Discover and read the best of Twitter Threads about #opensafely

Most recents (24)

WHOA!!!!! Stinky Cheese 🧀🧀

This paper from .@OpenSAFELY is an absolute shocker, claiming normal antibiotic usage during 2020 in the UK.

We know it wasn't because we looked at it already.

Was this paper published to cover up the #3tablets scandal?

🧵 ImageImage
Here is the claim from @BillyZhong229 the lead author, who seems to be a student (his twitter is less than a year old).

It's propaganda reinforcing the "Antimicrobial stewardship" dictat:

YOU WILL NOT PRESCRIBE ANTIBIOTICS FOR COVID

What were "COVID-19 national restrictions"? ImageImage
Well I did this analysis back in Feb showing the HUGE GAP between normal cyclical antibiotic prescriptions and the actual prescriptions during COVID - when GPs were told to stop prescribing antibiotics to the elderly and give them #midazolam instead.
Read 21 tweets
Finally, the #GoldacreReview is published! (During Parliamentary Easter holidays, mid-ping-pong on the #HealthAndCareBill...)

It's 221 pages - each PDF page is a double page spread - so this could be a lo-o-o-ong [Thread].

Here goes...
First point to note, in the Terms of Reference (p5), is that this is about "access to #NHSdata by #researchers, #commissioners, and #innovators" - i.e. #Planning and #CommercialReUse - so it is directly relevant to the operation of millions of people's #NationalDataOptOuts... Terms of reference for the review  1. How do we facilitate a
"185 wide-ranging recommendations for us to explore", says @sajidjavid (p6). Gulp! Time for some coffee...

"systems that ensure #underrepresented groups are well represented" may (partly) refer to this "landmark review", which got off to a slow start:

gov.uk/government/new… The far-reaching independent review into potential ethnic bi
Read 159 tweets
I have just read Preventable by @ASlavitt
My review to come

for me, the most remarkable thread through the book details the work of a "shadow science advisory network" that in effect replaced functions that the derelict Trump admin should have been doing
Slavitt explains how his network communicated both behind the scenes (in open channels to Kushner, Birx etc) & out in public, including these 2 USA Today columns

1-#stayathome usatoday.com/story/opinion/…

2-#opensafely usatoday.com/story/opinion/…
Slavitt details how Trump administration officials, governors, members of Congress and others were in constant contact with him & his network for expert guidance on pandemic response

As well, Slavitt had access to federal agency leaders, WHO, international leaders, etc.
Read 6 tweets
#PresidentialDebates should not happen without #LiveFactChecking, especially when our #despot is infamous for lies! This is a thread which attempts to dispute some of #TheHateYam's lies. The #SecondPresidentialDebate2020 begins at 24:19 on this video.
At 28:00 #PresidentDeathBreath congratulates himself on what he's done in terms of #PPE. All he did was loot the #FederalStockpile they sold it at auction abroad for #TrumpCrimeSyndicate profit, then #Kushner said it was their own not #ThePeoplesStockpile! abcnews.go.com/Politics/kushn…
Then he replaced the quality, American made #PPE stolen from #ThePeoplesStockpile w/substandard mice chewed expired crap he bought from #Putin, he allowed #Putin to fly it into #Boston on fighter jet! #Russian fighter jets do not belong in our airspace! politico.eu/article/corona…
Read 21 tweets
Just grabbed my last-ever cup of @ZolliKoffee. Today’s their last day in business.

Zolli created a great space for community conversations, attached at the hip to @JackalopeBrew tap room.

Small businesses need more support than they’re getting. Image
I knew this post would be a little bit of a #COVID19 Rorschach test.

Zolli believes in public health leadership and was able to last longer with federal support.

His business was dependent on activities that are reduced without the lockdown: offices, hospitality.
We can’t decouple the public health risks of #COVID19 (which are real) from the economic impact.

