In an Invited Editorial in @JAMAOnc today, my colleagues & I call for health systems to develop “Comprehensive #Pandemic Support Programs” for their most vulnerable patients.
Vulnerable patients want highly-ventilated or outdoor options & high-quality (e.g., N95) masks for safety. Make it happen.
Tip #3: Health systems should test whether vulnerable patients have a good #antibody response to #vaccines (cutoffs of 5,000 or 11,500 U/mL for anti-S antibodies) to inform risk.
Consider pre-exposure prophylactics, based on the patient & the variant(s) circulating.
Tip #4: Health systems should help patients to sample and correctly wear free high-quality #masks (N95, KN95, KF94, FFP3).
Community-based programs have proven successful. Health systems should step up to support their most vulnerable patients.
Tip #5: Health systems should help vulnerable patients to understand the benefits & limitations of COVID testing, when to time testing, precautions to take after exposures/symptoms, and how to access #RAT and #PCR testing.
Second, a lot of people can sustain a strong denial of reality about the ongoing pandemic during lulls. They suppress the existence of COVlD waves and excess deaths, disability, and retirements.
During waves, those defenses burst. Loss of control = anger...
Third, a lot of people (many reading this) understand COVlD correctly & experience righteous indignation during COVlD waves. We quite reasonably do not like all of the unjust and gratuitous suffering.
I find it helpful to channel that intensity into helping other people....
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As a vigorous defender of #CDC data, their switch from using normalized to non-normalized COVlD wastewater surveillance data today harms data quality.
"Normalizing" means accounting for basic confounders like rain levels. It is a choice to use worse data.
1/5🧵
Historically, the CDC data have correlated near-perfectly with similar metrics, such as Biobot's wastewater estimates (still active) or the IHME true case estimates (through mid-2023).
The changes reduce those correlations. It's like going from an A+ to a B.
2/5🧵
You can readily see the loss of data quality in the PMC "whole pandemic" graph (preview shown, subject to change) with choppier waves, caused by the CDC adding extra noise to the data and applying retroactively from BA.1 Omicron to present.
U.S. CDC numbers just released. Good news (for those not in Louisiana). "Only" a 5% national increase.
2025 has closely tracked with summer 2023 transmission. A 12-13% increase would have been expected based on those numbers. That said...
real-time data have been prone to retroactive corrections. This is frustrating, of course, because it leaves people making decisions based on data that are only of good quality when 2 weeks old.
If we saw a 12% increase this week, I'd say look at 2023 for a glimpse...
at the future. Instead, I would consider these plausible scenarios:
🔹Wave still similar to 2023
🔹Later wave with schools more implicated
🔹Something temporarily much better