It's 2:30 in the morning. I'm up with the baby, so of course I want to do a thread on the 2024 measles outbreak.

Illinois has over half the measles cases of the country.

Many medical providers have never seen a person with measles.

What do you need to know? Measles are highly contagious, unvaccinated people have a 90% chance of getting measles of exposed.

Where have exposures occurred during this 2024 outbreak? Hospitals/clinics, busses, schools, airplanes, congregate living settings. Know exposures can happen anywhere.

Lots of thoughts about the PHE ending in the US.
I'm processing how the death of 1.1+ million people (in the US), plus millions more becoming disabled, has left us ... callous I guess it could be worse- As Title 42 comes to an end, I can only be happy that we wont have remnants of this following us for years, like with HIV where for 23 years the US tested people's blood for HIV and used it as a reason to deny entry.

A close family friend has COVID. Lessons from her case that will cause me to move differently in my vaccine advocacy.

1- She is an elder who is 4x vaxxed. She didn't get the bivalent booster because she didn't know about it. Our messaging about the bivalent booster is pretty much the same as the other boosters. People who aren't spending their time staying up-to-date on all things COVID may hear "get your bivalent booster" and think "I already did that".
We need clear & simple messages.

On #immunitydebt
1- public health measures have limited exposure to diseases for a century. Yet, the phrase immunity debt just recently popped. When public health measures stopped exposure to waterborne diseases, people just lived longer, no faulty claims of immunity debt. 2- The age group most likely to be hospitalized by RSV are 0-6 mths. This age group was born during the "live with COVID" or "return to normal" phase of the pandemic. They didn't experience public health mitigations, therefore no "immunity debt" from it. cdc.gov/rsv/research/r…

There's a poverty tax, we all know this. Goods and resource often cost more in poorer sections of town.
We also see this in our criminal justice system. There are certain things that are crimes that would almost only apply to poor people. For instance, the mother in Georgia arrested for killing her baby. Circumstances- no heat in the house, mom heated their small home with the oven. Baby overheated and died.
Heating a home with an oven is something poor people do. Criminalizing its unintended consequences only impacts the poor

Dear @PublicHealth, did you consider having a local/state public health director lead mainstage talk about backlash?
Just doing our jobs led to us needing police protection many times during the pandemic. We did not have to go out of our way to utilize media to manufacture it. Our families have been tortured, our lives threatened. Many of us have lobbied for laws to protect our privacy by unlisting our addressed.
A colleague described how her kids were beaten up on the school bus after she implemented a mask mandate.
But, you're highlighting a

COVID fatigue is real.
Long COVID is real, and currently cost our economy 50 bil a year. This number is expected to increase as repeat COVID cases lead to more long COVID.
I also expect long COVID to impact our children's ability to learn in school and succeed. Especially if their parents are too sick or too fatigued to help their kids with school work.

We can't just stop at COVID fatigue being real and jump to "so let's give in to it".

We have to move to activism, "so let's decrease the rate of COVID in the community."

How? I have some ideas

My plan is to thank everyone individually for the care and support you have shown my family.
First by helping me identify a trauma & grief therapist in Philly, secondly by helping ensure that my family have the resources to maintain treatment.
My Twitter community is priceless. Last night, I talked to my 10 year old about the event that caused the life of her 9 year old cousin. Today, I will talk to you all about it.
The goal, education, with hopes that not another child is lost this way.
Let's discuss the #BlackoutChallenge

"We don't have to count raindrops to know it's raining"

A thread on why this should never be a premise we base public health policy on.

Also... hating every moment in our new normal that makes a thread like this necessary. My favorite T-shirt says "Epidemiologists count".

2 years ago I gave a lecture on how to count. My then 7 year old was shocked that I was giving a 3 hour talk to adults on how and the importance of counting.

But accuratly counting cases is core to epidemiology.

Today is my first day of vacation since Dec 2019.
How am I spending it? Well, just trying to make schools safer for all.

Thread about #SROs in schools. My concern about school safety has always been about way more than infectious disease spread.
School shootings, school violence, school to prison pipeline, school stress & anxiety, bullying, racially based macro and microaggressions, I've been trying to bring attention to this

When my oldest was in 2nd grade, we got a personal email from a parent on the first day of school.
It included pictures of their daughter. She had a childhood cancer. They talked about her struggles over the previous 20 months, and how her doctor had finally given them the green light to send her to school. They talked about how excited she was to attend school, especially since she didnt get to go in kinder or first grade. The parents ended their letter with a plea. A plea to parents not to send our kids to school with even a cold.

