Jay Varma Profile picture
Aug 1 4 tweets 2 min read
A lot of people do not understand how worrisome the #polio case in NY.

Based on what's been discussed publicly:

-the person with paralytic polio got infected in NY

-the source case in NY has not been found

/1
-for one person to get paralytic polio, it means that 100s were infected, b/c only ~1 in 200 develop paralysis

-since case was detected in early June & weeks have gone on before vax catch-up campaign, likely means 1000s of infections cumulatively to date

/2
-detection in wastewater further supports the fact that many have been infected & are shedding polio virus

-(injectable) polio vax works extremely well at preventing severe disease, but it does not block people from being infected & shedding virus in their feces

/3
-It's urgent to do catch-up polio vax campaigns throughout NY metro area

-Campaigns should include extensive outreach & community engagement (as with #measles) in Orthodox Jewish communities of NYC & NJ, given people vacation & attend camps in various parts of NY metro area

/4

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More from @DrJayVarma

Apr 13
I get that public health folks (myself included) are getting their moment in the sun, but is it really necessary to ape political & sports pundits with hot takes?

1/4
We don't know what direction BA.2 is headed.

Preventing infections is beneficial to health.

Masks prevent infections.

There are no direct harms from wearing a mask.

Some perceive widespread mask use as unacceptable, particularly in children.

2/4
Local officials should make judgments based on what their population believes is feasible & acceptable, accounting for both real & perceived harms.

What one jurisdiction chooses to do may not be right for another.

3/4
Read 4 tweets
Apr 11
One (of many) limitations of @CDCgov & @nycHealthy #COVID19 levels is that they tell you where epidemic has been, not where it might be going.

As of today, there’s a 33% chance #NYC will move from low -> medium citywide in one week (by April 18, 2022)

🧵⬇️

/1
My colleagues @WashburneAlex @WCMPopHealthSci Nathaniel Hupert have developed a forecast based on observation that outbreaks of new #COVID19 variants have growth rate & duration that is similar regardless of where outbreak occurs worldwide. Methods at bit.ly/3vajeHH

/2
Our forecast for #NYC’s current BA.2 outbreak is based on the hypothesis that cases in #NYC’s BA.2 outbreak will follow a trajectory similar to the UK’s BA.2 outbreak. See this image that tracks growth rate over time for both UK and NYC.

/3
Read 8 tweets
Dec 22, 2021
In this OpEd (nytimes.com/2021/12/20/opi…), I argued that we should reduce the recommended isolation period for #COVID19 in vaccinated persons. This is how I think through a problem like this. 🧵⬇️
Call it #ThinkLikeAPublicHealthPractitioner, which is different than thinking like a virologist, epidemiologist, or clinician.

Virology helps us answer: how infectious are people with COVID-19 based on duration of infection, vaccination status, symptoms, and other factors?
Epidemiology helps us answer: what is the impact on community disease transmission for different isolation policies and different levels of adherence to those policies?
Read 15 tweets
Dec 20, 2021
In the age of #Omicron, we have a more transmissible virus and waning public resolve to reduce human contact. For the US, a large number of infections is now inevitable. A large number of hospitalizations and deaths is optional. /1

nytimes.com/2021/12/20/opi…
Elected officials must adopt vaccine-first policies, because a layer of vaccine-derived immunity is the safest, most durable & effective way to avert mass hospitalization and death. But vaccines-first is not vaccines only. /2
We need additional layers of protection (masks, testing, ventilation) & intensive government coordination and support, particularly focused on hospitals, congregate settings, & schools. This is crucial, because vaccines take time to work & Omicron moves faster than humans do /3
Read 4 tweets
Nov 29, 2021
I worry that many commentators who opposed the Biden booster plan in the US succumbed to the same problem that mucked up mask guidance in Spring 2020: framing a supply-based recommendation (we don't have enough) as an evidence-based recommendation (you don't need it) 1/
I think it's much more credible to say "We wish everyone could wear a medical-grade mask, but we simply don't have enough right now so you need to sacrifice for healthcare workers" VS. "You don't need a medical-grade mask" (unspoken: because we don't have enough). 2/
In the first framing, you can then follow up by saying "We are working to produce more, and we think that by X date we will have enough for everyone." 3/
Read 5 tweets
Oct 24, 2021
1/ Always enjoy and learn from reading @edyong209 essays, but I disagree with the thesis that US public health agencies need to return to the early 20th century approach of social reform to be more effective. 🧵⬇️
2/What is the “public health” referenced throughout the essay? I assume @edyong209 is primarily referring to government agencies in the US often called “Health Departments.” Or does it also refer to govt programs that regulate food, medications, water, sanitation…
3/…and air since these are often (though not always) in other agencies? I think making these agencies (even) more politically active would jeopardize their credibility & funding, as we have seen with the politics of the FDA and EPA, for example.
Read 17 tweets

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