1. I tend to be an optimist. But I don't see how any amount of #COVID19 cases, hospitalizations, deaths, or disruptions will lead to fundamental change in our pandemic response. We have left it to individuals to protect themselves, battling against inequitable structural factors.
2. If there is a positive side, it is that people can be well protected with vaccine/booster, #BetterMasks, ventilation/filtration, rapid tests, and avoiding crowded indoor settings. We need to do much more to ensure it is not only those with means who can have those protections.
3. Policy changes are needed to truly make this happen. But if they are not forthcoming (and I fear they are not), we need to regain our collective spirit. If we are just out to protect ourselves, we will perpetuate disparities and prolong the pandemic.
4. If you can, donate #BetterMasks, rapid tests, or parts for #corsirosenthalbox to those in need. Donate to a charity that will do the same. Staff a vaccination clinic. Have groceries delivered to a family with young kids so they don't need to go to the store. Do something.

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More from @jonlevyBU

30 Dec 21
1. Those who focus on “Most kids will be fine if they get #COVID19” are missing the big picture. If we let kids get COVID in the next few weeks (which is a foregone conclusion with #Omicron without multiple layers of protection in schools), we create some major problems… 🧵
2. Kids will infect their families, putting their health at risk and creating the workplace disruptions that seem to be our primary focus right now.
3. Kids will flood the health care system. And it’s not just about hospitals - pediatric practices will be overrun. And that will have a major ripple effect for other kids who need support, including the mental health challenges gripping so many.
Read 6 tweets
29 Dec 21
Kids return to school in 5 days. If we don’t have #BetterMasks (and more) for all staff and students, schools might technically stay open but with no one to teach or learn. Local and state leaders need to get these masks immediately to distribute staring Monday.
Universal #BetterMasks alone can reduce exposure dramatically relative to universal cloth masks, let alone no masks. They can be more comfortable than cloth, and you could get through the next couple of months for < $20 per person paying retail.
Cost is prohibitive for some families, and many districts couldn’t afford to provide masks for all. Where the gov won’t help, maybe PTOs can step up? Bulk purchase where those who can afford subsidize for those who can’t? State help for low-income districts? Let’s get creative.
Read 9 tweets
26 Dec 21
1. In the coming weeks, you will be in a room with someone with #COVID19. But that doesn’t mean you will get infected. The dose makes the poison, so your goal is to reduce your dose as much as possible.

How do you do that? TL;DR - #BetterMasks, ventilation, and filtration 🧵
2. First the basics - Watanabe et al. 2010 published a dose-response model for SARS-CoV, which has been used as the conceptual foundation for SARS-CoV-2 risk modeling. You want to get yourself as far to the left as possible.
3. The question is, how much dose reduction is possible using simpler measures under your control?

Important to remember that measures are cumulative and multiplicative. So stack a few up and you can make a big difference.
Read 12 tweets
23 Dec 21
1. For your holiday reading pleasure, a special section was just published @AMJPublicHealth on "New Frontiers in Environmental Justice". I was privileged to co-edit it with @DrDianaHernandz. This is a very important topic at a very important time. So what's in the issue? 🧵
2. First, @DrDianaHernandz and I provide a roadmap for the articles, emphasizing how much has changed since a similar special section a decade earlier. This includes escalating burden of climate change, structural racism, and political extremism.

ajph.aphapublications.org/doi/10.2105/AJ…
3. An article by Goldsmith and @MichelleScience describes pathways that contribute to disproportionate environmental burdens on the LGTBQ+ population, a population often ignored in environmental justice work.

ajph.aphapublications.org/doi/10.2105/AJ…
Read 15 tweets
7 Dec 21
Look at the #COVID19 wastewater signal for Greater Boston, which tells us where cases are heading next week. It has NEVER been this high, even at last winter's peak. And vax rates in MA are generally higher in Greater Boston. And this is likely before #Omicron. Action now #mapoli Image
We have a choice:
1) Indoor mask mandate, all-out effort for boosters and vaccinations in vulnerable communities, expansion of testing
2) Do nothing, and watch as health care system is overloaded and families are devastated before the holidays

@MassGovernor, what say you?
And for those who argue cases don't matter any more, only hospitalizations and deaths - hospitalizations are at highest level since February, and today was the first day with 50+ deaths reported since March. So we are decidedly not "decoupled".
Read 4 tweets
17 Sep 21
1. Hi! Trained risk assessor here. Can we talk about this “1 in 5000” risk of getting #COVID19 if you are vaccinated, all of the things that are wrong with the number and how it is being used, and why I still think there is some value in the calculation? 🧵
2. First, for those unfamiliar, this first appeared (to my knowledge) in a column by @DLeonhardt in the @nytimes. He estimated a 1 in 5000 risk from stats in a few settings (UT, VA, WA). Let’s assume that his number is right. I still have a few major problems with it.
3. First, it is a daily risk, which is not how we commonly quantify risk. The column did say this directly, so it is not hidden from the reader, but many people dropped that nuance in talking about the number. Probably too much headline reading and not enough article reading.
Read 22 tweets

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