Note: This thread is related to #Coronavirus #COVID19

Follow the World Health Organization's instructions to reduce your risk of infection:

1/ Frequently clean hands by using alcohol-based hand rub or soap and water.

2/ When coughing and sneezing cover mouth and nose with flexed elbow or tissue - throw issue away immediately and wash hands.

3/ Avoid close contact with anyone that has fever and cough.

Caitlin Rivers, PhD+ Your Authors @cmyeaton Outbreak science + epidemiology + health security. Assistant professor at Johns Hopkins Center for Health Security (@JHSPH_CHS). ELBI alum. Mar. 01, 2020 1 min read + Your Authors

We learned last night from @trvrb that COVID-19 may have been circulating in the Seattle area for several weeks. This thread details some possible implications if that finding is confirmed. 1/

If that scenario is occurring in Seattle, it could be true elsewhere in the US. With narrow testing criteria and limited diagnostic capacity (both now improved), we may have missed sparks. 2/

We need to move directly to understand the burden of community transmission in the US. We should do that by testing hospitalized patients with ARDS or pneumonia of unknown etiology. 3/

This is now possible with the recent expansion of diagnostic capabilities to state and local public health labs. This effort is underway but it should be expedited. 4/

This data is needed to inform hospital preparedness. If there is a large burden of COVID-19 in the US, we should move quickly to implement the recommendations of my colleagues @JHSPH_CHS, outlined here:  http://www.centerforhealthsecurity.org/cbn/2020/cbnreport-02272020.html  4/

On the one hand, if it has been circulating here for weeks without being noticed, it could mean that severity is lower than feared, which I hope to be true. It would be important to know that soon. 5/

On the other hand, the doubling time of the epidemic in Wuhan was originally around a week, so it takes time for case counts to build and severe cases to be detected. 6/

We must learn from the experience of China, South Korea, Iran, Italy that this outbreak can be impactful, so we should accelerate surveillance and preparedness work. 7/7


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