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Monica Gandhi MD, MPH Profile picture
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28 Dec, 7 tweets, 5 min read
HOSPITALIZATIONS AS METRIC OF SUCCESS RATHER THAN CASES: @nytimes opinions piece we wrote 2 1/2 weeks back may have seemed forward looking but really seems to make sense now in light of @omicron variant
CDC said today breakthrough common; took Singapore data that viral load decreases more quickly & Netherlands data that virus less infectious with breakthroughs; shorted isolation to 5 days (then mask x 5 days); no quarantine if can mask 10 days
time.com/6129225/omicro…
Vaccines really work & if you want to encourage vaccinations (and boosters in those who need), stress how they work even in light of #omicron by not adopting 2020 strategies for 2022
time.com/6131104/rethin…
I explain in this podcast with @jarod_ormsby. If you spend a bit of time reading the 10 points above of the @nytopinion piece, can see that we address long COVID & testing difficulties too
podcasts.apple.com/us/podcast/imp…
And see that may schools closing in light of #omicron in US but not other countries maybe due to this concern raised this winter
But our need to work on #globalvaccineequity remains even more urgent than before in light of #omicron
@ashishkjha -who has been influential in US response- agrees that Omicron should shift our focus to hospitalizations but of course health departments will still track cases (& notes that CDC guidelines for I/Q still stresses wearing masks for duration)
beckershospitalreview.com/public-health/…

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More from @MonicaGandhi9

Monica Gandhi MD, MPH Profile picture
21 Dec
OMICRON: 2 fascinating articles today from S Africa in pre-print (researchers/doctors there are excellent)- question of day: Is Omicron less virulent intrinsically or is the lower hospitalization rate due to increased immunity? This one argues for latter
medrxiv.org/content/10.110…
Looked at seroprevalence rates in Guateng Province, S. Africa, 7010 people (18.8% had received vax'd). Overall seroprevalence ranged from 56.2% in children <13 to 79.7% aged >50 years. Cases went up, rates of hospitalizations & excess deaths did not increase proportionately, low
However, this one argues for less virulence intrinsically beyond just higher rates of immunity in Dec 2021. Proportion of omicron increased from 3% in early October (week 39) to 98% in early December (week 48). On multivariable analysis, after
medrxiv.org/content/10.110…
Read 4 tweets
Monica Gandhi MD, MPH Profile picture
20 Dec
Speech tomorrow night by President Biden: Some ideas/notes/references from our team for consideration by @POTUS @WHCOVIDResponse. Thank you for considering!
Goes along with this editorial by @j_g_allen in @NYT today to not close schools again
nytimes.com/2021/12/20/opi…
Here is a downloadable link to those suggestion for @POTUS, @WHCOVIDResponse so you can click on links. Of course we have dreams of ventilation and universal health care but we are focusing on what to do now for tomorrow's night speech. Thanks!
ucsf.box.com/s/r0gu16r1p8nl…
Read 6 tweets
Monica Gandhi MD, MPH Profile picture
17 Dec
These virulence studies showing Omicron may be more mild not only due to increased immunity in population but something to do with its viral pathogenesis are fascinating
And yes @sailorrooscout, I saw your tweet from earlier but not believing our South African colleagues when they tell us something is different about Omicron feels disrespectful to me too. HIV MD/researchers know our S. Africa colleagues working in the field of HIV well
Read 6 tweets
Monica Gandhi MD, MPH Profile picture
15 Dec
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
Read 8 tweets
Monica Gandhi MD, MPH Profile picture
14 Dec
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
This is a longer discussion on what makes a virus "eradicable" or not
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 Profile picture
11 Dec
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

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