…we actually need isolation to be shorter for reasons 1-4 and I worry that requiring a test would threaten that. We can tolerate some transmission in the post-vax era. Containment is no longer the strategy. Happy New Year! Here’s hoping for more steps forward like this in ‘22!
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Why I like 5 days of isolation, with no test, as recommended by CDC and now MA DPH. 🧵
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1. Remember when
#MedTwitter
rallied together against outdoor masks? Because when the “rules” are overly broad one loses sight of where the greatest risk lies. Energy is not unlimited. A 5-day rule concentrates energy on minimizing risk when risk is greatest.
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2. A 5-day rule incentivizes people to test because the harms from finding out you are infected are less. 3. A 5-day rule could prevent society from grinding to a screeching halt over the next week or two when everyone gets infected at once…
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... That’s not political nor is it prioritizing the economy over public health. It’s reality. We need the lights on and food on the shelves. Everyone is essential to someone. Education is essential.
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4. A 5-day rule acknowledges an unfortunate reality: everyone has COVID right now. The person you don’t know has COVID poses a greater risk to you than the one you do know has it who is on day 6. This new rule moves us closer to “living with” the virus.
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5. Why no test? I’m not convinced antigen tests measure “contagiousness”. I agree that data suggest you are more likely contagious when pos and less likely when neg. But there are many tests out there with different characteristics. What proportion are neg on day 5? On day 10?…
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@ShiraDoronMD
My understanding is that the CDC updated its guidelines from what you indicated herein.
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@ShiraDoronMD
Great tweet but you are wrong about one thing - it is political. The science hasn’t changed.
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@ShiraDoronMD
This all makes so much sense. But what if you test positive on an antigen test on day 5? Should you leave isolation to join hours-long indoor events like weddings, etc. in a cloth mask? Or travel by plane? Or should you wait one more day? This is not clear. Thank you!
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@ShiraDoronMD
Thank you for being so reasonable. And it’s nice to hear health professionals acknowledge containment is no longer the goal. What do you think a realistic goal is going forward? And if containment’s not the goal why isolate/test assympt ppl?
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@ShiraDoronMD
Not everyone can tolerate getting Covid even when triple vaxxed. The idea of "just lie back and enjoy it" is dangerous to people with pre-existing problems
Also a mild case of Covid doesn't mean that there won't be long Covid issues. My chronic fatigue has affected my whole life
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@ShiraDoronMD
These make so much sense. Maybe you should do PR for
@CDCgov
they keep botching the communication part.
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@ShiraDoronMD
I will be sure to tell my immunocompromised friends that you have decided it is necessary to sacrifice them for the greater good.
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