Share this page!

Enter URL or ID to Unroll

You can paste full URL like: https://x.com/threadreaderapp/status/1644127596119195649
or just the ID like: 1644127596119195649

How to get URL link on X (Twitter) App

  1. On the Twitter thread, click on or icon on the bottom
  2. Click again on or Share Via icon
  3. Click on Copy Link to Tweet
  4. Paste it above and click "Unroll Thread"!
  5. More info at Twitter Help
Michael Mina Profile picture
@michaelmina_lab
Jan 4, 2022 • 7 tweets • 3 min read • Read on X
Should @CDCgov reconsider guidance on isolation & add a Neg test? Yes!

Why?

Bc relationship between symptom start & peak virus load has changed!

Guidance must keep up accordingly.

To explain: I made a (tough to read) chart based on real experience of Prof. Kato @neurotheory Image
@CDCgov @neurotheory Here is the original tweet by @neurotheory showing this TERRIFIC Time course of tests.

@CDCgov @neurotheory I've written a bit more about this in a similar thread on Omicron, testing and symptoms.

3/
Also, symptoms are not a great indicator of infectiousness (just thinkg of a lasting cough that lingers, or congestion & headache that could indicate your body is killing the virus before it gets a chance to replicate)

Or the many with NO symptoms who ARE highly infectious!

4/
With COVID, you can be

Symptomatic & Infectious
Symptomatic & Pre-Infectious
Symptomatic & Post-Infectious
Symptomatic & Never infectious

Asymptomatic & Infectious
Asymptomatic & Pre-Infectious
Asymptomatic & Post-Infxous
Asymptomatic & Never Infxous

Why testing is crucial!
5/
On the other hand, a rapid antigen test is highly correlated to high virus load and infectiousness.

If you are positive on a rapid antigen test you are very likely to be infectious.

If you are *very* positive on a rapid antigen test you are likely to be very infectious

6/
Do Rapid Ag tests stay Pos long after ppl are infectious like PCR does?

No, Rapid Ag tests require LOT of protein to turn Pos. Unlike PCR theres no "magnifying" process

Only way for such a high amt of virus protein (to see a Pos by eye) is when a lot of virus replication

7/

• • •

Missing some Tweet in this thread? You can try to force a refresh
　

Keep Current with Michael Mina

Michael Mina Profile picture

Stay in touch and get notified when new unrolls are available from this author!

Read all threads

This Thread may be Removed Anytime!

PDF

Twitter may remove this content at anytime! Save it as PDF for later use!

Try unrolling a thread yourself!

how to unroll video
  1. Follow @ThreadReaderApp to mention us!

  2. From a Twitter thread mention us with a keyword "unroll"
@threadreaderapp unroll

Practice here first or read more on our help page!

More from @michaelmina_lab

Michael Mina Profile picture
Jun 12
I've been thinking on my review of RFK Jrs 8 new ACIP members

When announced, I found myself thinking "could've been much worse" and so was relatively favorable

However, the bar being set so low caused me to miss a huge piece... and there's still great risk!

Short thread
1)
While I was pretty favorable to a majority of the new members - the bar is set inredibly low -

I was just happy the 8 were not the most hard core ideologues for whom destroying vaccines is practically religion (like RFK Jr)

That obscured the biggest problem of the group

2/
Perhaps the biggest problem is it is a panel of people who, generally speaking, are generally NOT:

experts in diseases vaccines prevent
experts in vaccines
infectious disease epidemiology
clinical trials

If this was the private sector, no way would this group pass muster

3/
Read 6 tweets
Michael Mina Profile picture
Jun 12
RFK Jr released names of 8 ppl he is placing into ACIP to replace 17 removed

Actually a majority are v reasonable - 2 of 8 however align heavily w conspiracy & anti-vax but as I discuss, their presence may have a silver lining

My thoughts:
Thread



1/cnbc.com/amp/2025/06/11…
Joseph Hibbeln MD has long researched and advocated for optimizing nutrition, including studying things like seafood consumption in pregnancy and role of mercury consumption and whether it is linked to autism. Generally he’s come out saying it’s not.

