Dr. Lucky Tran Profile picture
Jan 2 4 tweets 2 min read Read on X
According to the latest CDC COVID-19 wastewater data, we are currently in the second-biggest surge of the pandemic.

It will peak in the next week, with ~2 million infections per day. During this surge, ~100 million people total (~1 in 3 people in the US) will likely get COVID. COVID-19 Wastewater Levels in the U.S. Chart shows national trends of SARS-COV-2 viral activity levels in U.S. wastewater
According to the latest CDC wastewater data, 35 states have very high or high levels of COVID-19. COVID-19 Wastewater Levels U.S. Map Map shows viral activity levels of SARS-COV-2 in wastewater in each state
Note: Latest CDC wastewater data is from December 28, 2023, so this doesn't even include the large number of infections that happened over the holidays yet (yikes). And some states are very slow to report their data, so if surrounding states are higher, this may be due to a lag.

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More from @luckytran

May 22
A new gold standard review of 100 studies finds:

- masks are effective in reducing transmission of respiratory diseases

- N95 respirators are significantly more effective than medical or cloth masks

- mask mandates are effective in reducing community transmission Clinical Microbiology Reviews: Masks and respirators for prevention of respiratory infections: a state of the science review
The new review showing the effectiveness of masks addresses the flawed Cochrane study, which was deliberately misinterpreted by anti-maskers & some media to spread misinformation around masks.

This new review will serve as a gold standard reference to debunk mask misinformation. The need for a new review on masks was highlighted by a widely publicized polarization in scientific opinion. The masks section of a 2023 Cochrane review of non-pharmaceutical interventions (9) was—controversially—limited to randomized controlled trials (RCTs). It was interpreted by the press and by some but not all of its own authors to mean that “masks don’t work” and “mask mandates did nothing” (10). Cochrane’s editor-in-chief felt the need to state publicly that in Cochrane’s view, the review’s findings did not support such a conclusion (11). Some scholars were quick to question the rev...
Link to "Masks and respirators for prevention of respiratory infections: a state of the science review" by @trishgreenhalgh @Globalbiosec @DFisman @jvipondmd and colleagues: journals.asm.org/doi/10.1128/cm…
Read 4 tweets
May 18
News: Biobot is sunsetting its COVID-19 wastewater public data visualization platform.

While Biobot will continue to publish their contextualized weekly respiratory risk reports, this represents another decrease in data transparency, and a step in the wrong direction.
The Future of Biobot’s Public Data:  With the abundance of publicly available wastewater data and our shift to contextualized respiratory risk reports, we are sunsetting our public data visualization platform (www.biobot.io/data).   This evolution represents Biobot’s commitment to maximizing the value of wastewater data. We believe that by adding context and expert analysis, we can empower individuals, communities, and public health officials to take proactive steps towards a healthier future.
I fear that the reason for removing publicly accessible data visualization is due to pressure from the government and CDC, who have made it clear in past statements that they do not like non-government scientists interpreting wastewater data.
It’s true that COVID wastewater data is complex and hard to interpret, but the solution isn’t to remove publicly accessible data, which is importantly for transparency and accountability.
Read 8 tweets
May 10
This North Carolina bill is ridiculous. It justifies punishing protestors for blocking emergency vehicles, yet bans wearing masks for health reasons. This bill is dangerously anti-public health and restricts people's ability to protest and exercise their First Amendment rights. HOUSE BILL 237: Unmasking Mobs and Criminals.  OVERVIEW: The Proposed Committee Substitute (PCS) for House Bill 237 would do the following: • Repeal the health and safety exemption from certain laws prohibiting the wearing of masks in public. • Enhance the criminal punishment if the defendant wears a mask to conceal the defendant's identity during the commission of another crime. • Prevent the executive branch or local governments from distinguishing between religious institutions and other entities during an emergency. • Impose criminal and civil liability on individuals who obstruct emerg...
Senator Buck Newton, who presented North Carolina's anti-mask bill that also penalizes protestors blocking traffic, says people "do not have the right to risk people’s health and safety." Shameless hypocrisy. Removing the right to wear a mask increases health risks for everyone. Newton said that lawmakers want to preserve the First Amendment rights of people to demonstrate, but added that protesters need to do so in an orderly way, and that it’s unacceptable for people to block ambulances, fire trucks, or other emergency vehicles. “The folks that want to express their frustration about a particular issue, certainly have the right to do that,” Newton said. “They do not have the right to risk people’s health and safety.”
What is also ridiculous is that the North Carolina anti-mask bill would ban people from wearing a mask for health reasons, but allows mask wearing for holiday costumes, work, theatrical productions, and parades. The bill leaves in place a number of other exemptions, including provisions that allow public masking for people who are:   ▪ Wearing “traditional holiday costumes in season;”   ▪ “Engaged in trades and employment where a mask is worn for the purpose of ensuring the physical safety of the wearer, or because of the nature of the occupation, trade or profession;”   ▪ “Using masks in theatrical productions including use in Mardi Gras celebrations and masquerade balls;”   ▪ Members of any societies, orders, or organizations engaged in any parades, rituals, initiations, ceremonies, celebrations ...
Read 4 tweets
May 7
We don’t talk about it enough but it’s a huge failure that there isn’t more urgency to develop better COVID vaccines.

