ranudhillon.bsky.social
Global health physician at Harvard working on epidemics & primary health systems
Led nat'l & local programs in 10+ countries including India, Nigeria & Rwanda
Fmr Special Advisor to President of Guinea on Ebola '14-16 & helped lead its national response
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We tried to propose a strategy for how to do this in the early going without luck & also overlooked indoor air cleaning which we’ve come to see as the most efficient solution both for Covid & countering future pandemics (which most likely would also be airborne)
hbr.org/2020/05/a-pl...
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Dithering on airborne spread without planning ways to reopen more safely (& later overselling vaccines as more definitive than they were) were central failings
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Lockdowns should’ve been very brief up front to clarify with laser-focus & urgency the mode of transmission & then institute measures to reopen as safely as possible
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I worry that the study will be politically influenced or outright doctored/falsified to show false results & associations with even bigger/broader ramifications for vaccines
bsky.app/profile/ranu...
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I only listed a few studies that include 100s of 1000s of children in my story. Here are more from the Autism Science Foundation:
autismsciencefoundation.org/autism-and-v...
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The tragedy is that, even w/inadequate efforts before this administration, we could still get ahead of H5N1
We recently outlined what a coherent strategy could be (& would now add poultry too) rdcu.be/ea153
None of this of course matters much if political will is opposing & institutions are gutted
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Thank you for clarifying and sending this along
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There is expertise & experience in doing this
These campaigns have been successful even in places with active war, no roads etc.
(Joe Rhatigan & I studied this for the Global Health Delivery Project)
(3/3)
www.globalhealthdelivery.org/case-collect...
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Measles has been reduced globally by mass vaccination campaigns premised on engaging communities on the safety & importance of the vaccine & then vaccinating thousands of kids within a matter of days
This is what we need to do in affected & vulnerable US communities now
(2/3)
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Samples have been sent further afield for testing.
For now WHO only reports "Metagenomic sequencing and additional investigations are ongoing to determine the cause of
illness and deaths in the two health zones".
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so both receptor binding changes and polymerase changes would be needed to go pandemic (as well as ph stability to allow efficient airborne transmissibility). The cattle viruses already have polymerase changes that are equivalent to E627K though.
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This is an interesting tidbit because it shows that these types of mutations already exist out in "the wild".
Does the fact that we found Q226L in a mouse on a farm back in June of this year change the threat picture of H5N1?
No, it does not, but we're playing a numbers game.
I would rather not.
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These are a few pragmatic steps we should take now
If we continue with the status quo, there’s a chance H5N1 never becomes a bigger threat but, with flu season forthcoming, also a possibility for it to abruptly adapt & immediately launch a global crisis
(10/10)
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(6) Regularly screen those at-risk for H5N1 infection
Until we have a better grip on spread, we should also screen at least a subset of people testing + for flu A to discern the presence/frequency of hidden infections
All H5N1+ cases should be sequenced
(9/10)
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(5) Track viral circulation & evolution by testing wastewater and sequencing whenever H5N1 is found to gauge for the evolution & accumulation of risky mutations
thelancet.com/journals/lan...
(8/10)
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Colorado has shown how this can be done with mandatory serial testing
We should do the same nationally or pursue other assured ways to pinpoint H5N1
We’ve proposed local wastewater sequencing as a workaround, though that would be more onerous
statnews.com/2024/09/27/h...
(7/10)
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(4) Stamp out viral circulation in dairy cows
Stopping circulation & spillovers from wild birds is tricky but cows may be a bigger risk for viral evolution given that they're mammals kept in large numbers with close, frequent contact with people
science.org/doi/10.1126/...
(6/10)