As someone who ran a high containment patient care unit similar to those taking care of #hantavirus patients right now for a decade & has taken care of viral hemorrhagic patients in multiple outbreaks, I have three quick points to make:
1) no this is not the start of a global pandemic. No lockdowns coming. It's a very complicated outbreak but low risk to general public based on what we know about the pathogen and data so far. There will/may be more cases, but many suspects may be negative.
2) but this is a high mortality disease which progresses fast. We need to get people w close contact (on the boat, those who left the boat) under observation both to ensure no more chains of transmission & so they get fast care if sick. Time to advanced supportive care matters.
3) We need to care for and protect healthcare workers taking care of patients on the boat and in all receiving countries, because they are likely to have close contact and be at risk for transmission as prior events have shown
And may be one more- the biggest thing COVID-19 taught me is the importance of humility and multidisciplinary expertise. They are called emerging pathogens for a reason.
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Lot of #H5N1 news this week: 🧵
-phylogenetic analysis suggests virus may have made single jump from bird to cows in Dec, & circulating in cows since
-virus is jumping back from cows in birds (no good, implies further opportunity for adaptation) 1/n
-H5N1 + reported in asymptomatic cows
-studies in milk show 1 in 5 (FDA data) to 40% of samples had H5N1 remnants on PCR, suggesting a much more widespread outbreak
-NIAID supported study showed no live virus in pasteurized milk, FDA results on larger national sample pending 2/n
-USDA reported virus found in a pulmonary tissue of a single cow (just one cow but concerning if virus adapting to lungs & possible changes in transmission capacity)
-USDA order asks lactating cows be tested before interstate movement 3/n
Dr @matthewjhepburn, Senior Advisor on Pandemic Preparedness, @WHOSTP, opens the Summit highlighting the importance of early detection both domestically and globally.
Dr @AlondraNelson46 reflects how @CDCgov Center for Forecasting and Outbreak Analytics should be a national asset with equity at its core, providing data from and to all our communities. And how important it is to link action to early warning.
The national security implications of pandemics are widespread. @JakeSullivan46 says these health issues aren’t adjacent to national security concerns but central to it.
Still opportunities to use infrastructure set up to give Regeneron/Lilly monoclonals (current versions don't work w omicron because of mutations). Administer: 1) Sotrovimab (this monoclonal still works w omicron) 2) Remdesivir (given w/in 7 days, ⬇️ hosp 87%)
Give what works.
Remdesivir is given as 3 day course, which means patients have to come back but dedicated infusion centers can provide good infrastructure. The data is very striking for early administration. nejm.org/doi/full/10.10…
The problem currently is that there are so many cases that there is a shortage of therapies that work- including oral antivirals. This is why it's not a good idea for everyone to get infected all at once right now.
And why vaccines are still your first and best line of defense.
To figure out if we have reached endemicity with a disease, we have to answer the question: Can our society function if current moment became status quo?
The surge of cases leading to worker shortages & still overwhelmed hospitals tells us for COVID, the answer currently is NO.
I think we need to think of the next few weeks of surge as phase onto itself that we have to manage and minimize damage from.
After the surge, we can ask that same question again and figure out the best metrics to follow in that new reality.
That question makes it obvious that endemicity is both a function of disease (virulence, prevalence) & society (demographics, immunity, resource/capacity, what society is willing to accept as ongoing cost.)
And that different communities will reach endemicity at different times.
I have news for people who are looking at the unfortunate loss of Colin Powell as a sign that covid-19 vaccines are not working: Almost no vaccines prevent ALL infections & deaths. Older & immunocompromised pts always depend on the rest of us to create population level immunity.
If you think it’s awful that lack of higher level population level to immunity to this virus is causing the vulnerable among us to suffer, wait till you see when the high anti-vax sentiment in some parts of this country makes us lose the same protection from other … contd
Vaccine preventable infectious diseases. If rates of immunizations go down more to measles, mumps, rubella etc… you are likely to see many more breakthrough infections related to those diseases as well.
What infectious diseases/epidemiology/global health topics in general or COVID-19 issues would you like more information on or are confused about?
What can scientists and public health folks do a better job of explaining?
A) honored you are sharing your questions & concerns here
B) because of the sheer number will try to group together in themes & respond to common ones
C) we are hoping to work on some web/social media resources down the road which maybe helpful
Re vaccine safety: in addition to existing post authorization vaccine adverse effects reporting system (VAERS), CDC instituted new initiatives includingV-SAFE text based, expanded acute & long term facilities & insurer databases reporting. More details: cdc.gov/coronavirus/20…