It is possible to #OpenSafely. That is not the same as it being easy.
Read 4 tweets
Last week, our family decided, with full participation of our 9yo in the discussion, to return to school in person as soon as @MetroSchools offers it for 4th grade.

Why? A few reasons.
Principally, in a household with an evidence-based pediatrician, we’re attentive to the American Academy of Pediatrics recommendation:

services.aap.org/en/pages/2019-…
The part in bold is this: “the AAP strongly advocates that all policy considerations for the coming school year should start with a goal of having students physically present in school.”
Read 8 tweets
COVID Update June 28: August will be another twist in the road. That comes tomorrow.

But I need to do something first. I’m reminded many people follow me for COVID info so I want to call out & atone for my mistakes. 1/
Each month at the end of the month, I do something which lacks any sort of judgment: tweet out what is likely to happen over the next month. 2/
This whole crisis has suffered from a lack of accountability so I want to start with myself & where I’ve been right & wrong. 3/
Read 37 tweets
I hate to sound like one of those “elite intellectual” types but if state governors don’t learn to understand (or remember from 2 months ago but whatever) what a time lag is between cases & hospitalizations & deaths we will keep repeating second grade over and over. 2/
Recent news— massive growth of cases, increased hospitalizations— is not the result of today’s action. It is a result is actions in May. 3/
DeSantis said the spike in cases has “nothing, nothing” to do with the reopening. (I think his explanation was “goblins” or “magic fairies.”) But definitely not him.

He and others fail to understand time. 4/
Read 24 tweets
I was early to #PhysicalDistancing and #Masks4All, and I remain pessimistic about some of the effort to #OpenSafely.

But I still wrestle with the merits of a general mask mandate. Sudden mass behavior change with an uncomfortable/unfamiliar idea is hard.
We demonstrated very clearly that we could #FlattenTheCurve in Nashville by starting with #SaferAtHome and easing into an #OpenSafely scenario.

I think working with businesses on effective protocols is easier and possibly as effective as a generalized mask mandate.
I try to lead by example and wear masks any time I get groceries or enter enclosed spaces (like city hall).

And all leaders need to be responsible with #Masks4All.

But I think we can accomplish the principles of #OpenSafely with business participation and leadership.
Read 4 tweets
COVID: Everyone should not have to know someone personally who has died or been seriously ill from COVID-19 for the US to finally do the right thing.

Why do we have to be experiential learners? It’s not like we don’t understand what a virus does. 1/
The fact that there is a “you’re making too much of a global pandemic” cult in our country is ... odd.

We may not be the only country with a group with that mindset, but it often seems like it. And we may the only one where the ringleader is the head of state. 2/
There is of course a reasonable conversation to be had about how to balance people’s income & health during the pandemic.

This is why we released open-safely.org, covidexitstrategy.org, and an entire library of resources for states at usofcare.org. 3/
Read 25 tweets
COVID Update June 18: Even as surges start to hit the South and West, all states must prepare for what’s next.

With only 5-7% of the public infected, we can’t be left as unprepared as Trump would have it. 1/
It almost entirely goes without saying that states are on their own here. Trump has gone from “hoax” in February to “its dying out” in June.

It was malpractice to leave us unprepared once. It is almost a war crime to do it twice. 2/
With preparation, we could have contained the virus, communicated more clearly with the public, prepared our hospitals, kept our nursing homes safe, and prevented loss of life.

Let’s do it this time. 3/
Read 24 tweets
NEW: There are 3 state warnings worth issuing today for COVID. Not panic, but time to consider actions.

Arizona
Arkansas
Utah

Here’s why.

There is also good news.
Hospitalization rates are increasing in all 3 states & test positive %s are moving up.

In the case of Arizona, cases up 240% in last 2 weeks & hospitalizations are up 77% this past month, 31% this week alone. Their leading hospitals are ringing the alarm.
Arkansas hospitalizations are up 180% over the last 28 days, 49% this week alone. Hospital capacity appears to be a concern at least in some parts of the state. Test positives are also increasing. New cases are doubling between 2-3 weeks.
Read 9 tweets
COVID Update June 4: There are efforts turn Coronavirus into a political litmus test.

