Dr. Lucky Tran Profile picture
Feb 13, 2024 10 tweets 3 min read Read on X
The CDC wants to stop telling people to isolate for five days when they are sick with COVID. This is a reckless, anti-public health policy that contravenes science, increases disease spread, and puts everyone at greater risk. 🧵 The Washington Post: CDC plans to drop five-day covid isolation guidelines  Americans who test positive for the coronavirus no longer need to routinely stay home from work and school for five days under new guidance planned by the Centers for Disease Control and Prevention.
The truth is COVID is still killing and disabling way too many people, and too many are locked out of society and can’t even access medical care safely due to high levels of COVID transmission. We still need strong isolation guidelines and better public health protections. /2
People look to the CDC for science-based guidance. But this policy change goes against the science and will cause more misinformation, misleading people to think that they can’t spread COVID if they “only” have “mild” symptoms. /3
The CDC claims that levels of immunity warrant a shift, but this is misinformation. It’s true that we are in a different phase than 2020, but thousands are still dying from COVID every week, millions have Long COVID, and every reinfection puts people at increased risk. /4 CDC officials acknowledged in internal discussions and in a briefing last week with state health officials how much the covid-19 landscape has changed since the virus emerged four years ago, killing nearly 1.2 million people in the United States and shuttering businesses and schools. The new reality — with most people having developed a level of immunity to the virus because of prior infection or vaccination — warrants a shift to a more practical approach, experts and health officials say.
This is a reckless and fatalistic comment. While it’s true that many people conceal their sickness, the solution isn’t to make doing the wrong thing acceptable. Public health shouldn’t be a race to the bottom. /5 “Public health has to be realistic,” said Michael T. Osterholm, an infectious-disease expert at the University of Minnesota. “In making recommendations to the public today, we have to try to get the most out of what people are willing to do. … You can be absolutely right in the science and yet accomplish nothing because no one will listen to you.”
Instead of throwing its hands in the air and rubber-stamping disease spread, the CDC should be keeping its isolation guidance, while doing a lot more to normalize the wearing of N95 masks, which would reduce the harm from those who are going out when sick. /6
This is logic is highly flawed. Governments should push for increasing structural supports like free N95 masks, more paid sick leave, and clean air infrastructure. These policies would do more to help workers, than green-lighting policies that would make workers more sick. /7 California’s state epidemiologist Erica Pan said the societal disruptions that resulted from strict isolation guidelines also helped spur the change. Workers without sick leave and those who can’t work from home if they or their children test positive and are required to isolate bore a disproportionate burden. Strict isolation requirements can act as a disincentive to test when testing should be encouraged so people at risk for serious illness can get treatment, she said.
Using only “clinical symptoms” to determine when to stay home doesn’t make sense as you can spread COVID without symptoms, and studies show many people hide or underplay their symptoms, which leads to disease spread. /8 The CDC plans to recommend that people who test positive for the coronavirus use clinical symptoms to determine when to end isolation. Under the new approach, people would no longer need to stay home if they have been fever-free for at least 24 hours without the aid of medication and their symptoms are mild and improving, according to three agency officials who spoke on the condition of anonymity to share internal discussions.
The main force driving the CDC’s COVID isolation policy change isn’t science, it’s business groups. And it will lead to increased exploitation of workers, and make workers more sick. /9 Officials said they recognized the need to give the public more practical guidelines for covid-19, acknowledging that few people are following isolation guidance that hasn’t been updated since December 2021. Back then, health officials cut the recommended isolation period for people with asymptomatic coronavirus from 10 days to five because they worried essential services would be hobbled as the highly transmissible omicron variant sent infections surging. The decision was hailed by business groups and slammed by some union leaders and health experts.
The last time the CDC weakened its COVID isolation guidance, it did so due to pressure from airline CEOs. The same corporate pressures are causing the CDC to go against science and public health now. /10 NPR: Delta's CEO asked the CDC for a 5-day isolation. Some flight attendants feel at risk

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More from @luckytran

Jan 6
BREAKING: The United States has recorded its first fatal case of H5N1 bird flu.

The death was reported by the Louisiana Department of Health. The patient contracted H5N1 after exposure to a combination of a non-commercial backyard flock and wild birds.

ldh.la.gov/news/H5N1-deathLDH reports first U.S. H5N1-related human death Current general public health risk remains low January 06, 2025 The Louisiana Department of Health reports the patient who had been hospitalized with the first human case of highly pathogenic avian influenza (HPAI), or H5N1, in Louisiana and the U.S. has died. The patient was over the age of 65 and was reported to have underlying medical conditions. The patient contracted H5N1 after exposure to a combination of a non-commercial backyard flock and wild birds.   LDH’s extensive public health investigation has identified no additional H5N1 cases ...
Please note that there still is no evidence of person-to-person transmission, which is why public health departments assess the *current* risk as low to the general public. People who work on poultry or dairy farms are most at risk.
Protective measures you can take include:
- Avoiding sick or dead animals
- Avoiding uncooked food product
- Wearing a well-fitting mask, gloves, and other PPE
- Getting your seasonal flu vaccination (to reduce the risk of coinfection)
Read 4 tweets
Nov 14, 2024
As a scientist who is the director of science communication for the medical center of a major university, my advice is:

