Dr. Lucky Tran Profile picture
Feb 13 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

Feb 9
Historically, extremist groups exploit crises to advance their bigoted political agenda. It's terrifying that the same thing is happening here with COVID in 2024, and few political groups on the left recognize this.
Read 4 tweets
Feb 1
According to a new study, up to 75% of adults have concealed an infectious disease from others in order not to miss work, travel, or social events. Unacceptable behavior. cidrap.umn.edu/misc-emerging-…
This is also why we need better structural supports like increased paid sick days. There are many people who want to do the right thing and stay home when they are sick, but can’t afford to miss work.
Wow. 61% of healthcare workers said they concealed illness due to not wanting to miss social engagements, school, or work.

Meanwhile, so many healthcare workers aren't wearing masks despite high levels of respiratory viruses.

This is an abdication of responsibility to patients. Eighty-five percent of students reported concealing a contagious illness, as well as 61% of healthcare workers. Only 8% of healthcare workers and 3% of students said they concealed illness due do a university policy requirement. Instead, almost all efforts at hiding were made because of not wanting to miss social engagements, school, or work.
Read 4 tweets
Jan 24
Latest data from the CDC: Only 21.5% of US adults have gotten their updated COVID vaccine. Chart: Cumulative Percentage of Adults 18 Years and Older Vaccinated with the Updated 2023-24 COVID-19 Vaccine  Data Source: National Immunization Survey-Adult COVID Module
Only 6.8% of people who are uninsured have gotten their updated COVID vaccine, compared with 23.5% of people who have insurance.

Despite there being a bridge program for people who are uninsured, this illustrates the problems of access and the update COVID vaccine rollout. Chart: Cumulative Percentage of Adults 18 Years and Older Vaccinated with the Updated 2023-24 COVID-19 Vaccine  Data Source: National Immunization Survey-Adult COVID Module
Here's the data on vaccination rates by race/ethncity, which shows that we are still seeing disparities in access and uptake of the COVID vaccines. Jurisdiction National National National National National National National National Demographics Week Ending Hispanic Multiple or Other Races, Non-Hispanic Black, Non-Hispanic Asian, Non-Hispanic 18+ years 1/13/2024 1/13/2024 1/13/2024 1/13/2024 1/13/2024 White, Non-Hispanic 1/13/2024 Pacific Islander/Native Hawaiian, Non-Hispanic 1/13/2024 American Indian/Alaska Native, Non-Hispanic 1/13/2024 Estimate (%) 13.0% 15.6% 17.7% 19.2% 21.5% 25.5% 11.0% 14.1% 95% C.l. 11.2 - 14.8 12 8 - 18 4 15.7 - 19.7 16.6 - 21.9 20.8 - 22.1 24.7 - 26.4 5.7 - 16.2 9.5 - 18.7
Read 4 tweets
Jan 23
This month, advocates have gotten officials to:

➡️Do PSAs on masks and clean air
➡️Distribute free N95s
➡️Issue masking guidelines
➡️Reintroduce mask requirements in hospitals
➡️Hold a Senate hearing on Long COVID
➡️Halt CDC's plan to weaken infection control

Advocacy works!
Read 11 tweets
Jan 23
CDC advisers planned to put out weakened hospital infection control guidelines, which suggested that N95 respirators are no more protective than surgical masks.

Advocates pushed back, and now the CDC are reconsidering and sending the draft back for revision!
Based on the significant interest in the draft recommendations, CDC is taking a proactive step of communicating back to HICPAC some initial questions and comments on which we would like additional consideration before submitting the guideline into the Federal Register for public comment. In addition, CDC is working to expand the scope of technical backgrounds of participants on the HICPAC Isolation Guideline Workgroup and eventually among the committee members through established processes in accordance with the Federal Advisory Committee Act (FACA) regulations and guidance. The expanded wo...
Another issue relevant to preventing transmission through air is to make sure that a draft set of recommendations cannot be misread to suggest equivalency between facemasks and NIOSH Approved respirators, which is not scientifically correct nor the intent of the draft language. Although masks can provide some level of filtration, the level of filtration is not comparable to NIOSH Approved respirators. Respiratory protection remains an important part of personal protective equipment to keep healthcare personnel safe.
Source: CDC - A CDC Update on the Draft 2024 Guideline to Prevent Transmission of Pathogens in Healthcare Settings blogs.cdc.gov/safehealthcare…
Some background by @DrJudyStone on the CDC’s plan to weaken infection control and how advocates have been pushing back: forbes.com/sites/judyston…
Read 4 tweets
Jan 5
UPDATE: The CDC just updated its COVID wastewater data.

COVID wastewater levels continue to rise, exceeding levels at the same time last year. COVID wastewater levels in the U.S. are at their highest since Omicron in 2021-22. COVID-19 Wastewater Levels in the U.S. (Jan 4, 2024)   Chart shows national trends of SARS-COV-2 viral activity levels in U.S. wastewater. The vertical axis shows the Wastewater Viral Activity Level, which indicates changes in SARS-CoV-2 virus levels in wastewater compared to the baseline level (in standard deviations).
Here is the CDC's updated COVID wastewater map.

Every single state that is reporting data is at very high or high levels.

15 states are not reporting data (or are too slow to report data). COVID-19 Wastewater Levels U.S. Map              (Jan 4, 2024) Map shows viral activity levels of SARS-COV-2 in wastewater in each state.
Sources:

CDC - U.S. COVID wastewater levels


CDC - U.S. COVID wastewater map
cdc.gov/nwss/rv/COVID1…
cdc.gov/nwss/rv/COVID1…
Read 4 tweets

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