologist. Methods is a speciality. We make recipes for others to use.

When I publish methods, I include relevant code, equations, assumptions, & interpretations. I *intend* for people to re-use these.

Citation is expected. Quotation marks would be ridiculous.
For eg, if you are estimating a per-protocol effect of treatment adherence with treatment-confounder feedback using inverse probability weighting, I’ve shared my code & my papers with correct language for your methods & results sections.

Use it, cite it. Thats why it’s there.
Read 5 tweets
Dec 6, 2023
Me, an epidemiologist: research shows widespread mask use reduces respiratory infections

Them, a rando: OMG WHY DO YOU WANT EVERYONE TO ALWAYS MASK EVERYWHERE FOREVER?!!!!
Me, an epidemiologist: research shows widespread mask use reduces respiratory infections

Them, another rando: oh yeah? Well one time I saw a mask and then I got sick, so how do you explain that, huh?!
Me, an epidemiologist: research shows widespread mask use reduces respiratory infections

Them, yet another rando: UUUGH, WHY ARE YOU STILL SO OBSESSED WITH DISEASES?!! WHAT ARE YOU EVEN?!!
Read 4 tweets
Dec 5, 2023
When people talk about masks & mask mandates for preventing respiratory infections, they love to talk about improper mask wearing.

And it’s true not everyone wears good masks correctly. But it’s also true that MOST people wear good masks well.

How many is most? About 85%.
Data from *Kentucky* show that during their mask mandates, 95% of people in indoor public spaces were seen to be wearing any mask.

And 87% of people were wearing masks that fully covered mouth and nose.

journals.plos.org/plosone/articl…
We did a separate study in Boston right around the same time — without knowing the Kentucky study was even happening.

What did we find?

95% of people were wearing masks in indoor public spaces. And 85% had them correctly over mouth & nose.
Read 9 tweets
Nov 13, 2023
Out now in Osteoarthritis and Cartilage: our new paper presents a graphical causal model for treatment of pain in knee osteoarthritis.

Open access link: oarsijournal.com/article/S1063-…
Image
We outline a 6-step process for creating causal graphical models using scientific evidence and expert knowledge.

Identify core variables, create a list of potential covariates, conduct a semi-systematic literature review, discuss with experts, synthesize, and visualize. Image
What do we mean by "semi-systematic" literature review?

Like a systematic review, you begin with a carefully created search hedge: key words for your exposure, outcome, and/or other core variables, combined with your covariate list.
Read 22 tweets

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