It’s pretty clear who wins from that. The virus. Only the virus. 1/
There is still very strong evidence that when people aren’t asked about Coronavirus with a political bent, the public is pretty unified.
-9/10 say they want to avoid crowds of 10+
-8/10 believe staying home is safer & masks 2/
Yes of course there are exceptions & that 10-20% is up for discussion here. 3/
Read 20 tweets
A friend of mine of who runs an essential, office-based business with ~50 employees and 1 employee just tested + for #COVID19 after finding out about an exposure over Memorial Day weekend family gathering

A thread on running a business in the time of #coronavirus👇
2/ The business has had a zero-tolerance policy on coming to work with any symptoms. This employee who tested positive apparently felt a little tired last week, but no fever, cough, or obvious symptoms. The employee was notified via contact tracing of the exposure on Memorial day
3/ Upon being notified of the exposure, the employee was able to get a same day #COVID19 test which turned out positive. This triggered same-day tests of everyone exposed at work and shutting down the office for deep cleaning
Read 10 tweets
1/ Many lawmakers are citing preventing preventing "deaths of despair" (drug use, overdose, alcoholism, suicide) as the rationale to reopen prematurely. @meganranney & @drjessigold have written a must-read piece in @statnews addressing this. A thread 👇

statnews.com/2020/05/31/dea…
2/ First, while we have ample evidence of the impact of #COVID19 (>100,000 deaths, ~4x as many hospitalizations lasting 1-2 weeks, a lasting debility among younger adults that has yet to be quantified), we don't have any data yet on deaths of despair

3/ Second, the economic conditions that lead to deaths of despair tend not to be temporary. For example,
@atheendar found that it took 5 years after factory closures to see full impact on opioid overdoses
jamanetwork.com/journals/jamai…
Read 10 tweets
COVID Update May 30: Looking ahead at June.

I did this as May started and may as well do again. 1/
The phases of the COVID crisis are easy to spot in hindsight.
Getting our bearings in chaos
-watching China
-watching Italy
-Washington & community spread
-Crisis w ventilators & hospitals
-PPE crisis
-Flattening the curve
-Devastated NY
-Nursing home deaths
-#StayHome 2/
Our reaction
-Reducing transmission
-Avoiding the Easter Sunday massacre
-Congressional support
-Shelter in place
-Economy stops
-Neighbor helping neighbor
-April death toll
-Massive job loss
-Factories, jails, homeless shelters, Navajo nation
-Blaming China & WHO 3/
Read 33 tweets
COVID Update May 29: With 102,000 COVID-19 deaths, we are busy creating the conditions for tomorrow’s outbreaks.

Houses of worship are vital places we lean on for strength. We shouldn’t turn them into sources of crisis. 1/
There are many things we should feel optimistic about in our fight against COVID-19. Science, more testing, masks & other interventions give us reason to believe we will be able to live alongside the virus while we try to cure it or prevent it. 2/
And we are learning how CV spreads. In the past week or so alone, we’ve learned:
-That superspreaders (5-10% of infected) drive 80% of infections
-That superspreader events are significant drivers (large crowds & bars)
-That pre-existing conditions are especially dangerous...3/
Read 29 tweets
THREAD FOR YOU: How do YOU open safely?
We’ve spent much time on criteria for govs/institutions, we may have left out group most likely to effectively minimize risk, you.
How? It’s easy test: 3Ms
Minimize contact intensity;
Manage # of contacts;
Maximize mitigation policies
I woke up this morning to this pretty powerful @TheAtlantic @JuliaLMarcus column: despite all the information and data, or maybe because of it, Americans aren’t getting advice they need. 2/
theatlantic.com/ideas/archive/…
People who do what I do work in bulk, meaning we plan for what will have the greatest influence but know it’s not ideal. Sure there are outliers, but if we can solve 80% of a problem by defining proper conduct, that’s pretty good. No perfectionists in our professions.3/
Read 16 tweets
COVID Update May 27: COVID-19 is the disease of the middle aged in some ways more than even of the elderly.

