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Joseph Allen

@j_g_allen • 48,501 subscribers

Prof at Harvard; Exposure and Risk Science; Direct Harvard #HealthyBuildings Program; Coauthor of HEALTHY BUILDINGS w/ HBS Prof Macomber

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I joined Erin Burnett OutFront / Erin Burnett last night to discuss hantavirus and the cruise ship outbreak. Some thoughts: THE SITUATION ON THE SHIP IS SERIOUS My first thoughts were about the good doctor who was on-air right before me, and the rest of the people still on the ship. Hantavirus is serious with a long incubation period, several have died already, and this strain spreads human-human (not just rodents). The ship's doctor got sick, and this doc stepped up to treat people on the ship. He described protections he was taking (goggles, gown, hand-washing), but they were insufficient because there is evidence this virus spreads beyond "close contact", which means ventilation and filtration are important. THE RISK AND THREAT TO GENERAL PUBLIC IS LOW Despite the situation being serious on this ship, the system is working the way it should. Health officials are investigating and tracing, severely ill passengers are being treated, passengers who left the ship are notified and in quarantine. For the general public, the threat is low. THERE IS EVIDENCE OF HUMAN-HUMAN SPREAD AND TRANSMISSION BEYOND "CLOSE CONTACT" I've read a lot of people say this can only be spread via "close contact", but there is evidence that is not the case. The best information we have about hantavirus spreading human-human (Andes strain, same one as the cruise ship outbreak) comes from a meticulous study about a past outbreak that wasn't a cruise ship. I read the paper (and the supplement, which is where the good info always is...). There are many examples of transmission without "close contact": Patient 1 --> Patient 4 "did not have any physical contact and simply said “hello” to each other as they crossed paths" Patient 1 --> Patients 3 & 6 "seated at different tables and spatially separated by 1–2 m" Patient 2 --> Patient 11 "No direct or close contact between the two patients was reported." Patient 8 --> Patient 28 "Patient 8 shared a room with Patient 28 and her relative. Patient 28 and Patient 8 did were not in close contact." OTHER IMPORTANT DETAILS IN THAT PRIOR OUTBREAK -In that outbreak, one person infected 5 at a birthday party. One of those infected then infected his wife. He died, and his wife infected 10 more at her husband's funeral/wake. -They got the outbreak under control by strict isolation and quarantine, with people having to stay home for 40 days with no contact with others. CHALLENGES, AND WHAT I'M WATCHING -The long incubation period (several weeks) means it will take some time to know if others get sick, or if we have had any secondary transmission after the boat (29 people from the boat already returned home, but are still within the incubation period). -There is one report of a flight attendant hospitalized/ill, but it's not clear if they have hantavirus. Someone with hantavirus boarded a flight *but was removed from the plane before takeoff* because they were so sick. So, if transmission did happen, it happened in that one hour while the plane was on the ground.

I joined Erin Burnett OutFront / Erin Burnett last night to discuss hantavirus and the cruise ship outbreak. Some thoughts: THE SITUATION ON THE SHIP IS SERIOUS My first thoughts were about the good doctor who was on-air right before me, and the rest of the people still on the ship. Hantavirus is serious with a long incubation period, several have died already, and this strain spreads human-human (not just rodents). The ship's doctor got sick, and this doc stepped up to treat people on the ship. He described protections he was taking (goggles, gown, hand-washing), but they were insufficient because there is evidence this virus spreads beyond "close contact", which means ventilation and filtration are important. THE RISK AND THREAT TO GENERAL PUBLIC IS LOW Despite the situation being serious on this ship, the system is working the way it should. Health officials are investigating and tracing, severely ill passengers are being treated, passengers who left the ship are notified and in quarantine. For the general public, the threat is low. THERE IS EVIDENCE OF HUMAN-HUMAN SPREAD AND TRANSMISSION BEYOND "CLOSE CONTACT" I've read a lot of people say this can only be spread via "close contact", but there is evidence that is not the case. The best information we have about hantavirus spreading human-human (Andes strain, same one as the cruise ship outbreak) comes from a meticulous study about a past outbreak that wasn't a cruise ship. I read the paper (and the supplement, which is where the good info always is...). There are many examples of transmission without "close contact": Patient 1 --> Patient 4 "did not have any physical contact and simply said “hello” to each other as they crossed paths" Patient 1 --> Patients 3 & 6 "seated at different tables and spatially separated by 1–2 m" Patient 2 --> Patient 11 "No direct or close contact between the two patients was reported." Patient 8 --> Patient 28 "Patient 8 shared a room with Patient 28 and her relative. Patient 28 and Patient 8 did were not in close contact." OTHER IMPORTANT DETAILS IN THAT PRIOR OUTBREAK -In that outbreak, one person infected 5 at a birthday party. One of those infected then infected his wife. He died, and his wife infected 10 more at her husband's funeral/wake. -They got the outbreak under control by strict isolation and quarantine, with people having to stay home for 40 days with no contact with others. CHALLENGES, AND WHAT I'M WATCHING -The long incubation period (several weeks) means it will take some time to know if others get sick, or if we have had any secondary transmission after the boat (29 people from the boat already returned home, but are still within the incubation period). -There is one report of a flight attendant hospitalized/ill, but it's not clear if they have hantavirus. Someone with hantavirus boarded a flight but was removed from the plane before takeoff because they were so sick. So, if transmission did happen, it happened in that one hour while the plane was on the ground.

