Tom Inglesby

@T_Inglesby

Director, Johns Hopkins SPH Center for Health Security, working to protect people from epidemics & disasters. Inf diseases, pub health, research, policy

Baltimore, MD
Vrijeme pridruživanja: travanj 2014.

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  1. proslijedio/la je Tweet
    Odgovor korisnicima i sljedećem broju korisnika:

    A fine line between “mild symptoms” and “Asymptomatic”. Limited cough, slight headache, intermittent tiredness or, sore throat. Have one of these-is that mild symptoms or Asymptomatic? What is clear is people are infectious quite long time and from quite early after infection.

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  2. proslijedio/la je Tweet
    2. velj

    Great thread. Need to take the long view and not act for the sake of acting. Not a political point this is our self interest in minimizing the virus’s disruption of life health and well being

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  3. 2. velj

    If nCoV starts spreading in US it's not because USG failed to contain it, it's because it'll have been a dz that was not possible to stop. That needs to be communicated clearly, or the public may lose confidence in the response, and that will make challenges of nCoV worse.(26/x

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  4. 2. velj

    At the start of 2009H1N1 initial case fatality estimates were much higher than would prove to be the case when more data was collected with time. There is good reason to think that CFR in nCoV will also fall substantially when we get more info over time. (25/x)

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  5. 2. velj

    We need to communicate to public about nCoV preparations, what they can do to lower risk of spread of infxn. Explain CFR may be 2% now, but will likely go down, perhaps a lot, when we get more data. Right now in China, it is the most severe are getting diagnosed. (24/x)

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  6. 2. velj

    We need hospitals to be prepared to take care of increased number of patients with ARDS-like illness. We need to move ahead rapidly on development of vaccines, antivirals, monoclonals and other therapies. (23/x)

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  7. 2. velj

    We need pub health agencies, labs, providers to be ready to Dx large numbers of infected much more rapidly than is happening now – there are many day backlogs now. We should also start sentinel surveillance for nCoV around country to see if nCoV already circulating in US.(22/x)

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  8. 2. velj

    It makes sense for US to take specific proven measures to try to interrupt spread of nCoV here, including screening, education, isolation of sick, protection of HCWs. At same time, work of preparing for response to a possible nCoV epidemic in US should move ahead quickly. (21/x)

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  9. 2. velj

    Policies now will set direction for nCoV response. Will force be used to compel actions w/ little evidence behind them? Even if pandemic is likely in any event? We need to look at each potential new action, gauge if likely to work, and at what societal cost. 20/x

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  10. 2. velj

    We should look ahead, consider the effectiveness of bans and forced quarantines and what kinds of consequences they will bring on, and reassess. (19/x)

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  11. 2. velj

    Also new US strategy: US residents returning from other parts of China get home quarantine for 2 wks, even if no sx. Will be highly challenging, resource intensive for Pub health agencies, some who say that work could be zero sum w/ other critical nCoV preparations. (18/x)

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  12. 2. velj

    If other countries get high transmission, will Americans returning from those countries also be sent into military quarantine? There's no evidence that kind of quarantine is better for containment than airport screening, education, instruction to get tested if ill. (17/x)

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  13. proslijedio/la je Tweet
    2. velj
    Odgovor korisnicima i sljedećem broju korisnika:

    Examples like this underscore the potential value of rapidly scalable point of care / point of need that satisfy criteria. Something to build into research prioritization, regulatory processes, etc.

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  14. 2. velj

    If other Chinese cities have high transmission, will USG policy expand so that Americans coming from all of China get military quarantine? Estimates are that there are as many as 70,000 Americans or more living in China.Will we start quarantining all of them who come home? (16/x)

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  15. 2. velj

    Also Leung et al: data suggest “independent self-sustaining human-to-human spread is already present in multiple major Chinese cities,many of which are global transport hubs w/huge numbers of both inbound and outbound passengers (eg, Beijing,Shanghai,Guangzhou, & Shenzhen).” 15/x

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  16. 2. velj

    Regarding plans for quarantine--US residents returning from Hubei to be in mandatory quarantine for 14 days on military bases. It's one thing to have up to 1,000 people in a military quarantine for 2 wks, but what happens as the epidemic expands?(14/x)

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  17. 2. velj

    Recognition of the lack of effectiveness of bans and the major consequences of travel and trade bans led all countries to agree by treaty (the International Health Regulations) to not put these kinds of bans in place during outbreaks. (13/x)

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  18. 2. velj

    We don’t have historical reason to believe travel bans work. Every year seasonal flu spreads extensively around the world. 2009H1N1 also spread quickly around world despite early attempts to put bans in place. The reproduction rate of nCoV has rivaled that of flu so far.(12/x)

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  19. 2. velj

    If US has widespread nCoV transmission in time ahead, should Americans be banned from flying to other countries?Will other countries ban US goods? Travel bans like this could be like a series of dominoes that fall, choking off interaction between the US and the world. (11/x)

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  20. 2. velj

    A prominent modelling team led by G. Leung in Hong Kong published a paper yesterday in Lancet reporting there were more than 84,000 passengers/month flying out of Wuhan to cities around the world in the last couple months. (10/x)

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