Sadly, this is something we deal with all too often in healthcare & IPC. Years ago we had a large measles exposure (@CDCMMWR link in thread) that involved a delayed diagnosis (related to Disneyland cluster) bc the family wasn’t transparent about vax status & illness (1/3)

https://twitter.com/abgutman/status/1743004257027072292

Measles is highly contagious & infectious, so it’s critical to use AIIR/airborne isolation, but that’s only possible when we know the patient may have it/has been diagnosed. The MMR vaccine is amazingly effective & saves lives. For ref the @CDCMMWR - (2/3)cdc.gov/mmwr/preview/m…

Such a great article on the increasing threat of fungi - hits extra close to home for those of us in valley fever areas.

https://twitter.com/theatlantic/status/1708104467739017289

“Helping existing fungal diseases reach new places isn’t the only effect of climate change. Warming temperatures can also help previously innocuous fungi evolve tolerance for heat.”

We can’t keep neglecting the intersection of human, animal, and environmental health. This article underscores the increasing health threats we’re facing. It reminds me of a RMSF cluster we faced years back in AZ…(1/n) washingtonpost.com/health/interac… A few years back we began seeing very sick pediatric patients admitted with RMSF (like multiple children in families, etc.) and many from tribal lands. To be blunt, RMSF is a really nasty disease - it hits hard and fast, despite being quite treatable. (2/n)

Big cuts to health - Subcommittee Markup of Fiscal Year 2024 Labor, Health and Human Services, Education, and Related Agencies Bill | House Committee on Appropriations - Republicans appropriations.house.gov/legislation/ma… Department of Health and Human Services (HHS)
Cuts $103.7 billion in funding – a 14% reduction compared to FY 2023 levels

So this is one of the biggest reasons I work in (& wrote a dissertation on🫠) hospital biopreparedness and what happens when we don’t invest in IPC…. New hospital data highlight rise in healthcare-associated infections during COVID | CIDRAP cidrap.umn.edu/healthcare-ass… Hospital bioprep/response pretty much relies on infection prevention programs (unless you’re part of a larger special pathogens system, which most aren’t). This means that a tiny team of people - who are often seen as a cost center & not a revenue generator, are responsible for…

Lots of attention on mask mandates in healthcare right now & I wanted to share a few things from the infection prevention/healthcare bioprep lens. Masking requirements &/or patient visitor restrictions are not unique to COVID, but often used during respiratory virus season. (1/n) Historically, we’ve used flu/RSV numbers to make the decision for when that starts/stops. Mask requirements are often used for those in high risk areas (ED/ICU/Onc/NICU), and for those HCW refusing a flu vaccine. (2/n)

There’s a lot going on in the news cycle about COVID origins and frankly, a lot of non-experts deciding to wade into it for notoriety (ugh) which only adds fuel to a tense fire. It’s so important the folks *doing* the research are engaged in these conversations. (1/n) Journalists, please make sure you’re including the virology/epi folks who are doing the work around origin investigation - their voice is CRITICAL. If you’re talking about enhancement of potential pandemic pathogens, you def need to talk to the people DOING the experiments (2/n)

A few things…..Norovirus outbreaks are on the rise, @KatherineJWu writes, and they’re very hard to stop. theatlantic.com/health/archive… First- 100% to disinfection being back (really, for the IPs, it never left). Noro is a beast. It spreads quickly, hits hard, and can be a pain to break the chain of infection. A few tips from your friendly infection prevention/epi folks…(2/4)

Well, after nearly 3 years, I’m finally experiencing COVID. I’m sharing this for a few reasons - most notably, the importance of masking and taking necessary precautions even if the symptoms are non-specific. (1/n) I recently traveled and was testing daily (thanks @CueHealth for the ease of use!) due to being around a lot of people + travel + rising case counts. All negative. During the last few hours of a long journey home, I started to feel a scratchy throat. (2/n)

A note for some folks still saying that COVID (and now RSV) are “not that bad”. Overwhelmed pediatric hospitals are a huge canary in the coal mine. I had the fortune to work in a pediatric hospital for a few years and even though RSV is seasonal, it is scary AF. (1/n) - I cannot imagine the stress of caregivers/parents during the hospitalization of a child with RSV. Just my time in PICUs and NICUs scared the crap out of me - the frequency of ventilators, central-line access required, and even ECMO, for RSV kiddos is haunting. (2/n)

