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Dominique Heinke Profile picture
Dominique Heinke
@Epi_D_Nique
ScD Epidemiologist | Postdoc | Perinatal Epi | #EpiTwitter #ADHD| alum: @harvardepi @northwesternU | Tweets own. | She/Her/Dr | SoMe Editor @PPE_Journal
Oct 29, 2022 • 10 tweets • 4 min read
The panic around Halloween candy & "rainbow fentanyl" hides a real danger:

Children 4-8 are 10X more likely to be involved in a fatal pedestrian crash on Halloween night.🧵

1. This is the story of a friend's son, who miraculously survived. 👇

Tips to keep kids safe for families:🧵

1. Visibility👀

Be visible to🚗

Light-colored costumes, reflective tape, glow sticks/necklaces/clip lights & flashlights.🔦

Be able to see🚗

Face masks limit children's ability to see 🚫👺
Use face paint ☑️🎨
consumerreports.org/car-safety/sma…
May 17, 2022 • 5 tweets • 3 min read
The consequences of forcing "normal" under profoundly abnormal conditions:

Everyone is set up to fail.

'And when I ask students what is happening to them, what is making school so hard this year, their consistent response is that it is just "too much." It’s all too much.'
... "Because even prior to the pandemic, “normal” wasn't working. ...Too many students felt churned through a system that through its schedule, structure, and offerings, communicated that they were not at the center of its design."
...
wbur.org/cognoscenti/20…
Jan 7, 2022 • 4 tweets • 2 min read
This chart is helpful for thinking about the relative differences in protection between different mask types.

The exact times posted? I wouldn't rely on those, especially since that was made pre-omicron.

The clear winner here is everyone with N95 or similar #BetterMask. Going into a public indoor space without a mask right now... VERY NOT RECOMMENDED!
Jan 7, 2022 • 14 tweets • 6 min read
I love data.

I'm constantly assessing risks & benefits on data.

But here's a secret:

Data-driven approaches are only helpful when you have reasonable quality data.

Bad data = bad decisions.

In a pandemic, bad decisions = unimaginable damage.
stayathomemacro.substack.com/p/emily-oster-… It's critical to adjust your assessments as the data change.

Schools may well have been safe enough in late August and managed ok through the fall given the case levels.

Even if high quality data were captured during the fall they tell us nothing about the safety NOW.
Jan 5, 2022 • 4 tweets • 2 min read
1. Cases are high due to holidays

2. A circuit breaker/delayed school start now means the millions of infectious people would become non-infectious before resuming normal life.

3. Breaking transmission now means fewer infections, disruptions & better vaccine protection later. An extra few days vacation or remote learning could keep keep schools open.

But force everyone back into the buildings right now and... well... too many people out sick to have school.

How long will staff be out w isolation & lingering symptoms?

Aug 18, 2021 • 40 tweets • 15 min read
Make no mistake, this is a policy choice.

And no, it doesn’t matter if hospitalizations & kids in ICU are really there bc of RSV:

A full hospital is a full hospital.

A full hospital can’t care for kids who are sick or injured for *any* reason.

This is crucial… As the linked article even very sick kids have high survival IF they can receive care.

But IF hospitals cannot take more patients, IF they run out if ventilators or staff, kids cannot get that life-saving care.

Sending kids to schools without adequate protections is dangerous.
Aug 17, 2021 • 4 tweets • 2 min read
Reports of mass quarantine or school closures due to Covid-19 often spark “but did they get it in school?” comments.

This is irrelevant.

Why?

All school transmissions will start w an infection from outside of school.

To *prevent* in-school spread quarantine is still needed. Another thing worth noting:

High community transmission rates means it will be *very* difficult to track down where someone contracted the virus.

Tracing works great when cases are low & there are limited possible exposures. When anywhere is a possible exposure point…
May 17, 2021 • 5 tweets • 2 min read
My fan-fiction CDC statement:

Dear America,

We now have enough data to say that the vaccines are highly effective at preventing transmission as well as severe outcomes. This is great news!

Most people who are fully vaccinated can feel confident their level of protection.

1/ This means that people with fully functioning immune systems who are not on immunosuppressant drugs have strong protection against getting Covid-19 in nearly all situations.

This includes when you are outdoors or indoors with unvaccinated people.

However...
Mar 19, 2021 • 12 tweets • 7 min read
@CarolineSeydel @tarahaelle I'll see if I can explain this via tweet!

As adults are vaccinated, they will be less likely to be infected, even if exposed to covid. As more adults become immune, the population who is still susceptible to infection will be mostly kids. @CarolineSeydel @tarahaelle So, for example, if only 10% of infections are in 5-14 range, as adults become vaccinated this group is more likely to make up an increasing proportion of cases.

This is true even if their infection rate was constant bc there'd be less infected adults.
Mar 19, 2021 • 6 tweets • 2 min read
On the subject of vacations:

It is possible (*for some folks*) to vacation safely during the pandemic, even with others!

