outbreak! (ebola, sars, coronavirus, etc)

I’m also pretty sure false negatives far outweigh false positives

my workplace, having the right equipment, had a volunteer-staffed temporary pcr covid test lab during the early pandemic and they didn’t do a binary pos/neg result, but had an inconclusive/retest result as well. not so many of them, but probably the right methodology

oops, I meant false negatives, not false positives.

I actually got an "inconclusive" result on one of my PCRs a few months ago, but it turned out to be a proper negative when I retested twice over the two days following thankfully

asking for a friend (no really, I haven't had it as far as I know). First tested positive on a rapid test 8 days ago, still showing a line on tests. Is she contagious?

In the UK she is legally allowed to go about her normal life after 5 days, but she's trying to figure out whether she should wait until the line disappears or if that's meaningless at this point.

Any insights welcome

Iirc there is a difference between infected and infectious, but solely based on my own experience I’d tell her to go easy just because I ended up very tired after because my case was mild and I didn’t really rest enough. So tl;dr she’s probably not infectious but I’d tell her to give it another couple of days and take it easy.

Our pediatrician told us you can test positive for weeks after you're actually contagious.

Yep. A good friend in January didn't get a negative PCR until three weeks after her first test, though she'd seen her doctor in the interim, who also made the distinction between infectious and infected, i.e. she was no longer contagious after about a week, give or take.

First, make sure you understand which kind of test you are taking. A PCR test is very accurate at the start of an infection because it can detect and amplify even trace amounts of virus DNA. But a PCR is not the right choice to figure out when you are no longer infectious, because of its sensitivity, Grad explains.

"There are some people who have little blips of being PCR positive for weeks, or in some cases even months, after an infection" – even though they're no longer contagious, Grad says.

A better bet is to use a rapid antigen test, because they're "positive when your viral load is high," corresponding to levels when people are likely to be infectious, says Landon. So if you're negative on a rapid test and you don't have any symptoms, consider yourself in the clear, says Chin-Hong.

What if 10 days have passed and you're still testing positive on a rapid test? "That definitely happens, and we don't have a good answer" as to why, says Landon. One thing to look at is how faint the positive line is on the rapid test, she says, because research has shown that the darker or more intense the line is and the more quickly it shows up, the more virus is present in your nose. So if you're past day 10, you feel better and you're not immunocompromised, and the rapid test line "isn't very dark or it's taking longer to turn positive each day, you're probably safe to be out in the world," she says.

https://www.npr.org/sections/health-shots/2022/02/17/1081510375/isolation-testing-omicron-infection

I’d concur with that: I spoke to a UCLH virologist when I was ill, and he said the Omicrons normally tail off after day 5 with negative LFTs a few days after that. I was testing negative on the 8th day.

thanks all, yes she isn't going to push herself but is trying to work out if a visit from her parents can go ahead-- they aren't especially vulnerable but are super nervous about getting it, so were considering cancelling a long-planned visit. It sounds like they should probably be OK, they're already on day 9 I think and the visit is later this week.

And here we are

https://www.theatlantic.com/health/archive/2022/06/pandemic-protections/661378/

And in early 2021, the sociologist Elizabeth Wrigley-Field and a small group of volunteers

also such a noted Cubs fan that they married in just to make it clear!

seriously, thanks for the link Ned!

I went to summer camp with Elizabeth!

I wonder why/how I haven't gotten it yet? I should say why/how/whether, I guess, there's no way to know for sure, really, but at no point have I had characteristic symptoms.

I guess I am in a weird state where I feel like I'm not trying very hard not to get it -- I'm traveling a lot, I'm seeing people, I'm in lots of crowded rooms. But then again, I wear an N95 on the plane and when I go in a store, which I feel like almost no one else is, and I certainly eat outside when it's convenient, which it usually is this time of year. So... I'm not trying very hard not to get COVID, but maybe I'm nonetheless trying harder than the median person? I guess by "not trying hard" I mean "I'm not taking any actions that would be annoying or difficult for me."

