“If we manage it the way that we manage it now, then most people will get infected with it at least a couple of times a year,” - @K_G_Andersen
nytimes.com/2022/05/16/hea… The new variants have not altered the fundamental usefulness of the Covid vaccines. Most people who have received 3 or even 2 doses will not become sick enough to need medical care if they test positive. Booster seems to decrease chance of reinfection — but not by much

China’s Zero COVID Strategy Braces for Omicron
“You have to give China a lot of credit for keeping COVID so low for 2 years, but now...we have passed the point where we can expect to prevent cases because it’s simply so transmissible...” @LawrenceGostin
voanews.com/a/china-s-zero… “In fact, the omicron variant might be one of the most infectious pathogens on the planet. So, I don't think it's sustainable for China to expect to have zero tolerance for cases because it's only a matter of time before China is overwhelmed with cases."

"The exposure-to-symptom gap, called the incubation period, is estimated to be about 5-6 days for the original strain, 5 days for the alpha variant and 4 days for delta."
For #omicron? May be a 3-day incubation period, shortest of any variant. 1/4
beckershospitalreview.com/public-health/… #Omicron might be the second most contagious disease on the planet, behind only measles according to a @ClevelandClinic infectious disease doctor.
Both @ScottGottliebMD and @JReinerMD have said it spreads like measles. Will "zero-covid" be possible vs omicron? 2/4

Much unknown about Omicron but ...it's spreading fast. In S. Africa, UK & Denmark-countries w/best variant surveillance & high immunity vs.COVID-Omicron cases growing exponentially. Omicron outcompeted Delta in S. Africa & may soon do so elsewhere.
theatlantic.com/health/archive… Omicron spreading in highly immune populations as quickly as original virus did in populations w/no immunity at all. If this holds & is left uncontrolled, big Omicron wave lies ahead-bigger than Delta. US has a low vax rate. Omicron may eat away at the immunity we thought we had

The following Christian denominations have no theological objection to #vaccination: vumc.org/health-wellnes… These denominations do have a theological objection to vaccination:

On #VaccineMandate and religious exemptions

"...employers in the difficult & legally precarious position of determining whether the requests are valid. Some states have tried to do away with non-medical exemptions overall for their employees." abcnews.go.com/Health/covid-1… 44 states & DC currently offer religious exemptions to vaccines, of which 15 offer broader personal belief exemptions for personal, moral or spiritual ideologies. 6 states -- California, Connecticut, Maine, Mississippi, New York & West Virginia -- only offer medical exemptions.

A short thread about #vaccination & #pregnancy.

In early 2009 I got pregnant - then came H1N1 flu. Data soon made it clear that pregnant women were among the most at risk from severe complications if they got H1N1 flu My ob didn't have the vaccine available.
Soon the public health department started vaccinating children & other at risk populations.
I called my obstetrician again. No doses.
I called every ob in a 100 mile radius. No doses. Finally an ob in a teaching hospital told me why.

Some experts are saying this delta wave may be the last one. In the US we have a promising oral antiviral pill in the pipeline (Merck), very effective vaccines & vaccine mandates tied to employment helping accelerate vaccination among the reluctant. But much of the world is still unable to access vaccines, more variants of concern likely & a recent poll showed only ~30% of parents willing to vaccinate their kids (likely to be high rates in some areas, near nil in others).

Mandates Boost Vaccination Rates Among Health Care Workers in California nytimes.com/2021/09/30/us/… New York’s mandate also accompanied a rise in vaccine compliance among health care workers, as did a mandate imposed by United Airlines, which reported this week that 99 percent of its work force of 67,000 was vaccinated and that 600 unvaccinated employees would be fired.

Is daily testing needed @statesdj ? In CA we test close contacts every three days, a negative test on day 6 and no further testing required.

