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Dan Diekema Profile picture
Dan Diekema
@dan_diekema
Infectious diseases physician, epidemiologist, and clinical microbiologist. University of Iowa to Maine Medical Center-MaineHealth. Views are my own. He/him.
Jan 16, 2022 • 7 tweets • 3 min read
This tweet is misleading. The study cited is a pre-print that reports Ct values and ability to culture virus from 21 subjects. In only 3 were they able to culture virus beyond day 6, and they were unable to culture virus from any of the 6 asymptomatic subjects after day 5... ...and as I've pointed out before, there is no lab test for "infectiousness", and ability to culture a virus from a sample does not equal infectiousness (reverse also may be true!). Best data to base public health decisions on would be good contract tracing data...
Oct 2, 2020 • 10 tweets • 3 min read
Since this is apparently the "day of a thousand hot takes" (most of which will be wrong), I'll interrupt my Twitter hiatus to highlight some things that this teachable moment should drive home. Because what's happening now reinforces several points often lost re #COVID19: 1/10 First are the timelines: INCUBATION period of up to 14 days means all the "X is negative today" stories are dumb, as X could still be incubating the virus. INFECTIVITY is likely highest prior to symptom onset, and infected persons can transmit for 2-3 days before sxs and... 2/10
Sep 1, 2020 • 8 tweets • 3 min read
Ugh. I hoped to stay out of this spat for a while, but I'm being attacked by @jljcolorado for a short video I made a few weeks ago. It was designed for our HCWs, and deliberately used the terms HCWs are familiar with when describing transmission: Droplet and Airborne. 1/8 Those are the categories we've used. They are overly simplistic, and I completely agree that this is a continuum, as I describe here: haicontroversies.blogspot.com/2020/07/a-tire…
But "aerosol" doesn't currently have a direct link in HCW minds to prevention approach, unlike Droplet and Airborne. 2/8
Jul 6, 2020 • 4 tweets • 2 min read
So I wrote a blogpost yesterday to outline how I think about the airborne/droplet debate, after reading the NYT piece about a letter that is now out in CID:
academic.oup.com/cid/article/do…
And the letter is of course much more measured, less controversial than the media coverage...1/4 (which focuses on the larger debate that's making many of us weary at this point, for reasons I stated in the post). The article makes 3 recommendations that don't seem controversial to me: (1) improve ventilation in public buildings, workplaces, schools, long term care..2/4
May 11, 2020 • 4 tweets • 1 min read
Sigh. Was doing ID consults all weekend, off Twitter. Think I will stay off for a while. Didn’t like Idiocracy the movie, and this prequel is excruciating because it’s real. Our non-warrior leaders can go self-isolate while planning the Great Reopening... ...the rest of us will keep battening the hatches and be sure there’s enough ICU beds on short notice for all those who don’t have the luxury of self isolating, and here I’m about to lose my cool so I’m out...will focus on what’s in front of me.
May 4, 2020 • 4 tweets • 2 min read
I've been presenting these contact investigation studies (repeatedly) to try to place into context the recurring drumbeats (Goldberg Drumbeats?) about airborne transmission on one hand, and about prolonged infectious periods on the other. Both concerns get raised in... (1/4) ..response to studies that detect SARS-CoV-2 using molecular methods, either in the air from patient environment (or experimental conditions), or from patient samples for weeks after infection. But we now have data from literally thousands of close contacts of COVID-19...(2/4)
Feb 25, 2020 • 6 tweets • 2 min read
Important thread on testing. Related note, I'm surprised that anyone assumes the US has strong public health surge capacity. US healthcare system is teetering and dysfunctional, providing inferior results for far greater GDP investment than any other industrialized nation...1/6 ...and healthcare system is the foundation of public health response to emerging pathogens. Every entry point is part of detection/response. CDC and state PH depts are filled with smart, dedicated, hardworking people, but budgets are tiny, CDC budget 1/100 of military budget. 2/6
Nov 2, 2019 • 4 tweets • 3 min read
Back from @VUMChealth, thrilled to visit as the Koenig Lecturer, honoring of an ID giant who accomplished so much before his untimely death at age 41. Oral therapy for IE in 1957? Tx of systemic fungal infnx? Nature pub on PMN granules? Yes, yes, yes. A true renaissance ID doc.. Image @DMAronoff and @trtalbotmd are gracious hosts, kept me calm as I returned to @VUmedicine 30 years after graduating (VUSM Class of '89!). Nashville has changed remarkably since then, but 208 Light Hall is exactly the same, so I was rattled by a few biochem flashbacks... Image
Apr 6, 2019 • 9 tweets • 4 min read
Happy to see that an emerging, antimicrobial-resistant, healthcare-associated pathogen has made the FRONT PAGE of the NYT! The reporters do a good job placing C. auris in larger context..@PaulSaxMD @mike_edmond @eliowa 1/9
nyti.ms/2G2C2jY ...especially the widespread agricultural use of azole antifungals, which needs to stop. The simultaneous and independent emergence of this azole-resistant organism as a human pathogen on multiple continents around the same time is fascinating...2/9
Feb 2, 2019 • 4 tweets • 2 min read
In the wake of the Northam debacle, I assume several reporters may already be tasked with searching various medical school yearbook archives for similar content. As a 1980's med school grad, I thought I should at least try to find mine and search it for dicey material..1/4 Image ..and I successfully located it, dusty by undamaged after 3 decades in storage! Paged through it and found mostly just fond memories. The only offensive content was the lack of diversity, particularly on the faculty/staff pages...2/4
Jan 28, 2019 • 11 tweets • 4 min read
I have run afoul of a prestigious journal’s embargo policy. Anything you may have read on my twitter feed about the impending publication of any study, is to be ignored and forgotten for the next 48 hours. OK, @ClareRock1 : here's the story. My flight to Denver was delayed on Monday, so I was home when the mail arrived. In it I found this week's NEJM--the old-fashioned hard copy. OVIVA was (finally) published, almost 2 years after I heard the data presented 1/10
May 2, 2018 • 4 tweets • 1 min read
Twitter is fine for respectful exchange of opinions, but when we’re really mad we dust off the Selectric and write a letter...yes, to an Editor! In this case about the C. difficile LabID event: ncbi.nlm.nih.gov/m/pubmed/29708… Adjustment by lab method still problematic, and now a new feature....last test reported wins! So if you use an algorithm that includes toxin EIA, be sure that test gets reported last. #lasttestwins
Apr 22, 2018 • 4 tweets • 2 min read
The “Journal of Infectious and Noninfectious Diseases” gets a shout-out at an excellent talk on predatory journals by Dr. John McConnell. #eccmid2018 Image Well over a million articles have been published in predatory journals....upward trend is steep! #eccmid2018 Image