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Céline Gounder, MD, ScM, FIDSA 🇺🇦 Profile picture
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Jun 27 • 12 tweets • 10 min read
1/ America Is In the 'Figure It Out Yourself' Era of the Pandemic
theatlantic.com/health/archive…
by @edyong209

Débrouillez-vous!
2/ I spent the earlier part of my career focused on #tuberculosis #TB & #HIV.

We are most definitely seeing the TB-ification of COVID.

3/ There's a long slog ahead.

4/ This is also why the US spends more than any other country per capita on health care, but has worse outcomes than other high-income countries.
commonwealthfund.org/publications/i…
5/ But there are reasons to hope.

Investment in community health workers in one such reason:
time.com/6138465/covid-…
6/ Community health workers:
🔹have the trust of the community
🔹build greater trust between the community and the public health system
🔹are an excellent return on investment
7/
8/ We need to imagine bigger.

My latest reading was focused on how to get there:

Imaginable by @avantgame
Curious by @mrianleslie
The Optimist's Telescope by @binajv
Contagious by @j1berger
Where's My Flying Car by J. Storrs Hall
Wonder by Frank C. Keil
Humankind by @rcbregman
9/ For example, imagine 🤔 this:
10/
11/ I am fighting hard to stay optimistic
because "only optimists change the world."
- @AlecJRoss, "The Raging 2020s"

But meanwhile, I worry about the upcoming SCOTUS decision on West Virginia v EPA:
cnn.com/2022/02/26/pol…

At stake?
Regulatory authority of ALL federal agencies
12/ Essential reading by @edyong209
with me, @KBibbinsDomingo @mwfrick @MatiH_ID @ShreyaKangovi @ewrigleyfield @AmyLFairchild @kdurquiza @luckytran @LisaAMcCorkell @rsgexp @DrJayVarma @DorfmanDoron @mattbc @akapczynski @ProfLWiley @Theresa_Chapple @realLandsEnd & more

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More from @celinegounder

Céline Gounder, MD, ScM, FIDSA 🇺🇦 Profile picture
Jun 28
1/ What's the US plan on monkeypox?

In summary:
🔹to expand vaccination for individuals at risk
🔹to make testing more convenient for healthcare providers and patients across the country
2/ @ASPRgov will make available:
🔹56K doses of Jynneos vaccine immediately
🔹240K more doses of Jynneos in the coming weeks
🔹750K more doses of Jynneos this summer
🔹500K more doses of Jynneos this fall

FOR A GRAND TOTAL OF: 1.6M doses of Jynneos vaccine
3/ The Jynneos vaccine will be allocated to jurisdictions based on the basis of their reported monkeypox case rates.

So if a jurisdiction is under testing, they won’t get the Jynneos supply they need.

It’ll be important to scale up monkeypox testing.
Read 16 tweets
Céline Gounder, MD, ScM, FIDSA 🇺🇦 Profile picture
Jun 28
1/ Growing concerns about #monkeypox
cbsnews.com/video/monkeypo…
on @CBSNews with @jdickerson

On Saturday, the @WHO said monkeypox wasn’t yet a public health emergency of international concern. 4000+ cases have been reported worldwide & ~250 in the US. Image
2/ With public health officials unable to follow all chains of transmission, they’re likely undercounting monkeypox cases by at least several-fold.

This probably won’t be WHO’s final word on the scope of the outbreak.
3/ Many of us are concerned that we're behind the 8-ball🎱 given how much monkeypox transmission is likely occurring under the radar.

The time to contain this outbreak is running out.
Read 14 tweets
Céline Gounder, MD, ScM, FIDSA 🇺🇦 Profile picture
Jun 24
1/ NYC expanding access to monkeypox vaccine as virus spreads across US
cbsnews.com/video/new-york…
on @CBSNews with @errolbarnett & @AMGreenCBS

The supply of the Jyneos monkeypox vaccine is limited.

NYC got a thousand doses yesterday, & they were claimed just like that.🫰🏾
2/ NYC will be giving monkeypox vaccines again on Sunday at its Chelsea Sexual Health Clinic (303 Ninth Avenue in Manhattan).
www1.nyc.gov/site/doh/about…

Other cities like San Francisco may be getting a *few hundred* doses of monkeypox vaccine.

This is not nearly enough.
3/ The general public is CURRENTLY at low risk for monkeypox.

Monkeypox is CURRENTLY spreading through social networks among men who have sex with men, but it is ONLY A MATTER OF TIME before there’s spread to women and heterosexual populations.
Read 15 tweets
Céline Gounder, MD, ScM, FIDSA 🇺🇦 Profile picture
Jun 24
1/ The medical impact of overturning Roe vs Wade, & with it, the constitutional right to an abortion:

cbsnews.com/live/video/202…

on @CBSNews with @taunyarivero & @CBSMMiller
2/ The typical woman getting an abortion in the US is poor & has a child/children.

Meanwhile, 40% of kids in the US have families poor enough for them to qualify for Medicaid or the Children's Health Insurance Program (CHIP).
3/ Forcing women to carry unwanted pregnancies to term will mean more women & children entrenched in poverty.

You don't need to be a doctor to know that poverty isn't good for your health.
Read 15 tweets
Céline Gounder, MD, ScM, FIDSA 🇺🇦 Profile picture
Jun 23
1/ Not impressed by this study either:

"Naturally-acquired Immunity Dynamics against SARS-CoV-2 in Children and Adolescents"
medrxiv.org/content/10.110…
2/ This study is based on data from 2020 to 2021.

Omicron was a game-changer with respect to immunity resulting from prior infection.
3/ While there was some protection from prior infection with Wuhan, Alpha, or Delta to reinfection by one of those earlier variants, we are not seeing the same thing with Omicron and its subvariants.
Read 8 tweets
Céline Gounder, MD, ScM, FIDSA 🇺🇦 Profile picture
Jun 23
1/ Not impressed with this press release from Moderna (also more "science" by press release):
investors.modernatx.com/news/news-deta…

These data are not interpretable & incomplete.
2/ They're missing data on how well the bivalent booster performs compared to the current Moderna vaccine under the same conditions (vs same Omicron subvariant with the same levels of community transmission).
3/ There is no data on the neutralization titers of the current Moderna vaccine vs BA.4 or BA.5, which will likely become the dominant subvariants later this summer.

When they say "for context," there is no context.
Read 10 tweets

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