We need to normalize breakthrough cases among the fully vaccinated +/- boosted

Certainly, preventing infection in the first place is still most desirable for a number of reasons (i.e., long COVID)

A brief 🧵 But as we in the (a) short term, have more virus in the community, and (b) long term, learn to live with the virus we’ll hear more about breakthroughs. /2

Over the last few weeks, many of my colleagues & I have been proactively talking w/unvaccinated healthcare workers, addressing their concerns, and encouraging vaccination before the NY state COVID19 vaccine mandate on HCWs effective this Monday.

It’s been an uphill battle.
1/ Sharing the facts, the science & the data has undoubtedly helped many who were on the fence on getting vaccinated

But many still remain unconvinced

There’s an incredible amount of mis- and disinformation circulating, even those working in healthcare aren’t impervious to it. 2/

Putting COVID numbers and vaccinations into context.

People often have a hard time grappling with large numbers. These illustrations from @TJCommission is intended to put COVID numbers into a more familiar (and hopefully meaningful) context.

Thread

From the beginning of the coronavirus pandemic, we’ve been inundated w/information

Some good. Some bad.

With a multitude of frontline communicators from clinicians to researchers to trainees, @EpiEllie & I discuss 3 guiding principles every science communicator should follow🧵 2) We write in our @BelferCenter op ed the critical role of scientific risk communicators and the ability to provide timely, accurate, and comprehensible guidance to the public, especially to combat the spread of mis- and disinformation

belfercenter.org/publication/gu…

My piece in the @nytimes “Why Are So Many of My Fellow Health Workers Unvaccinated?” covers not only the importance of vaccinating healthcare workers but the need to keep the conversation going

A brief thread on a bit more insight 🧵

nytimes.com/2021/05/28/opi… 2) As of early March 2021, surveys showed that nearly half of frontline health care workers remained unvaccinated, even though this group has been eligible for a Covid-19 vaccine since December 2020.

With expanded COVID19 vaccine eligibility and millions of Americans getting ready to receive a life-saving vaccine, Dr. Billal Sikandar of @UMmedschool @UMCapital & I share a helpful guide on what to do before, during and after receiving a COVID19 vaccine

belfercenter.org/publication/va… Preparing:
1. Continue to wear a mask and watch your distance while at your vaccine appt

2. Try to avoid taking OTC pain/fever reducing medication before receiving the vaccine

3. Wear loose clothing to easily expose injection site

4. Stay hydrated and eat something before

1) CDC reports 5,800 Covid infections in fully vaccinated people

“Some became seriously ill and 74 people died...396 -7% - of those who got infected after they were vaccinated required hospitalization.” @CNN

Important to note, it’s not unexpected to see breakthrough cases. 2) “The vaccines are not 100% effective in preventing infections and as tens of millions of people are vaccinated, more and more such cases will be reported.”

amp.cnn.com/cnn/2021/04/14…

1) As fully vaccinated persons wonder what activities they can engage in, it’s important to look at it from the lens of those around you and their vulnerability to the virus.

Dr @MonicaGandhi9 and I break it down in our latest @BelferCenter op ed:
belfercenter.org/publication/wh… 2) We highlight, with three remarkable COVID-19 vaccines authorized in the U.S. and millions of Americans getting vaccinated daily, it is indeed time for COVID optimism while still being cognizant of VOCs

There is a lot to be optimistic about as I discussed w/@chrislhayes @allinwithchris

As vaccinations continue, think of 3 tiers & activities we can do safely

Tier 1: vaccinated+vaccinated
Tier 2: vaccinated+unvaccinated
Tier 3: unvaccinated +unvaccinated

Image by @MonicaGandhi9

https://twitter.com/chrislhayes/status/1364254850071072768

2) Also think of “return to normal” in context of 3 stages as community transmission decreases, hospitalizations & deaths decline, herd immunity builds:

Stage 1: local and state
Stage 2: national
Stage 3: international

Here’s a good related read: vox.com/future-perfect…

1) In our recent publication Dr @KrutikaKuppalli & I review and discuss some of the most notable infectious disease outbreaks and trends of the past year and where appropriate, indicate how they were impacted by COVID19:
- Ebola
- Vaccine preventable diseases
- MDROs

Brief🧵 2) Over the past 40 years, there has been a 4-fold increase in the number of emerging pathogens with #SARSCOV2 being the latest novel pathogen and 70% of the world is underprepared to prevent, detect, and respond to them quickly and effectively.

The COVID19 Pandemic has highlighted now more than ever the need to take biopreparedness seriously

The @BioCommission released a report "The Apollo Program for Biodefense–Winning the Race Against Biological Threats" which I along w/many other SMEs in this field contributed to
🧵 2/The @BioCommission lays out 4 recommendations & technology priorities:

1)Implement the National Blueprint for Biodefense
2)Produce a National Biodefense Science and Technology Strategy
3)Produce a Cross-Cutting Budget
4)Appropriate Multi-Year Funding

biodefensecommission.org/wp-content/upl…

We're in the most consequential days of this pandemic

What actions need to be taken at the fed, state & local level to pick up the pace of COVID vaccine roll out?

My new op-ed in @ABC covers this & the need to address vaccine hesitancy among HCWs
abcnews.go.com/Health/speedin…

🧵/1 First, the weight of the surge has fallen squarely on hospitals and public health departments. They're tackling the onslaught of cases, hospitalizations & pandemic response without much federal support and deserve to be commended vs the blame game.

/2

Adding on to what Dr @darakass shared below on upcoming holidays and family gatherings.

The goal is to minimize risk as much as possible.

And risk is not uniform.

https://twitter.com/darakass/status/1326904170503409666

The safest approach is to stay w/in your nuclear family but as we mentioned on @allinwithchris @chrislhayes there is the option to merge social bubbles

In my @businessinsider piece I discuss how to safely do this and additional considerations to take

businessinsider.com/how-epidemiolo…

The New York State DOH has released "Interim Recommendations for Use of SARS-CoV-2 Antigen Tests
During COVID-19 Public Health Emergency" to ensure effective & appropriate use/interpretation of test results for accurate clinical/public health management

coronavirus.health.ny.gov/system/files/d… These recommendations are important components in operationalizing SARSCOV2 antigen tests and considerations for clinical presentation, exposure risk, and responding to both negative & positive antigen testing results.

The drop in COVID19 hospitalization death rate can be attributed to many factors eg better tools in toolbox to manage the illness & recognizing/intervening sooner

But another important/contributing factor to this decline is the ability to keep hospitals from getting overwhelmed And the best way to prevent hospitals from getting overwhelmed is to take preventive steps to reduce the risk of contracting SARSCoV2.

Please continue to wear a mask & watch your distance. Just these 2 easy steps is helping prevent illness, save lives & keep mortality rates ⬇️

When Trump was elected, I really hoped there wouldn't be any significant epidemic or pandemic threat this nation would face during his term given his poor understanding of outbreak science, the ability to manage large scale ID events & constantly undermining public health. Case in point, Trumps multiple tweets during the 2014 Ebola epidemic & criticizing President @BarackObama going so far as to tweeting how our brave HCW's who understand the value of human life & a health threat anywhere is a health threat everywhere, not be brought back to the US