I’ve been delighted to see the sudden surge in support for mandatory hotel quarantine (MHQ) in Ireland, with the aim of achieving zero covid. While it is, on balance, the best option, I fear that some commentators have underestimated the challenges. Here are some examples....

...1) MHQ is frequently framed as a temporising measure, with the aim of establishing quarantine-free travel bubbles with other zero covid regions. Not many countries have achieved zero community transmission. But in those that have, travel bubbles have been vanishingly rare...
...2) MHQ is super strict. The point of it is that it would allow Ireland to open up society again. If you miss cases in that context, you let infectious people into a country where socialising is the norm. The result is explosive outbreaks. In countries that have MHQ, you...
....don’t get exemptions except in the rarest cases. Not for funerals or sick relatives or graduations. Exemptions in most MHQ countries allow you out for a few hours at most on only the most compassionate grounds. If it’s too loose, it just doesn’t work.....
3) You still get occasional outbreaks and cases. The aim is for zero community transmission, not zero cases. If a covid+ve person in MHQ sneezes on a surface enroute to their room for example, you could get fomite transmission to a staff member. Quarantine hotels in themselves...
...have been the source of most outbreaks in zero covid countries because that’s where all the cases are. Infection control has to be scrupulous, but will never be perfect....
4) It only really ends when you have herd immunity from vaccination. It’s not quick and it’s not temporary. You can’t postpone MHQ for paddy’s day or Easter. If you do, you’ll see a rapid spike in cases very very quickly....
...MHQ is not a good thing. It’s the least bad choice in a selection of pretty bad choices. I have a 3 week old baby who won’t meet his grandparents or aunts and uncles until xmas at the earliest. But when faced with the choice between recurring lockdowns that serve no real....
....purpose, and MHQ with all it’s challenges, it’s no contest for me. I cant imagine any Australian or New Zealander would rather things were more like Europe. But with momentum growing for zero covid, I just think everyone should be aware of exactly what it takes to make MHQ..
....work. Denying people their liberty is a big deal and should never be taken lightly. But seeing elderly people afraid to leave their houses back home and kids being out of school, it’s DEFINITELY the best option.

More from For later read

#IDTwitter #IDFellows
Introducing our new series: “IDFN top 10 articles every fellow should read”🔖

#1: SAB management
by @mmcclean1 @LeMiguelChavez
Reviewers @KaBourgi, @IgeGeorgeMD, @Courtcita, @MDdreamchaser

We know is subjective & expect feedback/future improvements 👇

1. Clinical management of Staphylococcus aureus bacteremia: a review.
https://t.co/9tBCtp9mlP
👉 A must read written by Holland et al. where they review the evidence of the management of SAB.

2. Impact of Infectious Disease Consultation on Quality of Care, Mortality, and Length of Stay in Staphylococcus aureus Bacteremia: Results From a Large Multicenter Cohort Study.
https://t.co/XujO68pCuH
👉ID consult associated with reduced inpatient mortality.

3. Predicting Risk of Endocarditis Using a Clinical Tool (PREDICT): Scoring System to Guide Use of Echocardiography in the Management of Staphylococcus aureus Bacteremia
https://t.co/otcA1pxjAw
👉Predictive risk factors for infective endocarditis, and thus the need for TEE.

4. The Cefazolin Inoculum Effect Is Associated With Increased Mortality in Methicillin-Susceptible Staphylococcus aureus Bacteremia.
https://t.co/CQZiryVWZz
👉Presence of cefazolin inoculum effect in the infecting isolate was associated with an increase 30-day mortality.

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Recently, the @CNIL issued a decision regarding the GDPR compliance of an unknown French adtech company named "Vectaury". It may seem like small fry, but the decision has potential wide-ranging impacts for Google, the IAB framework, and today's adtech. It's thread time! 👇

It's all in French, but if you're up for it you can read:
• Their blog post (lacks the most interesting details):
https://t.co/PHkDcOT1hy
• Their high-level legal decision: https://t.co/hwpiEvjodt
• The full notification: https://t.co/QQB7rfynha

I've read it so you needn't!

Vectaury was collecting geolocation data in order to create profiles (eg. people who often go to this or that type of shop) so as to power ad targeting. They operate through embedded SDKs and ad bidding, making them invisible to users.

The @CNIL notes that profiling based off of geolocation presents particular risks since it reveals people's movements and habits. As risky, the processing requires consent — this will be the heart of their assessment.

Interesting point: they justify the decision in part because of how many people COULD be targeted in this way (rather than how many have — though they note that too). Because it's on a phone, and many have phones, it is considered large-scale processing no matter what.