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

Aug 29
COVID vaccine update: Pharmacies in some states won't give you a shot unless you have a prescription.

CVS: CO, FL, GA, KY, LA , ME, NY, NC, PA, UT, VA, WV, DC

Walgreens: AZ, CO, GA, IN, LA, MO, MT, NM, NY, OR, SC, UT, VA, WA, WV, WI

CVS is not yet offering shots in MA, NV, MN
The issue is that the CDC's immunization committee has not yet recommended the shots. Though the FDA label includes a broad list of conditions that will allow you to self-attest, pharmacies are worried that the CDC could restrict this further, so are waiting to see what happens.
Waiting on the CDC's immunization committee to finally recommend the updated COVID vaccines is a huge problem because the CDC is in CHAOS right now. They just fired the CDC leader, top scientists have resigned, and the immunization committee has been replaced by antivaxxers.
Read 7 tweets
Aug 27
It's official: Updated COVID vaccines have been approved by the FDA, but with restrictions.

Moderna: 6 months+ if high risk

Pfizer: 5 years+ if high risk

Novavax: 12 years+ if high risk

Anyone 65 years+ is eligible for updated COVID vaccines regardless of risk status.
Common conditions that make you more likely to get very sick from COVID-19, per CDC:

Cancer
Chronic diseases
Diabetes
Heart conditions
Weakened immune system
Mental health conditions
Overweight and obesity
Physical inactivity
Pregnancy
Smoking
Substance use disorders
Transplant
Here's the CDC's full list of of underlying medical conditions that increase a person's risk of severe COVID-19: CDC 2025 List of Underlying Medical Conditions That Increase a Person's Risk of Severe Covid-19 Asthma Cancer Hematologic malignancies Cerebrovascular disease Chronic kidney disease* People receiving dialysis Chronic lung diseases limited to the following: Bronchiectasis COPD (chronic obstructive pulmonary disease) Interstitial lung disease Pulmonary embolism Pulmonary hypertension Chronic liver diseases limited to the following: Cirrhosis Nonalcoholic fatty liver disease Alcoholic liver disease Autoimmune hepatitis Cystic fibrosis Diabetes mellitus, type 1 Diabetes mellitus, type 2* Gestat...
Read 6 tweets
Aug 19
From @dr_kkjetelina: “If you’re under 65 and not high risk, the window to get a Covid-19 vaccine is right now—before the FDA label changes (possibly this Friday). Once it happens, access will be limited immediately.”
Note: COVID hasn’t changed that much recently, so while they will be updating the vaccine in fall to match the latest variants, the current “old” vaccine should still provide good protection (and better than no vaccine if access is restricted).
It’s honestly ridiculous and horrific that we all need to make these complicated calculations to figure out when to get our next COVID vaccine.

COVID vaccines should be accessible to anyone who wants them every year (like flu vaccines) and all year round.
Read 7 tweets
Jun 11
NEW: After firing expert scientists on the CDC's vaccine advisory committee, RFK Jr. has named their replacements.

The new committee contains many figures known for spreading disinformation about vaccines and COVID including Robert Malone and Martin Kulldorff.

This is bad. The list includes several well-known critics of vaccines.  The eight new members, a significant decline from the 17 that previously served on the panel, include:   Dr. Joseph R. Hibbeln, a psychiatrist and nutritional scientist who previously worked on nutritional neuroscience at the NIH; Dr. Martin Kulldorf, an epidemiologist formerly at Harvard Medical School, who has served on an FDA safety committee as well as the vaccine subgroup of ACIP; Retsef Levi, a professor of operations management at the MIT Sloan School of Management; Dr. Robert Malone, a physician who conducted early research ...
Robert Malone has suggested COVID-19 vaccines cause a form of AIDS, and runs a wellness institute where he profits from promoting unproven treatments for measles and COVID-19. Malone, who runs a wellness institute and a popular blog, rose to popularity during the COVID-19 pandemic as he relayed conspiracy theories around the outbreak and the vaccines that followed. He has appeared on podcasts and other conservative news outlets where he’s promoted unproven and alternative treatments for measles and COVID-19. He has claimed that millions of Americans were hypnotized into taking the COVID-19 shots. He’s even suggested that those vaccines cause a form of AIDS. He’s downplayed deaths related to one of the largest measles outbreaks in the U.S. in years.
Martin Kulldorff was a lead author of the Great Barrington declaration which promoted mass infection with COVID and opposed infectious disease prevention measures including masks and vaccines for children. Other appointees include Dr. Martin Kulldorff, a biostatistician and epidemiologist who was a co-author of the Great Barrington Declaration, an October 2020 letter maintaining that pandemic shutdowns were causing irreparable harm. Dr. Cody Meissner, a former ACIP member, also was named.
Read 4 tweets
May 20
Under new leadership — who spread misinformation throughout the pandemic — the FDA announced it will limit Covid vaccines to adults over 65 & those with certain medical conditions.

Covid continues to spread & cause harm. This an anti-science move that will kill more Americans. F.D.A. Poised to Restrict Access to Covid Vaccines Agency leaders said there was evidence to justify approval only for older people and those with medical conditions. Many others may not be able to get the shots.
The data tells us that everyone can benefit from getting updated Covid vaccines.

Covid vaccines reduce the risk of becoming sick, developing Long Covid, and becoming hospitalized, for everyone. The data below describe how well vaccines work to reduce your risk. This risk reduction is in addition to protection you may have from previous infections with COVID-19 or from receiving earlier versions of COVID-19 vaccines.  COVID-19 vaccines:  Reduce your risk for critical illness (admission to intensive care unit or death) For adults ages 18 and older, the 2023–2024 COVID-19 vaccines reduced the risk of critical illness from COVID-19 by almost 70% in the first 2 months after vaccination. Protection decreased over time. During the 10 months after vaccination, the vaccines reduced critica...
It's important to note that most people have a condition that increases the risk of becoming severely ill with Covid-19.

These include: asthma, diabetes, heart conditions, mental health conditions, obesity, physical inactivity, smoking, and pregnancy. Underlying Medical Conditions That Increase Risk of Severe Covid-19. Source: Centers for Disease Control and Prevention.
Read 10 tweets
May 18
Good news: The FDA finally approved the Novavax Covid-19 vaccine.

Bad news: There are new restrictions that will create lots of problems for people who want to get the Novavax Covid-19 vaccine. FDA: Under this license, you are authorized to manufacture the product COVID-19 Vaccine, Adjuvanted, which is indicated for active immunization to prevent coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS- CoV-2) in adults 65 years and older. Additionally, COVID-19 Vaccine, Adjuvanted is indicated for individuals 12 through 64 years who have at least one underlying condition that puts them at high risk for severe outcomes from COVID-19.
The new stricter criteria limits Novavax to people:

1. aged 65 and over
2. aged 12 and up who have at least one underlying condition that puts them at higher risk of severe illness

This goes against the science that indicates that everyone can benefit from Covid-19 vaccination.
Note: CDC lists many conditions that may make someone likelier to become severely ill with Covid-19, including older age, asthma, diabetes, lung disease, obesity and pregnancy.

By definition, most people are higher risk and should have access to Novavax. cdc.gov/covid/hcp/clin…
Read 8 tweets

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