Dr. Casey Middleton

After leaving WHO, Trump officials propose more expensive replacement to duplicate it HHS proposes spending $2 billion a year to re-create systems the U.S. accessed through the WHO at a fraction of the cost, according to officials briefed on the matter.

"This is not reversing the damage. It is spending more than we spent on WHO to create an institution that’s unlikely to survive and will certainly accomplish only a fraction of what we did by working together with the entire world.”
- Atul Gawande, @agawande.bsky.social

🎁
wapo.st/4tKRwyM

#idsky #episky #sciencesky

Interpreting Breakthrough Infections Given Assortative Mixing of Partially Vaccinated Populations Declining vaccine coverage across the United States has increased the risk of outbreaks of vaccine-preventable diseases. Even when vaccines have low primary failure rates, conventional epidemic theory...

In a new preprint, we combine modeling with school-level vaccine data to contextualize the risk of 'breakthrough infections' and impacts on the ongoing US measles outbreak. #idsky #episky

www.medrxiv.org/content/10.6...

Use of the test-negative design to estimate the protective effect of a scalar immune measure: A simulation analysis Background The relationship between antibody levels (more generally, a scalar measure of immune protection) at the time of exposure to infection (so-called exposure-proximal correlates of protection) ...

🏅 Concurrent work from Z. Zhang, C. Boyer, & @mlipsitch.bsky.social explore alternative approaches, including generalized additive models (GAMs), to infer titer-protection relationships from TNDs.

Be sure to check out their paper if this work is relevant to you!

doi.org/10.1101/2024...

🎯 The scaled logit model, introduced by A. Dunning for case-control studies, provides this flexibility.

We demonstrate that the scaled logit model can accurately infer a wide range of titer-protection relationships by fitting only one additional parameter.

doi.org/10.1002/sim....

Using simulated studies and mathematical arguments, we show that logistic regression is ill suited to recover biologically plausible titer-protection relationships in TNDs.

⚠️ This finding is unique to TNDs, which rely on exposure odds ratios (ORs). Thus, we need a model with more OR flexibility!

Recently, TNDs have been extended beyond VE to study scalar correlates of protection (e.g. antibody titer).

This inference problem is more complex. Any regression model must assume a mathematical relationship between titer and protection.

🤔 Is logistic regression well suited for this task?

Measurement of Vaccine Direct Effects Under the Test-Negative Design Abstract. Test-negative designs are commonplace in assessments of influenza vaccination effectiveness, estimating this value from the exposure odds ratio o

TNDs offer a cost-effective study design to estimate vaccine effectiveness (VE). In these studies, logistic regression is used to find the association between vaccination and risk reduction.

✅ Lewnard, et al. demonstrate the strengths and limitations of this model: doi.org/10.1093/aje/....

Statistical methods for estimating the protective effects of immune markers using test-negative designs Abstract. While widely used to study vaccine effectiveness, test-negative designs (TNDs) also provide a platform for identifying and quantifying immunologi

Models can be powerful tools to study associations in data. But do they reliably reveal the truth?

🚨 In our new study, @danlarremore.bsky.social and I show that the model used to estimate VE from test-negative designs (TNDs) may not translate to other correlates of risk.

doi.org/10.1093/aje/...

If you live outside of Minneapolis but want to support the community, Lisa and her husband are doing boots on the ground work to protect families! Donate to their work via Venmo @lisa-szabo-1

Sometimes it feels really heavy to pretend everything is okay in our country and just keep doing research.

It seems like the best thing I can do for my career is the worst thing I can do as a human being.

After my driving experience tonight, I have come back to say that this technology must also do the pointy downy when it’s behind another car. Those lights be bright in my rear view!

I would accept this. I admit, the visibility the provide is great, but my visibility is terrible as I stare into them 😵‍💫🚙🔥😵

It really says something about the state of our country that I no longer believe banning LED headlights should be a top federal government policy priority…

But I still hate them, to be clear 😑

Also, did you try “male and female” for the puzzle innie and outtie bits? I wonder if it would understand this crass terminology I stole from the hardware store 🧩

I do not envy your journey! I think I’m convinced that I should keep using PowerPoint for now 😂

These puzzle pieces are really messing with my mind 😵‍💫

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Diagnostic testing as a public health intervention: challenges and opportunities Published in Future Virology (Vol. 20, No. 12, 2025)

How can diagnostic tests for infection support public health – and what challenges do we need to overcome to maximize their potential? Kristin Nelson, Tyler Brown, and I have a new article out digging into this exciting, complex issue: www.tandfonline.com/doi/full/10....

Watercolor painting of a subtle sunset over a lake, featuring light a light yellow to blue gradient in the sky reflected on the water.

I have recently taken up watercolor as a relaxing after-work hobby. This piece captures a subtle sunset over the lake at my parents’ house in Tennessee!

6/ This is not a debate. That data is crystal clear.

Since the 1996 Port Arthur massacre, Australia’s buyback program and strict licensing have kept mass shootings to ~0–1 per year.
The U.S. has about 400–650 mass shootings annually and over 46,000 gun deaths each year.

It’s not even close.

Advertisement to apply to join the MIDAS Trainee Executive Committee for 2026. Recruiting grad students or post docs doing infectious disease modeling research that are motivated to strengthen the trainee community. Responsibilities of committee members include organizing trainee events, representing trainee perspectives to the broader MIDAS network, and fostering trainee connections. Applications are due by 9am ET Jan 1, 2026 at: https://forms.gle/16ZuG5oTBFwpnR4W8

The MIDAS Trainee Executive Committee is recruiting new members for 2026! 🤓

This is a great opportunity for grad students & postdocs in infectious disease modeling to gain experience organizing events & connect with peers.

Applications are due by 9am ET on 1/1/2026, link in flyer & alt text.

HBV 1

Interdisciplinary scientists’ notes apps be like:
- VEdirect vs VEtotal
- d/dx(a^x) = ln(x) a^x
- grocery list
- to read: doi.org/…
- how to exit vim

More than 75% of food crops depend on pollinating insects. What a striking cartoon to show the impact of dwindling insect populations 🐝

When they ask you to bring your talk on a flash drive, and you’re a professional, so you use your Tweety Bird flash drive #Epidemics10

We’ve just released Epistorm-Mix, a new open dataset on how people in the U.S. mix across ages and settings in the post-COVID era.

📊 Contact-level data + contact matrices
Built for epidemic modeling & forecasting
Fully open data & code

🔗 www.epistorm.org/data/epistor...

The Securing American Funding and Expertise from Adversarial Research Exploitation (SAFE) Act would deny federal funding to any U.S. scientist who collaborates with anyone “affiliated with a hostile foreign entity,” a category that includes four countries: China, Russia, Iran, and North Korea. The prohibited activities would include joint research, co-authorship on papers, and advising a foreign graduate student or postdoctoral fellow. The language is retroactive, meaning any interactions during the previous 5 years could make a scientist ineligible for future federal funding.

I've been on the road so I'm behind the times—but if you wanted to destroy US science, I can think of no more expedient action.

Blatant unconstitutionality aside, fuck this backwards forwards and sideways.

www.science.org/content/article/u-s-congress-considers-sweeping-ban-chinese-collaborations

Every fall, for the last 13 years, I have worked with CDC and WHO colleagues on a report in MMWR to update the estimates of the global burden of measles disease and mortality. This year we were already planning to publish in WER because of restrictions on communication between WHO and CDC.