Please don't rely on an economist who has spread misinformation about COVID to advise you about how to effectively message on public health. Theres a Better Way to Talk About Fluoride, Vaccines and Raw Milk Nov. 13, 2024 By Emily Oster Emily Oster, an economist and the founder of ParentData.org, is the author of "Expecting Better" and "Cribsheet."
Masking Policy Is Incredibly Irrational Right Now Why must only the youngest children wear face coverings? By Emily Oster
Oster's work has been embraced by right-wing think tanks such as the Manhattan Institute and the Cato Institute. Her audience is affluent parents who seek permission to disengage from the social contract and ignore harmful impacts to the working class and people of color.
Here's a horrendous example of COVID misinformation spread by Emily Oster in 2020, which has been proven wrong by research many times since. Please do not listen to any of her advice about public health. Schools Aren’t Super-Spreaders Fears from the summer appear to have been overblown. By Emily Oster
Read 4 tweets
Nov 5, 2024
The current admin has failed to adequately address the ongoing and long-term impacts of COVID. They have been rightfully criticized and should continue to be held accountable.

However, a Trump win will make things worse, resulting in many more deaths and people becoming sicker.
Trump will accelerate mask bans, restrict vaccine availability, reduce healthcare access, stop clean air efforts, block Long COVID treatment funding, dismantle health agencies etc.

The outcome of the election will critically impact COVID and public health policy for decades.
Let’s break down a few of these points:
Read 13 tweets
Sep 18, 2024
New poll finds half of Americans believe they'll never get COVID again.

The data shows that COVID surges at high levels throughout the year. Denial is one hell of a drug. Half now expect to never get COVID again  Q: Which of the following statements most applies to you?  l expect that I will get COVID-19 at some point in the future, despite trying to stay as safe as possible: 20%  l expect that I will get COVID-19 at some point in the future, so I have gone about my life as normally as I could: 31%  I do not expect to get COVID-19 at some point in the future: 49%  Source: Ipsos Consumer Tracker, fielded September 4 - September 5, 2024 among 1,081 U.S. adults.
What’s tragic is that the CDC’s own study showed that most people are likely to take precautions like wearing a mask when they are alerted that COVID transmission levels are high.

However, most people are unaware of true transmission levels.

This is a public health failure. @CDCgov New in @CDCMMWR: Adults perceiving a high level of #COVID19 community transmission are more likely to take preventive actions, but a low percentage perceived local COVID-19 spread accurately. The more people know, the more likely they are to take action: bit.ly/mm7146a2 pic.x.com/qvkInxlsgs 12:00 PM • November 21, 2022
Read 4 tweets
Aug 28, 2024
Hearing people being turned away from CVS because they say the bridge program doesn’t cover the updated vaccines. A Washington Post reporter also heard this from the CDC.

Why has the CDC not updated their website to make this clear, and why are there not more stories on this?
The CDC’s website still says the bridge access program will end in August 2024.

The CDC should clarify that it doesn’t cover the updated vaccines ASAP.

People shouldn’t only find out at the last moment when they try to get the vaccine.

cdc.gov/vaccines/progr…
What You Need to Know CDC’s Bridge Access Program provides free COVID-19 vaccines to adults without health insurance and adults whose insurance does not cover all COVID-19 vaccine costs. This program will end in August 2024. Use these resources to promote the program and expand equitable access for COVID-19 vaccination.
A CVS spokesperson has told reporters the updated COVID vaccine will cost around $201.99 for uninsured patients paying out of pocket.

thecity.nyc/2024/08/27/new…
The new shots will cost around $201.99 for uninsured patients paying out of pocket at CVS, spokesperson Amy Thibault told Healthbeat.  They will still be free for Marketplace and Medicare enrollees and for uninsured, underinsured and Medicaid-eligible kids under the Vaccines for Children program. CVS said the shots should be free under most insurance plans at in-network pharmacies.
Read 4 tweets
Aug 23, 2024
There's lots of misinformation on rapid tests.

Rapid tests still work for new variants because they target an area of the virus that doesn't change much.

Negative tests happen because people don't test multiple times or due to user error.
Here's a good article from last year on rapid tests and variants. The same principles still apply. cnn.com/2023/09/18/hea…
*Meant to say misleading negative tests happen, even though someone has COVID, because people don't test multiple times or due to user error.
Read 4 tweets

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