In Georgia: Student close contacts continue attending school w/no symptoms & test negative every day for 7 days. nytimes.com/2021/09/19/hea… More states doing what CA doing...
" a number of school districts are turning to testing to keep more children in the classroom & avoid disrupting the work lives of their parents. The resource-intensive approach — sometimes known as “test to stay” or modified quarantine

From @latimes based on interview with Karen Gallardo a respiratory therapist at a hospital in Ventura County, CA
#GetVaccinated #WearAMask or what to expect if you have severe COVID-19 #GetVaccinated #WearAMask

Pediatrician friend recommends this link if you want info on masks for kids #BacktoSchool2021
Please share
“We have a huge problem in the US, and that is that here is no general population standard for face masks,” said Collins. “Now we have this problem, that we need kids with better masks, and we have no standard.”
medscape.com/viewarticle/95…

California K-12 CDPH trying very hard to keep kids in person learning on campus, even after exposure. One of their quarantine options requires frequent testing (antigen if asymptomatic) as in 4 tests in 10 days. The state is helping schools set up testing sites. If you don't want to get your kid tested 4x in 10 days you can opt to do a home quarantine for 10 days, return on day 11. Testing encouraged but not required. There is also a third option - proof of negative test on d6 or d7 after exposure, return on day 8 to campus.

A few school districts in SoCal has been open for full in person since mid-summer. At one, the district office is doing ~600 tests/day (antigen & PCR) for staff and students. Dashboard shows 250+ communicable cases on campus in 4 wks since reopening for full in person learning. Following CDPH guidance schools are targeting close contacts for quarantine. With so many cases, principals, nurses, teachers, secretaries must spend most of the day doing COVID related work - collecting close contacts, making notifications, going over quarantine options (3!).

Some schools have already opened for full in person learning.
Universal masking in vaccinated and unvaccinated should be required.
The school guidance for my state, CA, is convoluted - will be incredibly hard for school district without dedicated Covid mitigation staff. Schools should consider hiring someone to track cases and provide guidance to principals, nurses and other administrative staff. Opening in a surge with a highly transmissible variant is trickly.

From 5/20 - Basics of case investigation/contact tracing. Caser/tracer calls to ask positive case how they’re feeling, symptoms they have & for names & numbers of anyone they’ve had close contact within 48 hours of developing symptoms or pos test (asx).
seattletimes.com/seattle-news/h… Close contacts (anyone within 6' of case for 15 min or more will be asked to quarantine for 10 to 14 days.

Positive case will be asked to isolate for 10 days from onset of symptoms or positive test if asymptomatic. Symptoms improving & no fever for 24 hrs, case released d 11

#BREAKING
The @CDCgov plans to release new guidance on Friday urging schools to fully reopen in the fall, even if they cannot take all of the steps the agency recommends to curb the spread of the coronavirus
nytimes.com/2021/07/09/hea… The agency will also call on school districts to use local health data to guide decisions about when to tighten or relax prevention measures like mask wearing and physical distancing.

thread - contact tracing

A case is someone who tests positive.

A contact is someone within 6' of a case for more than 15 minutes from two days before and during their symptomatic period.

Doesn't matter if you're wearing a mask.

Contacts have to quarantine for 14 days. People in isolation or quarantine should only leave house to go to doctor/medical facility/get tested.

Negative test (nasal swab) will not "get you out" of quarantine.

Neither will a positive antibody (blood) test.

Six principles of crisis communications from Sandman & @EIDGeek via @CIDRAP

1. Don’t over-reassure.
2. Proclaim uncertainty.
3. Validate emotions—your audience’s and your own.
4. Give people things to do.
5. Admit and apologize for errors.
6. Share dilemmas. "Like most crises, the COVID-19 pandemic requires 3 kinds of risk communication. Before the crisis, the task is ‘precaution advocacy’ — warning a complacent public. We pretty much failed at that one."

"Many developing nations with hot climates & young populations have escaped the worst, suggesting that temperature & demographics could be factors. But countries like Peru, Indonesia & Brazil, tropical countries in the throes of growing epidemics, throw cold water on that idea." "The Dominican Republic has reported nearly 7,600 cases of the virus. Just across the border, Haiti has recorded about 85.

In Indonesia, thousands are believed to have died of the coronavirus. In nearby Malaysia, a strict lockdown has kept fatalities to about 100."

THREAD

Rare syndrome in #COVID19 positive children reported globally.

100+ cases of the unusual illness linked to Covid-19 have emerged in at least 6 countries resembling #KawasakiDisease including the US where several cases emerged in DC in past 24 hours. Doctors reporting cases of rare but potentially lethal inflammatory syndrome in children that appears to be linked to coronavirus infections.

-100+ cases in 6 countries
-doctors in Britain, US, France, Italy, Spain & Switzerland investigating .theguardian.com/society/2020/a…