Summary: No evidence of anti science or anti vaccine. Likely very balanced and nuanced rigorous scientist to serve on ACIP. 
2/
Cody Meissner MD
Is a pediatric infectious disease expert at my Alma mater - Dartmouth. He is a rigorous scientist and has defended vaccines while formally recognizing underlying issues that are causing people to turn away from them - such as vaccine success driving down disease - affording people the luxury of focusing on very rare side effects while forgetting the real impacts of the diseases. 

For example in @NEJM he wrote: 

Summary. Terrific Choice

3/Image
Read 11 tweets
Michael Mina Profile picture
Feb 26
This is horrible & exactly what we are afraid of - measles kills ppl

In ~100 infections in TX, someone has already died

For those w/out vacc- it is not the benign virus you’ve been told

1:5 hospitalized
1:100-1000 die

This will spread further.

1/
apnews.com/article/measle…
The measles vaccine is exceedingly safe

It stops infections & spread extremely well!!

Measles on the other hand

1) kills 1:100-1000
2) hospitalizes 1:5
3) Kills immune cells & deletes protection against other infections
4) causes early immune suppression / coinfections

2/
I am extremely concerned that the communities of vaccine hesitancy have grown enough that they are now “bleeding into each other”

Which means infection in one may well ignite outbreaks of many thousands

That will come w more disease and death

Vaccination will prevent this

3/
Read 4 tweets
Michael Mina Profile picture
Feb 19
Measles cases may likely grow into the 1000’s

The TX measles outbreak continues

With “bubbles” of undervaccination getting bigger, we can expect outbreaks in one to catch on to the next

Igniting transmission that may catch and spread across the U.S.

cnn.com/2025/02/18/hea…
One of the most common tropes is that measles is fine & doesn’t cause damage…

This is highly inaccurate

Measles literally grows by infecting and killing memory immune cells. It causes loss to existing immunity creating vulnerabilities & acute damage that is often severe

2/
To discover the massive-stealth-impact measles has on immune protection against infections not associated w measles, we looked at what happened in populations after measles outbreaks swept through, decade after decade across nations…

What we found was astonishing…

3/
Read 19 tweets
Michael Mina Profile picture
Dec 27, 2024
Important wake up call:

#H5N1 BirdFlu just sequenced by @CDCgov from severe Louisiana patient

Most important, the H5 virus mutated inside the single patient to gain an ability to bind human receptors in the upper respiratory tract

It takes just one…

cdc.gov/bird-flu/spotl…Image
This is exactly the type of thing we worry about.

The mutations developed anew in this patient have been linked to severe cases elsewhere

Thank goodness the patient didnt (as far as we know) spread to any people or wildlife but this is the real concern…

We must do better

2/
And what should we do… there are many things we (USGov) should be doing yet barely have:
Read 6 tweets
Michael Mina Profile picture
Oct 3, 2024
🧵 On Seasonality:
SARS-CoV-2 has "seasonality" as a contributor to transmission dynamics

People often refute it - So I made graphs and this thread

NOTE: Seasonality does NOT = "just a cold"
Many of worst viruses have seasonality

Transmission Dynamics ≠ Pathogenicity

1/Image
Image
Image
The first figure is Wastewater SARS-CoV-2 RNA levels averaged across the whole United States

See the REMARKABLE stability in the winter peak

The peak happens in the exact same week each year

Additionally, the start up the upswing to the peak (triangles) is also consistent

2/Image
A common misconception is that "Seasonality" means "no transmission out of season"

That is NOT TRUE

Seasonal forces are those that drive predictable behavior - like a winter peak in the first week of each year

3/
Read 14 tweets

Did Thread Reader help you today?

Support us! We are indie developers!

This site is made by just two indie developers on a laptop doing marketing, support and development! Read more about the story.

Become a Premium Member ($3/month or $30/year) and get exclusive features!

Become Premium

Don't want to be a Premium member but still want to support us?

Make a small donation by buying us coffee ($5) or help with server cost ($10)

Donate via Paypal

Or Donate anonymously using crypto!

Ethereum

0xfe58350B80634f60Fa6Dc149a72b4DFbc17D341E copy

Bitcoin

3ATGMxNzCUFzxpMCHL5sWSt4DVtS8UqXpi copy

Thank you for your support!

Follow Us!

Send Email!

:(