I feel this loss deeply. I feel the coldness of our neighbors every time I read a public death announcement. The "how many comorbities did they have' or "vaccination status" demands, I see written on public platforms.

https://twitter.com/edyong209/status/1514230215110762502

I'm often left wondering if people realize that the deceased have love ones that could read their comments. Love ones that need support, not questions wrapped in judgement.

In grad school, I remember thinking that if people understood how inextricably linked our health is with our neighbor's health, then maybe they would see the need for universal Healthcare. I never thought we'd be caring enough to do it bc it was the right thing to do, but because rich people would learn that if their housekeeper was sick, she could make their household sick. Or if the wait staff at their fav high end restaurant was sick, their health could be compromised.

I often wonder if people know the full list of things that makes someone at risk of severe outcomes from COVID.

I often wonder if the CDC's message that 90% of the country can take off their masks, oversimplifies that about 60% of people are at risk of severe outcomes. I wonder when we are going to have conversations that ability and health status changes over time, and that while you may have started 2020 at one risk level, you may be at a different level of risk today.

I spent an hour on the phone with a vaccine resistent person. I spent the first 20 minutes trying to get her to believe that I am not judging her for her choices, just hear to listen and provide factual information. The (50 something year old Black femme) described all the ways she protects herself from COVID. Like wearing gloves to the grocery store, wiping down her groceries and packages. Thankfully she wears high quality masks. She says she limits her outside activities to only essentials

Y'all, I'm too psyched!
Everyday I do research on my HBCU pick, looking for fun facts & notable grads.
Well, today is Day 3 & the letter C. So of course today is gonna be all about my Alma Mater, @ClarkAtlanta
I nearly died when I saw my name listed as a notable grad! So, let me tell you about MY SCHOOL!
CAU was founded in 1865, the first HBCU in the South. Our school motto has shaped my adult life
" I'll find a way or make one" and "Culture for service".
We were taught to never take no for an answer, just get a better pitch.

Day 2 #BlackHistoryMonth
#HBCUs that start with the letter B
Bowie State was one of the many HBCUs terrorized on Jan 31st.

Bowie is a public HBCU, the oldest in MD, established in 1865. It ranks in the top 25 HBCU for value and education.

https://twitter.com/Theresa_Chapple/status/1488486503013564418

A notable grad I'd like to highlight is @eunique. She has a goal of connecting new generations of Black Children to the knowledge and experiences of our ancestors. Her brand- Because of Them, We Can, has ensured that our children know the excellence of past.
Thank you!

The domestic terrorism that HBCUs are faced with needs to be discussed.
On this first day of #BlackHistoryMonth , my plans have shifted. I will teach my children about 28 of the 107 HBCUs in the US. We will learn their role in creating Black excellence.
theguardian.com/education/2022… Here are the 8 #HBCUs to choose from that start with the letter A. Today I will focus on Albany State and talk about the role it had in shaping a leading public health voice during this pandemic, Admiral Cedric Guyton, Assistant Surgeon General & Deputy Director of US Comm Corp.

Every time I hear the data about educational loss for children during the year of virtual learning, I ask a very simple question- was it because of virtual learning or because of the pandemic.
The most proximal thing always gets blamed.
My thoughts... Could it be that children just dont learn well during a pandemic, no matter what mode education is delivered? If their caregivers are being hospitalized and/or dying, could that be to blame for the educational losses we are seeing?

An @EpiEllie tweet from a while ago is the inspiration for mine today.
The biggest thing I got wrong during the pandemic was public & political support. I just knew since the world finally understood epidemics & pandemics, they would also realize the importance of public health I figured public health would be funded at levels necessary to actually protect the public's health. The nation would come together around the importance of universal Healthcare. We would understand that in a society, your health impacts my health.

My sister & niece finally got vaxxed! My sis was the most vaccine hesitant person I know, and she makes the healthcare decisions for my niece.
My sis was afraid, not uneducated, not didn't care, and def didn't deserve death bc she had fear of medicine that never served her well. She was cautious, created a buble with 1 family and never ventured outside of it without her N95 mask, face shield, gloves. She washed her hands often, and used contact free everything.
She bought at home Covid test as soon as they hit the market.
She knew covid was real...