Michael Mina Profile picture
Feb 16, 2020 9 tweets 3 min read Read on X
#doubledocs @EmoryMSTP @MSTP @NIGMS @NIH and other MD/PhD trainees: For those re-entering Med school after 4,5,6+ years of research for your PhD... for those of you who really loved your PhD... Don’t forget that love and excitement of research. 1/9
M3/4 and beyond is like a tidal wave of medicine and the medical environment can sweep everyone up. Afterall, It’s necessary to totally immerse yourself in these years, both just to get through Med school but also to figure out what it is you want to go into. 2/9
But if you find that you aren’t discovering your expected medical passion over the coming year or two and wishing you were in the lab... remember that that’s OK - if not actually on point. MSTP is designed to produce SCIENTISTS who are physicians. 3/9
During clinical training, it is easy to feel the need to prioritize the MD over the PhD, particularly when catapulted back into an environment of predominantly MDs. 4/9
But know that it is a great thing if you find yourself wanting to prioritize your research hat as you begin to approach residency decisions. After all, the two sides of the brain used for medicine and research sometimes couldn’t be more opposing 5/9
And many find that their strengths and appetite and the side of the brain they prefer to exercise lands more on the side of research and creativity. This is expected! You did the MSTP presumably because you wanted to carry your medical knowledge into your research agenda. 6/9
So although many MSTPs head straight for the clinics, patient rooms and ORs, remember it’s not just OK but encouraged that you can make your decisions about residency and beyond with an eye to your research love, as opposed to centering plans solely around medical training. 7/9
If you haven’t started into M3/4 yet, these thoughts might not feel too relevant, but if you’re like me and find during M3/4 year that you really want to be doing research - know you’re not alone and there’s no need to fit a square peg in a round hole. 8/9
There are a tremendous # of research focused residency programs (and not just fast tracked research IM programs) that exist, like clinical pathology, and other non residency options that exist for the MD/PhD #doubledocs that really love the research side of PhD/MD training. 9/9

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More from @michaelmina_lab

Apr 20
Here we go again with this asinine cautious approach to testing for H5N1

CDC is NOT recommending that people with no symptoms - but who have had contact w infected animals - be tested at all… and certainly are not recommending a swab w any frequency.

Though we should have learned it in 2020, Here’s why this doesnt make sense:

1/Image
Firstly, tests are our eyes for viruses. It’s literally how we see where viruses are

If we wait until people are getting sick, we may have missed a major opportunity to find viruses jumping into humans before they learn to become so efficient in us that they cause disease

2/
So waiting until we actually have highly pathogenic strains harming humans - when we have a pretty discreet population at the moment to survey - is short sighted

3/
Read 11 tweets
Jan 16
A lot of questions still on:

How long should I isolate?

Do I need to isolate?

When can I go back to work?

Is 5 days enough?

What if I’m still positive?

Why am I not positive when I first get symptoms?

This thread below (and the embedded thread) goes through many of these questions
Now that symptoms start earlier w COVID (bc immunity activates symptoms fast after exposure)

A frequent ? that comes up is what this means for Paxlovid

Often ppl think it means you have to start Paxlovid earlier

Nope - Opposite! You have more time

2/
Bc symptoms start faster but the growth of the virus still takes about the same time as it used to…

Symptom onset today is ~2d post exposure where before it was ~5d

So, as far as virus growth is concerned, day 5 post symptoms (when the trials took place) is day ~8 today

3/
Read 6 tweets
Jan 8
A heartbreaking consequence of lapses in vaccination!

A measles outbreak is spreadinf in Philadelphia.

MEASLES! It sends kids to the hospital, erases existing immune memory (creating long term risks) and kills 1 in 1000

It was eliminated in the US, but we seem hell bent on reversing that

inquirer.com/health/measles…
A particularly deadly consequence of measles is its erasure of previously acquired immune memory - setting kids and adults up for infections that they shouldn’t be at risk from!

We found for example that measles can eliminate as much as 80% of someone’s previously acquired immunity to other pathogens!
science.org/doi/full/10.11…
Image
Read 6 tweets
Jan 3
This paper from Kaiser on new XBB1.5 vax formulation is misleading

NO, it does NOT say that prior vaccination w non updated XBB1.5 vaccines offer no protection

No, it doesn’t even say the XBB1.5 updates to the vaccine formulation are important

🧵
1/
medrxiv.org/content/10.110…
Here are the key conclusions.
They are WAY misleading

The major issue is w the timing

The comparison is

A) a VERY recent XBB1.5 vaccine given in last 30 days,

Vs…

B) A vaccine received ~1 year or more ago!

Any effect is first and foremost owing to recency of vax

2/ Image
Given everything we know about major short term (weeks - few months) immune responses after vax or infections

The comparison is NOT able to say anything about the importance of updating the vaccine formulation for variants

It simply says what any Immunology 101
Text says..

3/
Read 15 tweets
Dec 24, 2023
Tip on pooling home tests

I’m gathering w family. Had one @Pfizer Lucira multiplex COVID-Flu home molecular test

Had 6 people and 6 swabs

Everyone used one swab. Dunked all 6 into one Pfizer Lucira test

Neg.

Tested everyone for price of one!

Pooling at home works!
Pooling can work w home tests including rapid antigen and rapid molecular tests

However for antigen id be a bit more cautious and not put more than 3 swabs in the buffer

With molecular, particularly Pfizer Lucira bc it has a large volume buffer, 6 is no problem.
Here’s a nasal swab that would work. Don’t use it as a nasopharyngeal swab at home - just use it like any home self swab and swab the anterior nares

a.co/d/iCO1nsI
Read 4 tweets
Dec 15, 2023
Please note - If you use expired rapid antigen tests - here's how I think about interpreting them

1) If Negative - do not trust it - especially if control line is faint / absent

BUT

2) If Positive - trust it - *very likely* true positive.

(short thread)
1/
An expired test will Not aberrantly turn positive just because it's old

Expiry makes lines not show up. Does make them become dark.

So, if using an expired test:

Do Trust a Positive.
Do Not Trust a Negative.

*And note that many tests have had extended expiry dates...

2/
Here is a thread about the extensions to the expiration dates.

Not all tests are extended but many of them have and that means that the dates on the box may be different from the actual expiration date. I write about it here and how to find out

3/

Read 4 tweets

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