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Céline Gounder, MD, ScM, FIDSA Profile picture
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7 Jan, 4 tweets, 3 min read
1/ Today, the Supreme Court is considering an emergency rule issued by the Occupational Safety & Health Administration (OSHA) for workplaces with 100+ employees to require non-vaccinated employees to wear a mask at work & test negative at least weekly.

washingtonpost.com/outlook/2022/0…
2/ As @DrDavidMichaels, former Assistant Secretary of Labor for @OSHA_DOL, notes, the Supreme Court justices are well protected vs COVID:

They could work from home.
They're all now fully vaccinated.
Everyone has to be PCR negative & wear N95 / KN95 mask.

Most aren't so lucky.
3/Frontline essential workers & others working in public-facing jobs remain at high risk:
4/ As I wrote in @TheAtlantic, even if you don't care about the health of frontline essential workers & others, you should care about the impact not protecting them from COVID has on the economy:

theatlantic.com/health/archive…

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More from @celinegounder

Céline Gounder, MD, ScM, FIDSA Profile picture
7 Jan
1/ @ZekeEmanuel @mtosterholm @llborio @RickABright @drdavidmichaels published 3 Viewpoints in
@JAMA_current on an updated national strategy for controlling COVID.

1st in the series:
A National Strategy for the “New Normal” of Life With COVID
jamanetwork.com/journals/jama/…
2/ We've got to set realistic goals: to flatten the curve, and to suppress COVID hospitalizations & deaths.

Our health system is buckling under the weight of COVID. This is not sustainable.

The good news is that measures to control SARS-CoV-2 will also control influenza & RSV.
3/ Masking😷, ventilation🪟 & air filtration will control COVID, influenza, RSV, & other viral respiratory illnesses.

Vaccines💉, rapid antigen tests & antiviral drugs💊 can also help reduce influenza transmission, cases, hospitalizations & deaths.
Read 46 tweets
Céline Gounder, MD, ScM, FIDSA Profile picture
5 Jan
1/ Screening To Prevent SARS-CoV-2 Outbreaks: Saliva-Based Antigen Testing Is Better Than The PCR Swab
healthaffairs.org/do/10.1377/for…
@ADPaltiel & @CDCDirector @RWalensky
September 2020 Image
2/ Image
3/ Image
Read 7 tweets
Céline Gounder, MD, ScM, FIDSA Profile picture
30 Dec 21
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 8 tweets
Céline Gounder, MD, ScM, FIDSA Profile picture
29 Dec 21
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.
Read 6 tweets
Céline Gounder, MD, ScM, FIDSA Profile picture
28 Dec 21
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 21
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

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