As we open up & go back to work, it’s possible we’ve missed something important— the danger to many of the returning 50-64 year olds. 1/
I can’t tell you how many times I’ve read that COVID-19 is completely overstated and just hits the elderly. Therefore we have overdone it. (Usually by Wall St types, not scientists). 2/
There’s a narrative that this is only dangerous to old people so everyone else can safely go to work. To the contrary, compared to the flu, it’s much more dangerous for middle aged people than older people. 3/
Read 28 tweets
COVID Update May 26: 100,000 people have died from COVID-related causes.

These deaths have been largely alone, not properly mourned, without notice, discounted, under-counted, and preventable. 1/
When my dad passed away in 2003 I stood next to his bed and held his hand. I will remember the feeling of his hand in mine the rest of my life & my eyes are red & hot that for so many people this couldn’t happen. 2/
But for the nurses, doctors & therapists holding an iPad, these losses have been unseen. They are here to heal us & they have had to act as our witness. 3/
Read 24 tweets
COVID Update May 25: State of the Union: as expected the early May openings are increasing hospitalizations.

Topics: the spread, science, the politics, the globe.1/
State of the spread in May: as expected

It’s moving South and Midwest as the Northeast improves. Why? Because that’s what outbreaks do. They find the open areas. Good early states— like WV and MT— are seeing growth now. AL, WI, TX are seeing growth. 2/
The most concerning development is pointed out here by @ScottGottliebMD. Hospitalizations, after a decline, are moving back up. With 20,000 new cases, this means 800 new hospitalizations/day. If this continues, it will put hospitals in some areas under pressure. 3/
Read 23 tweets
COVID Update May 23: 2 months ago, with things heading off the rails & we launched #StayHome, experts told me that if we were successful at reducing the death toll, many wouldn’t believe COVID was much of a problem after all.

Fascinating look at where else I was right & wrong.1/
One popular activity is to go back to earlier days in the pandemic when we knew less & hunt for places where people were wrong and light them up for it.

I think it’s often a bad practice but I’ve decided to participate— by going back & looking at my own statements. 2/
I don’t make predictions. If anything my skill is getting people to return my call & sharing what I hear from experts. In the third week in March I laid out what it might look like ahead based on what I heard.

I made 12 calls @medium captured. 3/

coronavirus.medium.com/beating-corona…
Read 27 tweets
COVID 19 Update May 22: The most dangerous current effect of the pandemic may be denial.

Denial this was bad. Denial it has killed significant number of people. Denial it might come back even stronger.

Most of all, denial that social distancing actions had a big impact.1/
This is going to be a different thread. If you want to skip it, I have a ton of data to share but it will wait until tomorrow. 2/
Yesterday a well-known TV host opened their program by going directly after me. Not just me but Anthony Fauci and Andrew Cuomo and Zeke Emanuel.

I have thick skin & I’m also fair game. This won’t be about defending myself. 3/
Read 33 tweets
1/ Q: What else do I need to know about my #risks as my state #reopens?

A: The nerdy girls answered several questions about this topic recently, but we love another amazing smart lady's interpretation (@DrLeanaWen), detailed here with a few more pearls.
2/
1-Relative risk: For #COVIDー19, this is determined by type of activity, duration of activity, and how close you are to other people (see our previous posts). The key message: prioritize outdoor activities, keep interactions brief, and space yourselves from other people.
3/
2-Pooled risk: If your friends/family are low risk, you are probably safe to get together.

3-Cumulative risk: More interactions=more risk. Minimize number of people with whom you interact.
Read 6 tweets

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