The key is not to pretend that children are magically protected, but to follow reasonable precautions.

#EpiTwitter: How would you behave to vacation safely? So, say for me, an unvaccinated adult potentially at risk for complications from covid, with an adult partner (low risk) and no children:

We are likely to drive to a destination where we can stay in our own space - say a cabin or vacation rental. Others would stay separate.
Jan 29, 2021 • 37 tweets • 10 min read
This study adds some new information on the spread of Covid in schools.

Let's walk through this and see what we can learn!

Thread! The study follows the experience of two K-12 independent schools through the fall of 2020.

School A (Southern US): 2299 students & staff
School B (Mid-Atlantic): 1200 students & staff

The schools had similar plans re: opening, closing, mitigation
Nov 2, 2020 • 7 tweets • 2 min read
When we are thinking about the best learning environment for kids *right now* it seems to me a mistake to use pre-Covid performance as the comparison.

That’s not possible in most places so the comparison it isn’t helping us answer the relevant question:

What works best NOW? 1/ Partially this is bc MANY things have changed with the pandemic.

Who among us isn’t more stressed?

Kids now live under the risk of a deadly disease.

Some have lost family.

Parents have lost jobs.

All have lost freedom and social interaction.

KIDS are different now.

2/
Oct 10, 2020 • 13 tweets • 5 min read
A few thoughts on this...

(Other folks who know much more than me should definitely chime in! Looking at you @Theresa_Chapple @JasonSalemi @COVKIDProject @EpiEllie!)

Mini thread. 1/n I’m all for a data-driven approach & I definitely applaud the work needed to pull this data together!

But.

Epidemics & outbreaks are local.

To me, pooling data across all states-or even within a state-is asking the wrong question.

Especially since testing in kids is low. 2/ Image
Jul 21, 2020 • 7 tweets • 2 min read
This is based on two pre-print studies (links in thread) one in Ireland and one in Denmark.

A few cautions are warranted in interpreting these studies. I won't cover the papers completely, just a few points 👇🏻 First, these are pretty small studies for the subject matter.

Ex: The Irish study covers only 1381 births in the window they studied (Jan - April). A similar number of births in the prior year led to 8 extremely low birth weight infants and 12 very lbw infants vs 0 & 3 this yr.
May 27, 2020 • 29 tweets • 11 min read
Since selection/collider bias is currently a hot topic, it seems like a good time for a #tweetorial!

Gather round #EpiTwitter (but not too close!) for a tour of my paper investigating the when's and why's of selection bias in birth defect epi. 👇🏻

1/🤷🏼‍♀️

onlinelibrary.wiley.com/doi/10.1111/pp… One of the reasons reproductive epidemiology is trick is that you are *always* dealing with selection.

Who becomes pregnant? Who stays pregnant? Who delivers too soon? Who has an induction?

Is the population in your study a biased sample?

2/
 link.springer.com/article/10.100…
Mar 15, 2020 • 9 tweets • 2 min read
Hey everyone:

This is a very uncertain and honestly scary time.

There are genuine risks to the health & safety of ourselves & those we care about.

Our lives are being significantly disrupted.

Here’s how I, someone w anxiety, is getting through. 🧵 Step one:

Radical acceptance.

My grandmother is 96. She lives in a rural area and relies on caretakers.

There’s a good chance she won’t make it through this.

I can’t change this.

So I accept this.

Life is different now & will be for a while.

I accept this.

2/
Jan 21, 2020 • 7 tweets • 3 min read
#Epitwitter Fun with Numbers:

It’s possible to put bounds on the case-fatality rate (CFR) for this outbreak with the available data.

A quick #tweetorial on the partial identification of absolute risk bounds!

1/n According to the quoted tweet we have this data:

31 cases with known outcome
6 of whom died

227 with an unknown outcome

First, the CFR among known data: 6/31 = 19%

2/n
Jul 15, 2019 • 6 tweets • 3 min read
If the amazing, cutting edge, in-depth discussions on #EpiTwitter make you feel both *inspired and incompetent*

(out-of-your-depth, totally lost, etc)

Here is your reminder that this is TOTALLY OK!

👇🏻 #SendingToMyself 🧵 Not all methods/issues are relevant to everyone’s work so there’s no reason you should be fluent in all of Epi.

In fact, you can’t be.

What you can be is the expert that I know I can go to when I come across something new that overlaps with your area!
Jul 8, 2019 • 11 tweets • 6 min read
I remember this feeling 👇🏻 so distinctly when I started at @NorthwesternU.

Tho not #FirstGen, growing up in an impoverished rural area (WV) with not great schools, attending a highly selective school was a huge culture shock. 🧵

politi.co/2FAIKOk Although I did very well in the end, I had a very rough start. I was convinced my admission was a mistake.

The culture was completely foreign to me & I didn’t begin to know how to navigate it. My parents had attended a very small, not selective LA school - not much help there./