What did I say last Friday about the Boston area peaking? The wastewater data are in, and the news is good. @MWRA_update and @BiobotAnalytics providing solid evidence, that importantly *can't* be put down to exhausted testing capacity or other factors 1/n
this is obviously good, but it's not out of the woods good. Many of these infections were in younger age groups. We are now starting to see more infections in older folks, who are more likely to require hospital care 2/n
this would be expected to lead to fewer but more consequential infections in terms of healthcare, and a curve there closer to a plateau. They might drop more quickly than that, and they did in S Africa, but there are more older people here (albeit they are more boosted) 3/n
Importantly this has yet to show any impact of school reopening. This should become apparent in the next week or so 4/n
But this suggests good news for the disruption caused by the sheer numbers of infections. Will likely take a few days to show up in case counts, which if they follow will show a peak around now. Just like there was a peak this time last year. Past is prologue (sometimes) 5/end
And if you're not yet, get boosted! And if you are an influential trusted member of a community that is presently less boosted than it might be, advocate to your friends that they should get a third shot!

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More from @BillHanage

8 Jan
Why are we not all chilled given vaccines work against severe illness even with omicron? Well in the US (and pretty much anywhere) we are yet to see infections of large numbers of older people, and healthcare is already stretched. Here goes 1/n
This makes the point at least as well as I could
2/n
Right now close to 10% of folks in my neighborhood are infected. What this means is both good and bad 3/n
Read 10 tweets
7 Jan
So a brief thread on the state of the pandemic in the Boston area. It is quite plausible that about 10% of the population is currently infected, more in some age groups than others. A *lot* of omicron. What next? 1/n
First that 10% figure. Earlier this week, the local school district tried pooled testing before reopening after the holidays. It didn't go well as 157/362 pools came back positive, that's consistent with about 5% of the population being positive 2/n
(we don't know exactly, because the individual swabs never got tested. But some pools will have had >1 positive swab by chance, so it is probably more than 5% although way short of some of the numbers in the email parents received. Not great communication there) 3/n
Read 16 tweets
6 Jan
The local school district has done a phenomenal job of keeping education going while keeping transmission minimal in the last year. We all owe everyone involved a debt of gratitude. Recent experience with omicron however, is worth sharing. It's sobering if not very surprising 1/n
The plan was to test the community before returning to school after the winter break. A day of testing, and then the positive cases would be informed and don’t come to school. This is pretty smart in normal circumstances because... 2/n
...prevalence (the number currently infected/infectious) at a given time is not the same as incidence (the number infected in a given period). This would stop a larger number of infectious folks coming into the schools. Great plan. These are not normal circumstances 3/n
Read 12 tweets
30 Dec 21
Thread worth your time from @JasonSalemi on the remarkable things going on in Florida - a state in which more than a *third* of pandemic deaths happened in the delta wave, which other states with more vaccination were better able to fend off. I will make a couple comments below
Note some of this dramatic vertical line is likely catchup from slower testing over the last weekend. That said, a subset of folks won't be seeking tests. Not clear how that evens out
and this shows hospitalizations starting at the same rate as the delta wave. This is not good *but* the crucial question is how long they continue to increase and whether there is a very sharp peak. There's one other thing...

Read 5 tweets
29 Dec 21
I liked this because I greatly respect @sdbaral's commitment on these issues, but in the current circumstances I think it is a lot more complicated than this thanks to all the non-linear aspects of infectious disease 1/n
If folks making deliveries had to negotiate poisonous gas, or a horde of vicious venomous kittens from which others were insulating themselves, then sure. But that’s not so here. The force of infection in the community depends on opportunities the virus has for transmission 2/n
If staff in a grocery store are packing deliveries rather than working the till they are still exposed to their coworkers – but they are not being exposed to people who would otherwise be shopping and providing a highway for the virus into a new host, be it staff or customer 3/n
Read 9 tweets
24 Dec 21
This is a disgraceful and evidence-free position taken by the NFL. It is nevertheless an opportunity to explain a few things about omicron and what we are learning about it 1/n
espn.com/nfl/story/_/id…
First the very serious point that the transmission properties of omicron mean that existing quarantine/isolation rules need to be reassessed to prevent extreme disruption. But we don’t have the evidence base for those changes that we would like, and we won't for a while 2/n
Quotes from the piece "I think all of our concern about [asymptomatic spread] has been going down based on what we've been seeing throughout the past several months," Newsflash, there’s a new player on the scene and what was true for delta is not necessarily so for omicron 3/n
Read 9 tweets

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