A wedding in rural Maine led to the state's largest #covid19 outbreak. The screening for the party was symptom and temperature checks. The presumed index case showed symptoms the day after the ceremony. Remember- spread is also *presymptomatic* https://www.bostonglobe.com/2020/08/29/nation/how-an-intimate-wedding-rural-maine-led-states-largest-covid-outbreak-disaster-that-spread-hundreds-miles/?event=event12

2/ In all, half of the attendees became ill. An elderly couple were infected by a wedding guest-- the wife unfortunately passed away.

A jail 220 miles away had an outbreak from one of the wedding attendees.

This article tells the story of one outbreak...

3/ But it really tells the story of how outbreaks happen.

They happen when you least expect it-- when you think you've taken enough precaution; they spread quickly, and affect people far and near.

The best we can do is follow the basics consistently.

4/ This wedding outbreak happened from a crowded, indoor party.

Avoid indoor socializing whenever possible.

Avoid extended close face to face contact for prolonged periods of time (multiple minutes).

Avoid crowding.

Wear masks.

Stick to these basics consistently.

5/ This is also another example where rapid antigen testing could have helped, because in theory it should be able to detect highly infectious cases & could have prevented an infectious index case from ever entering the wedding. https://www.washingtonpost.com/outlook/2020/08/17/rapid-coronavirus-testing-pcr/

6/ This outbreak happened in rural Maine, where community transmission was low.

But low transmission is not the same as no transmission, & most places will likely not reach *no* transmission.

What this means is that outbreaks like this can theoretically happen anywhere.

7/ The lower community transmission that is achieved, the lower the probability of an outbreak like this happening.

It could still happen, but the more we test; the faster we trace/isolate, the more controlled future outbreaks will be, which is the key.

7/ sharing additional outbreak here — even with controlled community transmission,
-close contact
-closed spaces
-crowds
can lead to a major spreading event https://twitter.com/AbraarKaran/status/1300425821170151431