So... I'm not trying very hard not to get COVID, but maybe I'm nonetheless trying harder than the median person?

Ha, this.

I mask when teaching at the store, library, basically any public interior space...yet I've eaten inside restaurants and hung out in trusted homes.

I had an exposure recently where the person I hung out with indoors, unmasked tested positive the next day, and 5 days after, 10 tests (combo of PCR and antigen), all negative, no symptoms. this was after an exposure to Omicron earlier in the year 2 days before someone tested positive, same thing.

the most recent incident, nobody else has tested positive yet, so it could have been "she wasn't very contagious", but I've survived about 5 direct exposures in a 1.5 year period now. as has my brother's girlfriend.

there’s also the possibility you’ve had a very tiny infection where your immune system cleared an unnoticeable amount of virus

I've considered that too.

xpost that's definitely possible.

in either case I'm glad my more comfortable N95s arrived cos the ones I had previously left a semi-permanent indentation on my nose

Latest nyc 7-day average is about 12%

Quantity of testing is down, which lends distortion but this is the highest % in months

FL's plateau has lasted almost a month. Theory is BA.5 is pushing out BA.2 and thus prolonging the wave.

Wonder if that is the case in NYC.

Exhausting

Yeah, I don't see our national averages dropping until well into August before school starts. Everyone's traveling, and I can't blame them.

leeeeeroy jenkins

LACC and Fire Marshall is no longer letting anyone in #AX #AnimeExpo pic.twitter.com/3sLP6z3Jb6

— Anime News Network (@Anime) July 1, 2022

The vaccines in trial against all coronaviruses are exciting (if they work) - gimme that never have another cold shot right in the arm.

Cases at my hospital dropped to around 15, back up to 24, and thus weekend definitely won’t help.

xpost yeah really hoping Moderna and Pfizers excitement about their bivalent pills aren't a lot of smoke. they are really needed. i don't care how many times I have to get stabbed

https://www.youtube.com/watch?v=m2ou-WIxfLY

Just home-tested again after flying 2x and being in a few shops & restaurants in a rural area where no one was masking at all. Back in NYC now and still negative! Riding the wave (of never having had covid).

A compendium of anecdotes:

My older daughter caught covid the last week of school in May, presumably at prom. She missed her last three days of high school ever and, despite minimal symptoms for a day or so, kept testing positive for well over a week.

That makes my wife the last of us to have never tested positive for covid. But - and this is a big but - she started seriously losing her hair in January, which would have been right after her booster. Could that have sparked an autoimmune response resulting in her alopecia? She wouldn't be the first one, anecdotally; apparently serious hair loss is a relatively common side effect of covid, though dunno about the vaccine.

Somehow virtually none of our close family friends have caught covid, but the dad in one of the more cautious families finally caught a (mild) case. And the son in a family of five good friends just caught it, the first of his family to ever test positive (despite a mom that travels a ton for work); they had to cancel a trip that, ironically/sadly, was meant to be a family reunion remembering the passing of a couple people that died during (but not of) covid. Most dramatically I learned a friend of mine who finally caught covid in May ended up having something of an anxiety-induced breakdown and can no longer even drive, let alone fly. He's been on disability leave from a big tech company here because even working 4 day weeks his productivity had apparently dropped down to 60%. He can barely leave the house.

We just got back from a trip to Los Angeles, where we met up with the Aussie side of the family, for whom this was the first trip since covid hit (none of us got or are sick, so far). All four of them caught covid for the first time back in the spring, as did my sister and her family in England. It finally seems to be catching up with folks that avoided it for years. And yet the one person I know that has perpetually been most at risk, given his job is closely tied to both concerts and restaurants, has never tested positive, even when his entire family tested positive. Compare that to my kid's new piano teacher, a family of six that all had it at once. No rhyme or reason.

My parents caught it two weeks ago; Dad most likely brought it home from work. Mom suffered severe sore throat, runny nose, hacking cough, but no fever. Dad, not feeling well on Father's Day weekend, only realized he had it five days after symptom onset; that's how mild his symptoms were (both are jabbed and boosted). He tested PCR-negative last Wednesday, Mom yesterday. That's the closest it's come to me.

