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Céline Gounder, MD, ScM, FIDSA Profile picture
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29 Dec, 6 tweets, 3 min read
1/ CDC has shortened the recommended isolation period for COVID from 10 to 5 days
IF symptom-free at 5 days
AND recommends that people wear a mask for 5 more days.

But no testing?

cdc.gov/media/releases…

with @vladduthiersCBS @nateburleson @jamieyuccas on @CBSNews @CBSMornings
2/ Rapid antigen tests are our best measure of contagiousness, even if not perfect.

We should absolutely be using rapid antigen tests to assess whether someone is safe to come out of isolation & return to work.
3/ The FDA has had over 2 years to assess how best to use rapid antigen tests.

The FDA treats tests to DIAGNOSE an infection the same as tests to assess whether you're INFECTIOUS / CONTAGIOUS with that infection.

This makes no sense.
4/ The FDA has dragged its feet on:
- creating separate regulatory pathways for tests to DIAGNOSE infection versus those to assess whether someone is INFECTIOUS / CONTAGIOUS with that infection.
- reviewing & authorizing rapid antigen tests.

propublica.org/article/heres-…
5/ Supply of tests is absolutely an issue here, too.

The Biden administration could have done more sooner to scale up the availability of testing, including rapid antigen testing:

kff.org/report-section…

vanityfair.com/news/2021/12/t…
6/ This comes from the American obsession with high-tech biomedical silver bullets.

Vaccines are our BEST TOOLS in the toolbox to fight COVID.

But we have to use ALL the tools in the toolbox, which includes:
- masking
- ventilation & air filtration
- testing
- treatment

• • •

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More from @celinegounder

Céline Gounder, MD, ScM, FIDSA Profile picture
30 Dec
1/ The CDC tried to balance public health with what people are willing to do in its COVID isolation/quarantine policy.

Yes, everyone is exhausted of living through this pandemic.

But what about what healthcare workers are willing & able to do? to keep doing?
2/ Healthcare workers are just like everyone else:

We've lost loved ones to COVID.

Some of us have gotten sick or died from COVID.

Some of us or our family members have lost their jobs to COVID.

Some of us have kids in school & have had to navigate hybrid learning, too.
3/ But in some ways, we're not like everyone else:

Many of us went into the pandemic already burned out by an increasingly toxic business of medicine that prioritizes $ over patients.

We've had to work overtime to care for sick & dying patients.
Read 7 tweets
Céline Gounder, MD, ScM, FIDSA Profile picture
28 Dec
NYC is rolling out oral antiviral drugs for treatment of COVID: Pfizer's Paxlovid & Merck's monulpiravir.

www1.nyc.gov/assets/doh/dow…

FREE
SAME DAY
HOME DELIVERY

REGARDLESS OF INSURANCE
OR IMMIGRATION STATUS Image
Note that Paxlovid will initially be in short supply.

Pfizer anticipates manufacturing 80M courses of Paxlovid in 2022,

& the U.S. government has contracted to purchase 10M courses of Paxlovid (enough for 3% of the U.S. population).
Although Merck's monulpiravir has lower efficacy in preventing progression to hospitalization, it will initially be in less short supply than Paxlovid, with 10M courses available by end of 2021 and at least 20M produced in 2022.
Read 6 tweets
Céline Gounder, MD, ScM, FIDSA Profile picture
28 Dec
1/ CDC has shortened the recommended isolation period for COVID from 10 days to 5 days if symptom-free at 5 days
& recommends that people then wear a mask for 5 more days.

cdc.gov/media/releases…

Is this good advice?
2/ We ISOLATE people who HAVE COVID.

We QUARANTINE people who’ve been EXPOSED TO COVID.
3/ CDC recommendations are reasonable IF PAIRED with rapid antigen testing to come out of isolation.

Why? People are infectious for a wide range of time. Some for a couple days. Others, for over a week.
Read 11 tweets
Céline Gounder, MD, ScM, FIDSA Profile picture
27 Dec
1/ Talk about a leading question:
Why is the media assuming, without data,
that more COVID boosters = better?

The COVID vaccines are excellent at preventing severe disease, hospitalization, & death.

Even every ~6-month boosters won't prevent all infections.
2/ More here:

theatlantic.com/ideas/archive/…

newyorker.com/news/q-and-a/w…
3/ What about long COVID?

Vaccination reduces the odds of long COVID, but doesn't eliminate the risk.
Read 4 tweets
Céline Gounder, MD, ScM, FIDSA Profile picture
22 Dec
1/ Should people be traveling over the holidays in the midst of an Omicron surge?
with @CBSMornings' @GayleKing

Here's how my family is managing our risk AND staying safe:
- We had a big lunch🥤🍝so we didn't have to eat/drink in the airport or on the plane✈️.

continued➡️
2/ Here's how my family is managing our risk AND staying safe (continued):
- We wore N95 masks😷in the car🚘with windows🪟open on the way to the airport.
- We wore N95 masks😷in the airport and on the airplane✈️.
3/ Here's how my family is managing our risk AND staying safe (continued):
- We're rapid testing daily. ImageImage
Read 7 tweets
Céline Gounder, MD, ScM, FIDSA Profile picture
22 Dec
1/ How accurate are the COVID rapid antigen tests?
How should you interpret the results?
with @CBS @CBSMornings' @tonydokoupil

Rapid antigen test positive➡️you have COVID

Rapid antigen test negative
BUT had a high-risk exposure or have symptoms of COVID
➡️get a PCR test
2/Here's some preliminary data from @US_FDA:

fda.gov/medical-device…

But evaluation of the rapid antigen tests vs Omicron is ongoing. ImageImage
3/ Again:

Rapid antigen test positive➡️you have COVID

Rapid antigen test negative
BUT had a high-risk exposure or have symptoms of COVID
➡️get a PCR test

🙏🏾🙏🏾🙏🏾 to the sports leagues & Bway theaters
who are testing daily, multiple times a day, with different kinds of tests.
Read 4 tweets

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