NATALIE E. DEAN
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Twitter Threads

July 2, 2020 - Comparing April and June Numbers

THINK LIKE AN EPIDEMIOLOGIST: There are more new confirmed cases each day in the US than at any time during the earlier April peak. But is it really meaningful to compare those numbers? How do epidemiologists decide when to sound the alarm? A thread. 1/11 pic.twitter.com/rPelzIvcxs

— Natalie E. Dean, PhD (@nataliexdean) July 3, 2020

June 23, 2020 - Median Age of Cases is Dropping

THINK LIKE AN EPIDEMIOLOGIST:

What does it mean that the median age of new cases is dropping in some areas? I see three possible explanations, not all good. A thread on how to distinguish between them. 1/10

(Figure h/t @ScottGottliebMD) pic.twitter.com/Y6m45qoBL6

— Natalie E. Dean, PhD (@nataliexdean) June 23, 2020

May 24, 2020 - Vaccines for SARS, MERS, and HIV

Why don't we have a vaccine for SARS? MERS? HIV? These viruses have been around longer than SARS-CoV-2. A mini-thread to provide some perspective and even a little dose of optimism. We are not in the same situation here. 1/7

— Natalie E. Dean, PhD (@nataliexdean) May 25, 2020

May 21, 2020 - Heterogeneity and super-spreading events

This preprint on SARS-CoV-2 transmission dynamics was a great read. The discussion about heterogeneity often focuses on numbers of contacts, but that always felt incomplete to me. As much as possible, we must link the models to the biology. (Thread 1/7)https://t.co/ptE6KCbrC2 pic.twitter.com/76pznbAl7w

— Natalie E. Dean, PhD (@nataliexdean) May 22, 2020

May 19, 2020 - ProPublica article on contact tracing

We are all going to need to learn a lot more about contact tracing. How is it done? How can we make it more successful? This article by @CarolineYLChen provides a great overview. Highlighting a few key parts. 1/7https://t.co/r73a4xxKTu

— Natalie E. Dean, PhD (@nataliexdean) May 19, 2020

May 11, 2020 - Scientific innovations in prophylaxis and treatment

Science is our exit strategy. Driving case numbers low buys us important time to develop, test, and deploy vaccines, but there are many other important reasons to slow transmission.

A thread on what each day buys us. 1/8https://t.co/SVytaVkegN

— Natalie E. Dean, PhD (@nataliexdean) May 11, 2020

May 9, 2020 - Uncertainty in the herd immunity threshold

Seeing papers make the rounds that the herd immunity threshold may be much lower than the rough approximation 1-1/R0. Maybe, but let's slow down a minute.

#1. There is still way too much uncertainty.
#2. This does not qualitatively change our strategy.

My comments. 1/

— Natalie E. Dean, PhD (@nataliexdean) May 9, 2020

May 4, 2020 - Lessons from Kerala, India

Kerala, India, is implementing “test, trace, isolate, support,” and it is paying off so far. They are working hard to keep case numbers low. What can we learn from them? A short thread. 1/5 https://t.co/izNFhJJB5o

— Natalie E. Dean, PhD (@nataliexdean) May 5, 2020

May 3, 2020 - Learning from experienced countries

In comparing outbreaks across countries, I think there is a lot of luck involved in the timing (it’s when, not if). But places that have faced outbreaks in the past have a collective memory and can respond quickly. Highlighting a few examples. 1/7https://t.co/HawqDHbUzw

— Natalie E. Dean, PhD (@nataliexdean) May 3, 2020

April 23, 2020 - Positive predictive value tutorial

1/7 Lots of folks trying to understand sensitivity and specificity. Maybe the most important concept to understand right now is that of POSITIVE PREDICTIVE VALUE.

Given a test result is positive, what are the chances you were actually infected?

Biostats 101 primer on the topic.

— Natalie E. Dean, PhD (@nataliexdean) April 23, 2020

April 19, 2020 - Serosurvey design considerations

1. It's easier to poke holes in a study than to run a study yourself. We should expect many more SARS-CoV-2 serosurveys in our future. So in the spirit of promoting good science, here are my thoughts on best practices for the design of serosurveys. pic.twitter.com/eIxAiaE24V

— Natalie E. Dean, PhD (@nataliexdean) April 19, 2020

April 17, 2020 - Review of Santa Clara serosurvey preprint

A rapid, unsolicited peer review on emerging serosurvey data from Santa Clara County, and why I remain skeptical of claims that we are identifying only 1 out of every 50 to 85 confirmed cases.

1/10https://t.co/fk45sn1NHl

— Natalie E. Dean, PhD (@nataliexdean) April 18, 2020

April 10, 2020 - Clinical trials during a pandemic

Hey friends! ?? I wrote my first newspaper article.

In this perspective piece, I talk about the importance of randomized clinical trials even in the most challenging settings (like pandemics!). And I outline smart ways to accelerate this process.

1/https://t.co/C4iBfYKq4r

— Natalie E. Dean, PhD (@nataliexdean) April 10, 2020

April 6, 2020 - Scientists and clinicians hard at work

1/ There's no shortage of discouraging news out there right now. So I wanted to share a different angle. I am really proud to be part of an amazing community of scientists and clinicians.

A short thread on a few of my favorite things, in case you missed them.

— Natalie E. Dean, PhD (@nataliexdean) April 7, 2020

March 29, 2020 - Harvard Business Review article on Italy

It amazes me that anyone can see the situation in Italy, see their own case numbers follow a similar trajectory, and think that watchful waiting is an appropriate course of action. We must learn from our neighbors.

A thread on this insightful HBR review.https://t.co/XilRJitZkK

— Natalie E. Dean, PhD (@nataliexdean) March 29, 2020

March 21, 2020 - Intepreting percent hospitalized or died

What does it mean that 20% of hospitalizations are in patients 20-44 years?

An EPI 101 tutorial on how to interpret this widely circulated figure. pic.twitter.com/VtV5je4Kj2

— Natalie E. Dean, PhD (@nataliexdean) March 21, 2020

March 17, 2020 - Creative strategies from South Korea

For big, difficult problems, we need big, creative solutions.

A few highlights from this great read on South Korea’s #coronavirus strategy. A useful template for other countries.

1/8https://t.co/Ru6fPYSmjJ

— Natalie E. Dean, PhD (@nataliexdean) March 18, 2020

March 13, 2020 - Sensitivity and specificity tutorial

EPI 101 thread on sensitivity and specificity, plus its application to #COVID19 screening. For those who want a refresher!

The way we summarize the accuracy of a test (such as RT-PCR on a #coronavirus throat swab) is with two quantities: sensitivity and specificity. 1/12

— Natalie E. Dean, PhD (@nataliexdean) March 13, 2020

February 16, 2020 - Treatments for MERS and SARS

As dozens of clinical trials are underway for #COVIDー19, a natural question is... why don’t we already have licensed treatments for other severe types of #coronavirus like #MERS and #SARS?

A thread.https://t.co/YQz4Tnid6P

— Natalie E. Dean, PhD (@nataliexdean) February 16, 2020

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