Ranu Dhillon

A Plan to Safely Reopen the U.S. Despite Inadequate Testing The big dilemma in the U.S. is how to reopen the economy when the amount of available testing for Covid-19 is likely to remain inadequate for months. If the lockdown and other social-distancing restri...

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...

Dithering on airborne spread without planning ways to reopen more safely (& later overselling vaccines as more definitive than they were) were central failings

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

In work led by Ben Pinksy, Grant Higerd-Rusli, Matthew Hernandez & @abraarkaran.bsky.social, in @thelancet.bsky.social, we describe the importance of testing a broader range of people for #H5N1 bird flu in order to check for potentially hidden spread & new routes of transmission

t.co/yZeHRcUV65

Four ways COVID changed virology: lessons from the most sequenced virus of all time After 150,000 articles and 17 million genome sequences, what has science taught us about SARS-CoV-2?

After 5 years, 150k papers and 17 million genomes, here's what we learned about SARS-CoV-2 and viruses in general.

It holds lessons for future pandemics - only if we listen. "We’re in a worse place in terms of pandemic prevention" @eddieholmes.bsky.social told me.

www.nature.com/articles/d41...

The Diseases Are Coming Elon Musk’s slash-and-burn government tear will have lasting effects on global health.

"I know how lethal Donald Trump’s assault on America’s outbreak preparedness could be. We are sure to regret it," warns @craigspencer.bsky.social @theatlantic.com www.theatlantic.com/ideas/archiv...

Texas cities run short of MMR vaccine as measles outbreak drives demand Pharmacies are struggling with supplies as fatal outbreak expands and health secretary sows disinformation

NEW: As measles cases rise in Texas, pharmacies in some cities are running out of MMR vaccines. The surge in demand comes even as RFK Jr. and the CDC frame vaccination as a "personal" choice — my latest: www.theguardian.com/us-news/2025...

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...

These unanticipated, abrupt & cruel funding cuts will cost lives

Ebola outbreaks demand diligent & meticulous tracking of transmission chains

Even small lapses can allow spread to escalate dramatically & become hidden in ways that can take months to regain a grip on

As Ebola Spreads in Uganda, Trump Aid Freeze Hinders Effort to Contain It, U.S. Officials Fear (Gift Article) Two more people are reported dead from the disease, and dozens are in isolation, as the outbreak grows.

A leaked recording shows that American officials fear the spread of Ebola in Uganda and beyond, because of the Trump cuts in foreign aid

www.nytimes.com/2025/03/06/h...

Exactly - this study would be needless, wasteful & ridiculous, but, even more so, treacherous

Given how this admin operates, there is a real risk it will pressure, doctor or falsify results to imply risks & links that are not real & then use that to undermine safe & proven vaccines

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...

I recently read accounts of the plague & it was jarring just how much it shaped & redefined social order/life in that era

Covid had a fraction of that impact but it’s fallout still fuels much of what happens now

A more severe pandemic is something we need to be doing more to prevent

What to Know About Measles and Vaccines | Johns Hopkins Bloomberg School of Public Health Experts worry that misinformation and falling vaccination rates could cause measles outbreaks to become more common in the U.S.

In a measles outbreak, children as young as 6 months can be vaccinated early and then vaccinated again per the regular schedule. This is an extra vaccine and does not count towards the two they should have.
publichealth.jhu.edu/2025/what-to...

Dr. @gavinyamey.bsky.social & I highlight the serious risks of the U.S. withdrawing from the WHO,both for American & global health security. When the WHO is supported, the world benefits. In the face of rising infectious & chronic disease threats, we need solidarity, not isolation.
#GlobalSolidarity

Steps to prevent and respond to an H5N1 epidemic in the USA Nature Medicine - Steps should be taken now to prevent an epidemic of H5N1 in humans and prepare for an outbreak should it occur.

In Nature Medicine, we highlight 8 steps to prevent H5N1 🦅 🐄 🐓 (bird flu) from becoming a pandemic.

