Read on Twitter
Many college campuses are returning to in-person instruction soon. Most of us don't know what that means for COVID-19. Let's look back on relevant experiences. Perhaps a mumps outbreak on a campus in 2017?
A thread. 1/ https://twitter.com/nitanother/status/1293299230057136128?s=20
A thread. 1/ https://twitter.com/nitanother/status/1293299230057136128?s=20
Mumps is a directly transmitted virus, transmission occurs via respiratory droplets and saliva. Mumps immunization is required for students arriving on campus but some people who get the vaccine don't have a lasting immune response and may be susceptible anyway. 2/
(This was apparent during the 2014 and 2017 NHL mumps outbreaks. I've written about those elsewhere but this article and the interactive graphic at the bottom break it down extremely clearly - better than I ever have https://globalnews.ca/news/1731721/interactive-the-nhls-mumps-outbreak/ ) 3/
While mumps is very different from COVID-19 with a much higher R0, outbreak response for mumps involves contact tracing, and quarantine/isolation. Sound familiar?
Let's look at how contact tracing unfolded during the outbreak. A brief summary, NOT a peer-reviewed article. 4/
Let's look at how contact tracing unfolded during the outbreak. A brief summary, NOT a peer-reviewed article. 4/
Well... Contact tracing was challenging for several reasons for this. Recall that it was 2017 so tech and comms were similar to now - smartphones, texting, email, etc.
The major problems were
1) getting accurate, usable contact info from patients
2) getting ahold of people 5/
The major problems were
1) getting accurate, usable contact info from patients
2) getting ahold of people 5/
Why are these recurring problems with contact tracing?
1. Nobody likes a tattletale / snitches get stitches
2. People are busy
3. There's no real reward/punishment/enforcement (more on this later).
https://twitter.com/NYGovCuomo/status/1271075217801129985?s=20 6/
1. Nobody likes a tattletale / snitches get stitches
2. People are busy
3. There's no real reward/punishment/enforcement (more on this later).
https://twitter.com/NYGovCuomo/status/1271075217801129985?s=20 6/
For the *gulp* ~33% of all contacts who were reached, not everyone wanted to comply with quarantine protocols. Nobody can make them.
Reaching 33% of contacts is not going to stop any epidemic, even if all those contacts are compliant.
So what's the solution? 7/
Reaching 33% of contacts is not going to stop any epidemic, even if all those contacts are compliant.
So what's the solution? 7/
We learned that there are 2 important things to highlight to patients:
1. Contacts never know who named them (privacy policy)
2. There's no punishment for naming contacts, even at prohibited events (tho good cop/bad cop tactics have 100% ruined this for public health efforts) 8/
1. Contacts never know who named them (privacy policy)
2. There's no punishment for naming contacts, even at prohibited events (tho good cop/bad cop tactics have 100% ruined this for public health efforts) 8/
So what can we do to improve CT on campuses? This is where data specific to this outbreak end. But other public health research has shown us that incentivizing and rewarding cooperative behavior is WAY more effective than punishing non-compliance. 9/
Maybe an ethical implementation of incentives and rewards is worth exploring for CT if it can help students be safe and healthy. Even the janky gym around the corner has a rewards referral program. Can schools and contact tracers explore options for this? 10/
Whether it's responsible to return to campuses in the US this fall or not (it's mostly not), there might be unexplored possibilities to improve CT results.
We know what hasn't worked in the past, which is a valuable starting point for identifying what to change.
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We know what hasn't worked in the past, which is a valuable starting point for identifying what to change.
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