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):
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)
Mar 7 • 7 tweets • 2 min read
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)
Dec 31, 2021 • 7 tweets • 2 min read
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)
Aug 18, 2021 • 5 tweets • 1 min read
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).
Jun 23, 2021 • 6 tweets • 1 min read
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)
Apr 10, 2021 • 6 tweets • 1 min read
Statements like “we can end the pandemic once X occurs”, present both a false dichotomy and a myopic inaccuracy in how pandemic response and public health functions. It takes a lot to truly get a pandemic under control (1/n).
Vaccines are easily one of the most valuable tools we have. To make this work though, we need equity and that’s a huge issue we’re facing here in the U.S. and abroad. This also requires us to address hesitancy. (Adding - get vaccinated once you’re able to! ) (2/n)
Apr 2, 2021 • 5 tweets • 1 min read
While grabbing coffee today, I couldn’t help but notice a large group of older gentlemen at the coffee counter (outside) w/out masks on. It wasn’t the weird look they gave me when I put mine on as I approached, but rather the stressed look the coffee shop employee had (1/2)
The shop is still requiring them despite AZ’s relaxation of restrictions. Yes we were outside, but after paying/while waiting, they all stayed huddled around the tiny counter & in her workspace. Even when vaccinated, you should still mask up in public.
Feb 3, 2021 • 4 tweets • 1 min read
Single Dose Vaccination in Healthcare Workers Previously Infected with SARS-CoV-2 medrxiv.org/content/10.110…
“At all time points tested, HCW with prior COVID-19 infection showed statistically significant higher antibody titers of binding and functional antibody compared to HCW without prior COVID-19 infection (p<.0001for each of the time points tested)."
Jan 31, 2021 • 4 tweets • 1 min read
Sharing some insight as some one who’s been doing contact tracing for 10+ years: it’s about empathy and privacy. It’s also about having a general exposure definition to help gauge potential exposure. Is this perfect? Nope. No one has ever said contact tracing is perfect. (1/3)
It *is* an important public health tool. Sure, it would be great to have a super complex algorithm to help narrow if an exposure occurred, but that’s just not feasible (from both the PH standpoint AND that of the person being interviewed). Trust me, this isn’t an easy task. (2/3)
Jan 23, 2021 • 5 tweets • 2 min read
During a convo yesterday I realized that we really haven’t invested much communication or awareness into what recovery means for others. There's still fear/stigma about being around some one after their iso period is done. This is a complicated topic, but one we should focus on🧵
For example, CDC does not recommend using testing to end isolation. Moreover, during the 90 days after infection, PCR testing is not recommended as a + indicates viral RNA shedding since we know reinfection during that time is exceedingly rare. cdc.gov/coronavirus/20…
Jan 18, 2021 • 4 tweets • 1 min read
It’s fascinating to me to see people pull up tweets from Feb 2020 as a means to try and discredit people working in pandemic response. Our guidance evolves with the data and science, which is at a rapid pace during a pandemic of a novel disease. (1/3)
This is a tough part of our job, but one that means we’re improving continuously. PubHealth & healthcare response means leaning into these evolutions. Many of us speak to media/on social media in additional to our day jobs & it’s about using the best info we have at the time(2/3)
Jan 10, 2021 • 4 tweets • 1 min read
For everyone dumping on vaccine rollout- yes there have been a lot of issues & bottlenecking, but please know that a population-wide vaccine distribution is *tough*. Especially as hospitals and health dpts are doing the heavily lifting while under the weight of this surge.
We absolutely need to improve it and this has been another item in a long list of things the US has struggled with during COVID-19, but please note just how challenging and fractured a population-scale effort is.
Dec 29, 2020 • 4 tweets • 2 min read
Breathtakingly honest and spot-on, @edyong209 brings 2020 full circle with this recap of our pandemic year and what 2021 might hold.