Free access at rdcu.be/ea153

w/ @ranudhillon.bsky.social @abraarkaran.bsky.social Robert Garry

Clade 2.3.4.4b H5N1 neuraminidase has a long stalk, which is in contrast to most highly pathogenic H5N1 viruses circulating between 2002 and 2020 | mBio While the truncated version of the N1 neuraminidase stalk domain may be associated with increased virulence in poultry, the long version of the stalk domain has been associated with increased transmis...

Cool paper from Florian Kramer & colleagues about a novel feature of circulating H5N1 clade 2.3.4.4. These viruses have a longer stalk in their neuraminidase (NA) enzyme, a key viral protein. This was not seen in past H5N1 strains (2002-2019)
Why does it matter?🧪
journals.asm.org/doi/10.1128/...

Map is not up to date, RI, NY, WA not updated

Measles in US in 2025

164 cases

Alaska, California, Georgia, Kentucky, New Jersey, New Mexico, New York City, Rhode Island, Texas

Most children, some too young to be vaccinated
82% under age 20

Vaccination Status
Unvaccinated or Unknown: 95%
1 MMR: 3%
2 MMR: 2%
www.cdc.gov/measles/data...

🧵

A screenshot of text that reads in part: "Our current assessment of the situation is that what we have is a fairly limited in time and very limited in geography cluster of unusual deaths. It has been proven negative for hemorrhagic fevers. Other samples have been taken, a systematic investigation, looking at all the suspect, even the extremely suspect suspect cases, has been done. And there clearly is, based on onset of symptomatology to death, it looks and appears very much more like a toxic type of event, either from a biologic perspective, like a meningitis or from a chemical exposure. And there have been– there is some indication now from the authorities that there’s a very strong level of suspicion of a poisoning event related to the poisoning of a water source, in relation to that specific village. So that’s under investigation by the appropriate authorities in country. We will continue to investigate. Clearly, and it’s something that, our press officer here at ECA mentioned to me many times, that we are very concerned about these events until we prove that there’s a mixed epidemiology and that many people are dying of malaria and other diseases."

In case you missed it, from Dr Mike Ryan at today's WHO press conference on those unexplained deaths in DRC

"very limited in geography"

"strong level of suspicion of a poisoning event related to the poisoning of a water source"

tinalexander.github.io/notes/2025/0...

Frequency, kinetics and determinants of viable SARS-CoV-2 in bioaerosols from ambulatory COVID-19 patients infected with the Beta, Delta or Omicron variants - Nature Communications SARS-CoV-2 can be spread by aerosols. Here the authors show that between 50-60% of ambulatory COVID-19 patients exhale culturable virus and that this is associated with lower neutralizing antibody tit...

Half of Covid-19 patients emitted infectious virus in respiratory particles smaller than 5 microns (>30 min to settle out). Culturability of aerosols was associated with lower neutralizing antibody titers, so immune response matters for transmission potential.
www.nature.com/articles/s41...

Steps to prevent and respond to an H5N1 epidemic in the USA Nature Medicine - Steps should be taken now to prevent an epidemic of H5N1 in humans and prepare for an outbreak should it occur.

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

Measles is an outlier in terms of contagiousness & markedly more contagious than even the most contagious Covid variant

Some affected areas seem to have pockets with markedly low vax rates

It will be difficult to prevent onward spread in these areas without mass catch-up vaccination

Thank you for clarifying and sending this along

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...

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)

The clear response *should* be to urgently engage communities on the need & safety of vaccination

Measles is super contagious - the avg infectious person infects ~12-18 people

For the most contagious Covid variant, it was ~9-12

Other measures likely won't be enough to stop this outbreak
(1/3)

As Texas measles outbreak grows, parents are choosing to vaccinate kids At least 124 people, mostly babies, children and teens, have been infected. Eighteen people have been hospitalized.

I commend every parent who is choosing to do the right thing by vaccinating their child as the measles outbreak spreads. There's no shame in changing your mind on a stance you were wrong about. Especially when it concerns protecting children from disease.
www.nbcnews.com/health/healt...

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".