You can't keep up. Maybe you start doing what they were doing what they did in this context in NYC in the spring...you prioritize the oldest cases for contact tracing, trying to catch up...
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...and effectively leaving behind the cases where you might actually be able to expect to meaningful (the more recent cases). Because let's be clear, even without a total logjam and unsustainable levels of contacts to follow up on, CT has been theatre in Ontario for some time...
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...from the point of view of actually controlling disease. Our turn-around times simply aren't quick enough. Let's think about this...
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If I have a case who's been reported to me after a several day turn-around time on their test (brown bar below), and who took a few days to get tested (green), but who was infecting when pre-symptomatic (orange)...pic.twitter.com/2jfxKV29Tg
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By the time I reach out to their contacts, their contacts' secondary cases are already infecting a tertiary generation of cases! I already missed the boat! Does it sound good? Yeah! Are apps awesome? We love apps! Leaf trombone! Ocarina app! House party!
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So we're doing late and ineffective contact tracing on a small fraction of cases, and paying nearly 1000 people to impersonate Lucille Ball in the candy factorypic.twitter.com/aF8cRsHnRl
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Can contact tracing be important and impactful? Hell^yeah. If you're in the North, or Atlantic Canada, or Saskatchewan at 13-14 cases a day. We need the kinds of closures Dr. DeVilla was begging the province to allow yesterday to get back to a level where CT becomes meaningful
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What might be even more powerful? Leverage the place-based nature of COVID risk, and rather than rely on apps, use QR readers on venues so that when you have a case, you can identify the venue where the superspreader event they were infected at happened.
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E.g., did they tap-on/tap-off when they got invited to a Rose Garden reception for Amy Coney Barrett, that kind of thing. Efficient. This is the sort of stuff
@zeynep was writing about in her magnificent piece in the Atlantic. https://www.theatlantic.com/health/archive/2020/09/k-overlooked-variable-driving-pandemic/616548/ …9 replies 25 retweets 67 likesShow this thread -
The Rose Garden event was paid advertising for Zeynep’s fantastic super-spreader article.
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Not on purpose. But they were bound to get unlucky. And yes venue tracing seems more sensible once cases spike.
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They’ve been very lucky until now and that luck has been misinterpreted by many into buying into their deprecation of the need for precautions.
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Replying to @jwoodgett @DFisman
That’s exactly why I spent many paragraphs explaining how overdispersion fries our causal reasoning circuits. It’s too easy to conflate luck with immunity & moralize bad luck. But we can learn from sustained success. Constantly drawing from that negative binomial. Bound to hit.
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