An Operation Warp Speed for nasal vaccines and more variant proof vaccines would transform our ability to deal with COVID and help us mitigate future pandemics.
The current COVID vaccines have reduced deaths but governments are in denial that there’s still a too many deaths, too many getting Long COVID, & too many locked out of society. Better COVID vaccines (with treatments & other public health layers) would make a huge difference!
Governments are failing to value technology development in preventing and mitigating future pandemics.

mRNA vaccine technology was developed decades before COVID and this made a critical difference.

New nasal and variant proof vaccine tech will be needed for future pandemics.
Read 5 tweets
Apr 7
UPDATE: COVID wastewater levels are low in most US states.

If you've been holding off on healthcare or other activities, now is one of the best times of the year to go.

Note that even in low periods you are still at risk of COVID exposure, so it makes sense to take precautions. Chart: COVID-19 Wastewater Levels by US State (April 2024)
Please note that the above chart is with the proper color scheme for COVID wastewater levels (darker shade = higher levels). Apologies for the color error in the last export!
CDC data shows that COVID wastewater levels are low or minimal in all four US regions. COVID-19 Wastewater Levels by US Region (April 2024)
Read 11 tweets
Apr 5
CDC's recommendations for the public re: bird flu outbreak in the US

1️⃣ Avoid being near sick or dead animals and contaminated surfaces
2️⃣ Wear respiratory or eye protection if you are near
3️⃣ Do not prepare or eat uncooked or undercooked food such as raw milk or raw cheeses Recommendations for the Public  People should avoid being near sick or dead animals or surfaces contaminated with the animal’s feces, litter, raw milk, or other byproducts when not wearing respiratory or eye protection. Animals in which HPAI A(H5N1) virus infection has been identified include wild birds, poultry, other domesticated birds, and other wild or domesticated animals (including livestock such as cattle and goats). As always, people should not prepare or eat uncooked or undercooked food or related uncooked food products, such as unpasteurized (raw) milk or raw cheeses, from animals...
CDC's recommendations for farmers re: bird flu outbreak in the US

1️⃣ Wear N95 respirators, eye protection, and gloves, and wash hands to reduce risk of infection when handling animals
2️⃣Train workers to use PPE correctly Recommendations for Farmers; Poultry, Backyard Bird Flock, and Livestock Owners; and Worker Protection  To reduce the risk of HPAI A(H5N1) virus infection, poultry farmers and poultry workers, backyard bird flock owners, livestock farmers and workers, veterinarians and veterinary staff, and responders should wear recommended PPE (e.g., the same PPE is recommended for persons exposed to any confirmed or potentially infected animals as for exposed poultry workers; for specific recommendations see: PPE recommended for poultry workers). This includes wearing an N95™ filtering facepiece respirat...
CDC's recommendations for clinicians re: bird flu outbreak in the US

1️⃣ Look out for symptoms
2️⃣ Follow infection control recommendations, including using PPE
3️⃣ Initiate antiviral treatment ASAP
4️⃣ Collect specimens and notify health depts
5️⃣ Encourage patients to isolate
Recommendations for Clinicians  Clinicians should consider the possibility of HPAI A(H5N1) virus infection in people showing signs or symptoms of acute respiratory illness or conjunctivitis and who have relevant exposure history outlined in Highly Pathogenic Avian Influenza A(H5N1) Virus in Animals: Interim Recommendations for Prevention, Monitoring, and Public Health Investigations. Examples of symptoms include but are not limited to: Mild illness: (e.g., cough, sore throat, eye redness or eye discharge such as conjunctivitis, fever or feeling feverish, rhinorrhea, fatigue, myalgia, arthra...
If signs and symptoms compatible with avian influenza A(H5N1) virus infection are present: Isolate patient and follow infection control recommendations, including using PPE. Initiate empiric antiviral treatment as soon as possible. Do not delay treatment while awaiting laboratory results. Notify state and local health department to arrange testing for influenza A(H5N1) virus. Collect respiratory specimens from the patient to test for influenza A(H5N1) virus at the state health department. If the exposed person has conjunctivitis, with or without respiratory symptoms, both a conjunctival swa...
Read 5 tweets

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