Thing is… even prior to #COVID19, it was known that viral shedding can occur in feces up to 3 weeks or longer. Isolation periods have always been subjective. That said, for airborne spread, there is a need to take precautions while infectious in that way #Omicron
Specific to #COVID19 (in #Pediatrics)

“duration of viral shedding in infected pediatric patients. Virus was detectable for a mean (SD) of 17.6 (6.7) days overall and was detectable for a prolonged period of time in all cohorts of children”

jamanetwork.com/journals/jamap…
Then this.

“Duration of symptoms ranged from 1 to 36 days. Positive tests were recorded up to a median of day 21 (range 6-38).”

pubmed.ncbi.nlm.nih.gov/33911876/
Viruses in general do this:

“duration of viral shedding was 51.4 days (y = 9.558-0.186x). The median viral load of the HAdV-7 group at weeks 2 and 3, and more than 3 weeks”

We have always sent ppl back to work/school while still shedding (& + test)

pubmed.ncbi.nlm.nih.gov/33565614/
BUT.. difference between detectable & infectious

“SARS-CoV-2 RNA shedding in respiratory and stool samples can be prolonged, duration of viable…short-lived. SARS-CoV-2 titres in the upper respiratory tract peak in the first week of illness”

thelancet.com/journals/lanmi…
Also, peak transmission is *before* symptoms (virus furiously replicating in new host)

“infectiousness peaked on or before symptom onset …44% (95% confidence interval, 30–57%) of secondary cases were infected during the index cases’ presymptomatic stage

nature.com/articles/s4159…
@CDCgov not requiring negative test to go back to work itself is not unreasonable. Back in 2020 there was a a 10 vs 7 day quarantine debate

“interpretation of the infectivity of a person based on a positive PCR test can be inaccurate.”

ncbi.nlm.nih.gov/pmc/articles/P…
The worst/most transmission/infectious ness may be just for one day

“We identify that people infected with SARS-CoV-2 or influenza can be highly contagious for less than 1 day, congruent with peak viral load”

elifesciences.org/articles/63537

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More from @usnehal

3 Jan
This 👇👇👇 (h/t @joemd)

Also, at midcareer female success is threatening to men our age AND to younger men who rely on patriarchal patronage systems. Women, overpoliced by the system, then, yes, are tougher bosses AND we *do* tend to adhere more closely to ethics.

I do do all:
On #MedTwitter there is a pattern of “callouts”, yes vs all genders & ages, but also pattern of misogyny and misogynoir. It happens towards nurses & doctors alike. One of the reasons I connected with @ShrimpBrokkoli is because I saw a yt male resident ridiculing her online.
I saw that behavior being taught by NON-clinical faculty & that REALLY crossed a line.
If you are a woman + nurse + frontline + Black/WOC, you already live with so much violence towards you. Added online made up drama from a trainee vs nurse?
No, no, & no.
webmd.com/a-to-z-guides/…
Read 16 tweets
2 Jan
Directness & saying what you mean is important. The receiver also needs to be ready to tolerate this. Society & business places tend to prefer the passive aggressive so being direct does invoke blowback.
There is particular social cost to being direct & going against social norms

if your optics/demographics invoke mental models …say of expected discretion, “civility”, or “be kind” or “softness”

OR

if mental model invoked is “angry Black woman/man”

fastcompany.com/90413951/women…
“Be kind” is red flag: it identifies the passive aggressive shushing/shaming people who are threatened by @candor & perceive directness as aggression. It’s a fixed mindset trait or a negative consequence when empathy/emotions overindexed in ways to block growth & learning.
Read 9 tweets
2 Jan
As a #vaccine & #publichealth advocate I *always* respond to any question with sincerity. Since I got put on lists of pro-#DEI/#equity/#BLM docs to target is anonymous accounts will “@“ me then when I respond in good faith it is tallied as my “harassing” = manufacture fake #data.
This is a deliberate anti-#publichealth #SciComm strategy to bully, harass (but then claim opposite), intimidate, & drive out

Sadly, it is successful

Hundreds of public health officials have left jobs, mislabeled by #disinformation smears

#MedTwitter

cnn.com/2021/05/23/hea…
If do not leave on own
manufactured/fake outrage or drama or
internal lobbying relationships/political pressure
⬇️
to get dedicated #publichealth officials fired

@KHNews #MedTwitter #NurseTwitter #ScienceTwitter #pandemic #COVID19 #QAnon #disinformation

khn.org/news/public-he…
Read 5 tweets
2 Jan
Good question. Not everyone in #SciComm is actually equipped either, is the issue, as there is no credentialing, training, or gatekeeping of quality on #science #communication, much of which is #marketing or reputation management for hospitals & for profit #healthcare companies.
In particular, there is a real dearth of credible, reliable #publichealth #communication & #scicomm. Much of what I have seen called as “SciComm” is “personal brand” & #marketing a private practice for revenue goals. Critical thinking or unbiased communication is still lacking.
Keep in mind just how prevalent gossip & smears & vicious rivalries are in #academia. Do we trust *these* people to responsibly #communicate to the public on delicate issues?

Let’s instead train #journalist on #science than other way round. #SciComm

thesocietypages.org/discoveries/20…
Read 4 tweets
2 Jan
This is happening in U.S. & U.K. Once I got to the management & C-suite, especially in #NYC, I was unwilling to send #HCW into unsafe spaces to be injured or die.

@drbreenheroes this is the crux of the issue. “#Mentalhealth” is really #moralinjury from #ethics violated.
The frontline is disproportionately POC, women. Those making guidelines or in C-suite are able to protect themselves. Leadership manipulates data/definitions, then shames, gaslights. Non-clinicians hired to override #HCW with “opinion.” Those at frontline who speak up: fired.
Who is among these flags (& whose loved ones)? It is not those pushing out pre-prints or on TV nor those safely behind a screen from a second home. It is those at the frontline, working without support, protection, or even without pay (some hospitals asking docs to volunteer).
Read 4 tweets
1 Jan
This is what targeted racial harassment looks like: nitpicking things like “smiled” or “wore clothes like a celebrity, as a celebrity” or “bought cookware.” It is part of the “gold digger” narrative.
This is common in #healthcare#professionalism” where there is hazing & bullying by racist &/or classist made up non-rules lacking standards…yet people are called “breaking the rules.”

It’s exactly how bullies operate: double standards, mislabel/smear, exclude, marginalize.
In the U.K., “BAME” includes the formerly colonized, thus making race constructs or power different from U.S. as latter had race-based chattel slavery.

Thing is, those formerly colonized have many who have internalized self hate & racism.

psycnet.apa.org/record/2021-69…
Read 76 tweets

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