Thread by @celinegounder

1/ I joined @JohnsHopkinsSPH' Dr. Josh Sharfstein @drJoshS on his podcast @PublicHealthPod to discuss this recent @JAMA_current Viewpoint:
jamanetwork.com/journals/jama/…

Why at this phase in the pandemic should we fight SARS-CoV-2 as one of a number of viral respiratory infections?

https://twitter.com/PublicHealthPod/status/1494710848790704131

2/ Why can't we eradicate SARS-CoV-2 / COVID?
- Many non-human hosts (eg bats, mink, rodents, deer)
- Highly infectious
- Very short incubation period
- Lots of asymptomatic & pre-symptomatic transmission
- Hard to target with surveillance-containment / ring vaccination

3/ We will have to co-exist with COVID.
It will be part of everyday life.
But we can CONTROL COVID.
We can control COVID at a high level or at a low level.

4/ My colleagues and I advise looking at viral respiratory infections holistically.

SARS-CoV-2 + influenza + RSV

Together, all 3 cause a significant burden of disease, hospitalization, & death,
especially among very young children & the elderly.

5/ Viral respiratory infections also trigger asthma and COPD exacerbations,
which in turn result in a lot of hospitalization & death.

6/ The measures we use to control COVID will also control influenza, RSV, & other viral respiratory infections.

7/ Some examples:
- Masks
- Rapid at-home tests (we also have rapid antigen tests for flu and could develop for a range of viral respiratory infections)
- Treatment (Paxlovid for COVID, Tamiflu for influenza)
- Indoor ventilation & air filtration

8/ I can imagine a world in which the local weather report includes:
- the chance of rain🌧️or snow❄️
- outdoor air quality: pollen🌻, wildfire🔥smoke
- indoor air quality: SARS-CoV-2🤒community transmission rates

Some take an umbrella🌂 or a mask😷 when they go out.

Some don't.

9/ Let's leverage new systems & ways of thinking that have emerged from this pandemic to fight other viral respiratory infections, too.

10/ In the early 2000s, we saw a dramatic scale-up of testing and treatment capacity to fight HIV/AIDS.

That has become the foundation for better TB treatment, perinatal care, & primary care.

11/ How does this change our data dashboards?

We shouldn't be relying on cases reported / positivity rates.

Those numbers are biased by who seeks or has access to testing & PCR vs rapid Ag test.

We should be doing random sampling of the population:

https://twitter.com/EricTopol/status/1491081844829601793?s=20

12/ Will we take indoor air quality in the 21st century as seriously as water quality in the 20th century?

theatlantic.com/ideas/archive/… by @j_g_allen for @TheAtlantic

13/ What are high yield interventions that reduce disease, hospitalization, & death from ALL viral respiratory infections?