“People have been doing this for almost a year without backup.” Each COVID-19 peak has sapped more energy & morale, & afterward, fatigued HCWs have had to deal with a backlog of postponed surgeries, as well as new pts who have been sitting on their medical problems..”
Sep 21, 2020 • 5 tweets • 1 min read
In terms of aerosols, droplet, & “airborne”- the best approach to communication I’ve found is that this requires enhanced respiratory protection in a healthcare setting. It’s not entirely airborne and it’s not entirely droplet, but rather something in the middle. (1/n)
We know this means different things for AGMP. For the public, I think it’s a good lesson in that the “6 ft” rule isn’t a hard rule in that there’s no magic force-field that prevents the virus from going further. Infection prevention involves multiple things simultaneously (2/n).
Aug 16, 2020 • 5 tweets • 2 min read
It's increasingly worrisome that we're not talking about healthcare-associated infections (HAIs) in COVID-19 patients. Across the country we are seeing spikes and several studies have shown elevated risk for HAIs, especially bloodstream infections. 1/
COVID-19 patients, especially those in ICUs, are more likely to have invasive medical devices (urinary catheters, ventilators, central lines, etc.) - these are wonderful medical tools but also increase the risk for infection. 2/
Jul 28, 2020 • 5 tweets • 1 min read
And this is why we read the whole study - "The temporal, spatial, and exposure evidence suggests that SARS-CoV-2 transmission may have occurred during the flight. However, the majority of 16 cases in the outbreak were not attributed to transmission on the flight.”
“Exposure to the virus in Wuhan or by infected members within the same tour group account for most cases in the outbreak."
Jul 19, 2020 • 4 tweets • 1 min read
Folks, it's SO important to differentiate masks in terms of efficacy/wearability/medical contraindications. This is a prime example of why we need to explain that sure, N95s are higher particulate filtration, but they also require fit-testing to *truly* work + health screening.
I'm a trained fit-tester to help expedite mask-fitting in our hospitals during this pandemic. It is dangerous to push N95s on people without explaining that they require a TRUE fit to work effectively and ultimately, many people can't wear them due to medical conditions.
Jul 7, 2020 • 9 tweets • 4 min read
A few thoughts on the “airborne" conversations right now…First, I ultimately think this comes down more to scicomm & our ability to communicate nuanced situations & data. How we approach airborne vs droplet is antiquated & even more so in how we communicate it… (1/x)
So much of this really plays into healthcare infection control where these situations are approached extremely different. In the community, as @apoorva_nyc@BillHanage emphasized, it's really the indoor, close setting that sees the super-sreader events involving aerosols (2/x)
Jun 16, 2020 • 5 tweets • 2 min read
A couple of things to unpack from this before hitting the panic button... first, concerns for toilet plumes aren’t new (ahem, norovirus) (1/x) Flushing may release coronavirus-containing ‘toilet plumes’ - @washingtonpost washingtonpost.com/health/2020/06…
Second, this study looked at fluid dynamics, which is an important distinction. A big piece of concern with plumes comes down to two pieces- infectious dose and how much has been excreted and then aerosolized in the plume. (2/x)
Feb 29, 2020 • 6 tweets • 2 min read
Hey @KrutikaKuppalli - let’s drop some truth on why people don’t need to wear surgical masks unless they’re sick….
First, these supplies are in short supply and the folks that need them are first responders/healthcare workers. Second..truly, you don’t need them unless *you’re* sick and that’s to protect those around you from your germs.
Feb 5, 2020 • 11 tweets • 3 min read
There’s a particular irony in people emphasizing the role of hospital preparedness right now. Comments about HPP funding and such are important, yes, but what we really need to address is how hospitals invest in biopreparedness. (1/x)
Primarily, hospital preparedness for infectious diseases is led by infection prevention/epidemiology (we saw this w/Ebola and it took up like 80%+ of our daily activities). The issue though is that these programs are woefully understaff & bioprep is not a major priority (2/x)