Can't recall if I mentioned that another person we know, their daughter tested positive the day after running a marathon. Which means she literally ran a marathon with covid.

Covid (@UCSF) Chronicles, Day 838
The die is now cast: BA.5 is destined to be our dominant virus.
In today’s 🧵I discuss the implications on the course of the pandemic, and how to think about responding.
(I use “BA.5” & not “BA.4/5” since BA.5 is poised to outrun BA.4.). (1/25)

— Bob Wachter (@Bob_Wachter) July 4, 2022

Great thread, I always love Wachter. My only quibble (and it's not just him saying this) is this part:

But since we’re missing ~80% of cases due to home tests, today’s true case-rate isn't far from Jan’s.(6/25)

Because that pre-supposes that we weren't undercounting in January, when all tests (home or lab) were difficult to obtain. But that is just a minor gripe.

The lengthy plateau he mentioned is what has me worried - we're in the midst of a month long plateau at very high levels in FL. There's been little respite. We had maybe a month of low cases after BA.1 before things started to rise again.

People keep saying "the pandemic will end, they all do", but if new scarier variants occur that cause mass reinfection, I don't see how it ends, other than "just giving up", which seems our current M.O. Endemicity seems so far away still.

Another good hot off the presses article:

Finally out after peer-review @NatureMedicine:
Emergence of SARS-CoV-2 Omicron lineages BA.4 and BA.5 in South Africa. In this publication, we describe the origins, evolution and impact of BA.4 & BA.5, which emerged in SA and now dominate most of the global COVID infections. 1/x

— Tulio de Oliveira (@Tuliodna) June 27, 2022

Wachter clearly knows what he's talking about, but honestly I've had trouble with him ever since he seriously overreacted over his (vaxxed, mild symptoms, 28-year old) son not answering the phone and essentially freaked out. Then again, anyone fully immersed in the shifting dangers of this disease is probably prone to freaking out now and then, as we've all discovered.

I’m going to start masking at my basically outdoor bar job— getting paranoid about getting it again.

At least two of my friends have had their second Cron :(

Stay safe tabes.

I ordered new N95s that fit comfortably over my big-assed nose

Well, these latest tidbits at least make me feel less like a crazy forest hermit… I reckon I’ve been applying just about the right level of restraint/caution.

But lord do I hate this

Congrats humanity on making sure this is an endemic pandemic. Reports about B4/B5 feel pretty bleak.

It also feels like the fear mongering over the last week is increasingly difficult to separate from the reasonable warnings and data sharing. Saw a couple threads just yesterday getting shared widely on Twitter that start out as wise and apt data sharing and warnings, but quickly devolve into essentially saying masks should be worn at all times, even outside and that outdoor transmission is possible even if you pass by someone with 4/5. I've also seen a lot of unverified doctor's tweets getting widely shared with anecdotal data that these variants appear to be leading to much more severe hospitalization among even vaxxed and boosted younger folks. It's all just seems even harder to sort the signal from the noise lately.

Don't get me wrong, numbers are trending in a bad direction and I think it's important to alert and warn to see if we can shift any behavior now that mask wearing has been abandoned by so many, but I wonder at what point the hysteria starts to do more harm than good.

If "essentially saying masks should be worn at all times, even outside and that outdoor transmission is possible even if you pass by someone with 4/5" is an accurate depiction of events, would you still classify it as "hysteria"? I'm not being disingenuous, I can't fully unpack every tweet either, but I'm still wearing N95s into places and on transit, and it seems like a good and easy thing I can do when the covid+ rate is supposedly 25% in NYC (one figure I've seen).

Oh I am still wearing a N95 on transit, in buildings and if I (rarely) happen to be in a large crowd outside, but these tweets are suggesting that we should be masked everywhere outside, which does seem to me over the top based on what we've learned over the last two years.