Healthcare-associated infections (HAIs) rose in 2020 and even more in 2021. To be frank - no shit, Sherlock. Here are some thoughts on why and honestly, that this is a bigger canary in the coal mine. Current HAI Progress Report (1/n) cdc.gov/hai/data/porta… First- it’s not surprising that HAIs would increase during a pandemic - so many cases of COVID in 2020 were seriously ill and required ventilators/prolonged stays/central lines - all things that increase the risk for HAIs. (2/n)

Incubation Period of COVID-19 Caused by Unique SARS-CoV-2 Strains: A Systematic Review and Meta-analysis | Infectious Diseases | JAMA Network Open | JAMA Network jamanetwork.com/journals/jaman… “Average incubation times for each variant were 5.00 days (Alpha; 1 study), 4.50 (Beta; 1), 5.10 days (Beta/Gamma; 1), 4.41 (Delta; 6), and 3.42 (Omicron; 5).”

I’m glad there’s more attention to healthcare response but frankly, there are serious gaps with how we approach these reviews- for one, who is interviewed? (1/n) gao.gov/products/gao-2… Previous GAO reports (which are super important and helpful) interviewed hospital administrators. We need a more comprehensive group of people. IPs? We did *a lot* during covid response. MDs. RNs. EVS. House supervisors. (2/n)

Recent travel got me thinking about risk tolerance in the time of COVID - this is a deeply personal notion and one that has increasingly changed with the tide of cases and tolerance for “dealing with COVID”. (1/N) I’ve seen a lot of mixed emotions from ID/medical/public health folks - some are still diligent about mask wearing in public, some citing a near total return to pre-COVID behaviors. (2/n)

Here’s some helpful information on monkeypox since it seems like some armchair experts like to lean in hyperbolic tweets about it. Yes it can be spread through respiratory secretions but this has been well established in our response measures. (1/3)
cdc.gov/poxvirus/monke… Using a study done in a chamber to try and link monkeypox aerosol dynamics to the discussions around COVID transmission is quite frankly a poor take. Here's more on transmission cdc.gov/poxvirus/monke…

You’re likely seeing a lot of “ffs” from public health folks at the news that TSA is dropping mask mandates on airplanes, trains, and public transportation. Here are some thoughts (while screaming into the void):
(1/n) Cases are rising in the U.S. and with so many public health measures relaxing, we’ll likely see increasing case counts. This data also reflects an underreported # bc home antigen tests aren’t report. (2/n)

A few observations/concerns from the last few weeks of infectious disease and global health security: many of us are increasingly concerned about data integrity and true situational awareness as govts pull back on testing and rely on at-home tests (big data gaps) (1/n) This ultimately means we’ll be flying blind on what’s actually happening in terms of community COVID numbers. @PPI_Insights is a great resource for this FYI. Second, we’ve relied on vaccine-induced immunity for protection against severe disease/death, but as this wanes… (2/n)

An ode to travel woes during this COVID season: on an intl work flight with a stop in the UK. My pre-flight PCR has not resulted… and is required for the layover. (1/n) I am fully vaccinated. The rapid molecular I did yesterday doesn’t count. So I ran to the testing center within the airport for an antigen. As you can imagine, many are in this same situation (result delays, travel restrictions, etc.) - it is La grande shit show. (2/n)

Some thoughts on a lot of the news today - first, I’m grateful that we continue to evaluate vaccines throughout the changing nature of this pandemic (and have so many efficacious vaccines). It’s hard to address any of this w/out acknowledge the privilege of it all (1/n) I entirely agree w/@IDSAInfo about this being a partnership with ensuring global vaccine access/distribution for low and middle-income countries. None of this can be done in a silo. (2/n).

One of the most important pieces of infection prevention is working with bed placement - we try to avoid shared rooms, but in emergent situations/overflow, the focus becomes on avoiding transmission of any infectious diseases (1/n) For patients w/an ID, we try to pair like w/like - flu w/flu, MRSA w/MRSA, *if necessary*. Same with COVID. The assumption is never “they’re six feet apart, so we can mix it up” - we know patients may pass each other, move around, are in the room unmasked for a while, etc. (2/n)

Thoughts on communicating transmission.. Much of the discussion around airborne, aerosols, and droplets (oh my!) is about communication and subsequent operationality (interventions). (1/n) In public health/IP, we use droplets to explain short range and size, aerosols for long-rage (and also size), and subsequent interventions based off that. SARS-CoV-2 has been a case study in that often these approaches may need more nuance. (2/n)