43,807 次观看 • 2 个月前

Erin asked my opinion about this new info, and I basically said it means we’re still trying to figure this puzzle out so we we should be a bit cautious with definitive statements about this virus. Look, if we don’t do a good job now with quarantining and making sure we don’t have cases that aren’t original ship passengers, we’ll be chasing cases here and there for weeks to months, and because of the long incubation period there will be a blanket of uncertainty over all of this.

Erin asked my opinion about this new info, and I basically said it means we’re still trying to figure this puzzle out so we we should be a bit cautious with definitive statements about this virus. Look, if we don’t do a good job now with quarantining and making sure we don’t have cases that aren’t original ship passengers, we’ll be chasing cases here and there for weeks to months, and because of the long incubation period there will be a blanket of uncertainty over all of this.

31,880 次观看 • 1 个月前

No one should be surprised more ship passengers tested positive - this was expected. The focus has been on how to prevent secondary transmission, and this is what I discussed last night on MS NOW This is why I've been harping on the 'prolonged close contact' being inconsistent with the literature and experience on the ship - if we get this wrong, those in quarantine take the wrong precautions (or we don't isolate them...), and spread continues. Ayman, Catherine Rampell, Antonia Hylton, Elise Jordan

No one should be surprised more ship passengers tested positive - this was expected. The focus has been on how to prevent secondary transmission, and this is what I discussed last night on MS NOW This is why I've been harping on the 'prolonged close contact' being inconsistent with the literature and experience on the ship - if we get this wrong, those in quarantine take the wrong precautions (or we don't isolate them...), and spread continues. Ayman, Catherine Rampell, Antonia Hylton, Elise Jordan

24,138 次观看 • 1 个月前

Great question from _ last night that *everyone* should be asking about schools: "So, Joe, if it's not that hard to do, not super expensive, better health outcomes and better schooling outcomes, what's up, why hasn't this money been spent?"

Great question from _ last night that everyone should be asking about schools: "So, Joe, if it's not that hard to do, not super expensive, better health outcomes and better schooling outcomes, what's up, why hasn't this money been spent?"

142,926 次观看 • 2 年前

Me, on the absurdity of our approach to indoor air quality standards v. outdoor air quality (you will be shocked by what I share, and you will agree it's absurd.) Thanks to Eric Topol for having me on. Full links to our 60-minute interview in his bio.

Me, on the absurdity of our approach to indoor air quality standards v. outdoor air quality (you will be shocked by what I share, and you will agree it's absurd.) Thanks to Eric Topol for having me on. Full links to our 60-minute interview in his bio.

23,527 次观看 • 1 年前

"I'm sick of chasing sick buildings." Have a quick listen to this one part of my TEDx talk where I list the types of calls I get *every single day* (and why, for the first time in my career, I'm optimistic about the beginning of the end of the sick building era.)

"I'm sick of chasing sick buildings." Have a quick listen to this one part of my TEDx talk where I list the types of calls I get every single day (and why, for the first time in my career, I'm optimistic about the beginning of the end of the sick building era.)

11,823 次观看 • 1 年前

While we're talking about numbers...great progress in lowering the outdoor air pollution limit for PM2.5 from 12 ug/m3 to 9 ug/m3. Do you know what the legally enforceable limit is for *indoor* particles? Have a listen.

While we're talking about numbers...great progress in lowering the outdoor air pollution limit for PM2.5 from 12 ug/m3 to 9 ug/m3. Do you know what the legally enforceable limit is for indoor particles? Have a listen.

11,138 次观看 • 2 年前

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