Maybe I shouldn't have focused on that specific item, there's just an over the top tone to a lot of threads that scan as fear mongering. Can't find it quickly now, but saw one that said "if you leave your house without a mask on, you will be killing someone with your choice". Which, maybe? But that feels... extreme and not helpful.

Liiiiiike...telling people what their assessed risks are and what they can do to protect themselves and others, when you just acknowledged that numbers are trending and infection counts are rising, and more people are getting more seriously ill...obviously no one is HAPPY about this reality! But just reporting on it isn't fearmongering.

But I'm talking about the threads that start out as reporting, but devolve into unsourced speculation - the latter is my concern, not the former.

I 100% agree that we should be ringing alarm bells right now.

I guess the “everywhere outside” thought is driven by epidemiologists saying this is by some distance the most contagious variant yet.

So the risk level of specific behaviors may no longer be at the baseline to which we have been accustomed.

I’ve added “when close to other people outdoors” to my times-to-mask. Maybe overcautious, we’ll see.

Xposts sorry

I follow a lot of disabled & chronically ill ppl on my media and yes, the messaging from some people in that area is more intense, because their lives are pretty intense already and it sounds like they're living in a different reality than people who don't identify as "high-risk" or compromised or w/e. I don't always know how to receive that message because practically speaking most people seem to be at 0% working empathy reserves and Idk what can be done about that.

xxxpost I'm always skeptical of "oh shit, it can be transmitted even with fleeting contact" reports because they said this during Delta and this was all based on one anecdotal story of someone who passed an infected person in an airport and there was zero attempt to actually ascertain whether this person had possibly been around other infected people that day or other days. eventually this anecdote DID get called into question in a few studies but naturally it didn't circulate as well as the original story. and also, the 'fleeting contact' depends on what happened during that contact. if someone coughed on or near you, maskless, it really doesn't matter at all how long you were in their presence.

as far as I can tell, there's nothing to suggest that outdoor transmission for BA.4 and BA.5 is more likely other than the fact that it's just inherently the most transmissible of all of the variants. i wouldn't begrudge anybody for masking outdoors, but I have seen no reputed source actually suggest it's necessary. and there are a LOT of amateur cranks on Twitter who have spread a lot of misinformation.

and I'm hardly a "COVID minimizer" in saying that, though Twitter would say otherwise. these are the same people who were screaming OMG EBOLA IS AIRBORNE during the Ebola epidemic of 2014 even though, no, it was not airborne. a lot of the people circulating rumors aren't even experts in their field, but it gets picked up as they're a blue check for another reason. so I am sympathetic to what jon says - fearmongering and unsourced information don't help anybody.

this isn't me saying 'these things are false', but people jump from "suspicion" to "100% confirmed truth" very fast.

the empathy reserves thing is very true. the "OMG WHAT WOULD YOU HAVE US DO, LOCKDOWN FOREVER" reactionary crew seems to jump on any Tweet that suggests BA.4 and BA.5 might be a bad thing. it's all strawman, strawman, strawman with them. wondering how bad it will get here. South Africa didn't have much of a BA.2 wave.

impossible to tell this week because the 4th of July fucked up reporting royally.

I have a chronic autoimmune condition (crohns) and tbh I’ve never found a solid accounting of how that elevates my risk level or not. My wife has hypothyroid and diabetes and those definitely elevate risk.

I would give anything to be doing the things I was doing last July tbh… anything other than getting covid and drawing the short straw re severity lol

my partner has crohns and i believe the elevation of risk is mainly dependent on the medication you take and whether it is an immunosuppressant or not (or at least this is what her specialist told her). she finally caught Covid a few weeks ago and had it realtvely mildly - mainly some weird pains.

jvc & Neando - maybe our media feeds are just different. I haven't noticed a preponderance of the kind of tone I think you're describing. I definitely see perspectives on things that I don't know what do to about, but the fault in that is not on the person who's just explaining what's happening. I am troubled by the BA 4/5 stats and I'm heading back into NYC today for a large outdoor event tomorrow. Sigh.