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?
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:
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?

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More from @celinegounder

Feb 17
1/ The Moral Danger of Declaring the Pandemic Over Too Soon
by @gregggonsalves
nytimes.com/2022/02/17/opi…
2/ Deja vu all over again:
3/ Biden’s new global vaccine push is running out of funds
politico.com/news/2022/02/1… by @ErinBanco
Read 4 tweets
Feb 17
1/ Americans are tired of the pandemic. But disease experts preach caution — and endure a ‘kill the messenger’ moment
washingtonpost.com/health/2022/02…

by @WashingtonPost' @JoelAchenbach

with @gregggonsalves @CDCDirector @RWalensky @POTUS @MCarnethon @AndrewNoymer
2/ I'm feeling more demoralized now than at any point to date in the pandemic.

washingtonpost.com/health/2022/02…
3/ Viruses don't respect our timeouts.

washingtonpost.com/health/2022/02… with @gregggonsalves
Read 4 tweets
Feb 14
1/ The elderly are in a league of their own when it comes to COVID risk:
theatlantic.com/health/archive…
by @TheAtlantic's @sarahzhang
2/ If someone you love is over 50 isn't yet vaccinated & boosted, please help them get 💉💉💉.

While on service at @BellevueHosp last month, almost 3/4 of my patients were not vaccinated.
They weren't anti-vaxxers.
They just needed help getting vaccinated (homebound elderly).
3/ It's hard for some older people who have chronic medical conditions, disabilities, limited resources, limited social networks, etc to get vaccinated.

We need to be REACHING OUT, not waiting until people ask for help... or... all too often... it's too late.
Read 6 tweets
Feb 1
1/ Good news today for many parents!

Pfizer is applying for FDA authorization of 2 doses of its COVID vaccine in kids aged 6 months to 5 years.

The COVID vaccine is SAFE in all kids 6 months to 5 years.

Kids 2-5 years may need a 3rd dose.

with @MSNBC's @KatyTurNBC
2/ We need to wait & see whether a THIRD dose is needed to provide enough protection in kids 2-5 years of age.

But in the meantime, there's no real downside to getting kids under 5 started on their first two COVID shots. They're safe.
3/ Parents' worries about safety seem to be driving low vaccination rates in kids 5-11, who've been eligible for COVID vaccination since November.

Here are findings from @KFF's latest Vaccine Monitor poll:
kff.org/coronavirus-co…
Read 7 tweets
Jan 24
1/ Are we on the other side of this Omicron peak?

Think of peaking as taking a ski lift to the top of the mountain, and then starting to ski down the mountain.

We've just started skiing down the Omicron mountain.

with @MSNBC's @craigmelvin
2/ SARS-CoV-2 is spreading in epidemic waves.

It burns through social networks with each surge.

Then it takes time before there's a shift in social networks to again be enriched for people with no/partial immunity.

And then you get another surge of infection.
3/ The Omicron surge will NOT be our last surge.

There will be MORE variants. Omicron won't be the last.

Not enough people in the US are fully vaccinated.

We remain vulnerable to future variants & surges.

We should better prepare & insulate ourselves from future variants.
Read 4 tweets
Jan 13
1/ Big day at the Supreme Court today:
- UPHELD: vaccination requirement for staff working in facilities that accept Medicare & Medicaid funding
- BLOCKED: OSHA rule requiring vaccination or weekly testing for employers with 100+ workers
nytimes.com/2022/01/13/us/…
2/ It is now highly unlikely that the U.S. will hit the ~85-90% of Americans vaccinated to get to the other side of the pandemic.
3/ States & cities can impose their own vaccination requirements, as did @NYCMayor:

www1.nyc.gov/office-of-the-…
Read 5 tweets

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