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"Medicine is an incredibly hierarchical culture. MDs are taught to respect authority…Not a perfect system, but it mostly works as long as science is driving things at the top. However, infectious disease medicine in the US is no longer driven by science."
mattmireles.com/be-afraid/
From @mattmireles, who was EMT/paramedic before tech.

I don't agree with everything in the piece (future isn't yet written, press & state have both failed) but there is a lot of truth here.

I'd counsel preparation vs fear, but the scenario described is not an impossible one.
I've been wrestling with the ethics of talking more openly about worst case scenarios.

I think that, as with climate change, it's important to TALK about them so that we can AVOID them.
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Balaji S. Srinivasan
@balajis
My one edit to this:

I don't think it's practical to "end" the FDA, anymore than it was practical to "end" the Fed

Too much infra around it, can't replace overnight

Instead, do it like crypto. Route around with an alternative

Here, that's expanded right-to-try at state level
That is, if you say "end" the Fed or FDA, it works as slogan but the establishment doesn't take it seriously. These institutions are the core of the whole system, all backlinks go into them, can't just set that to zero.

The real threat is to *build the alternative*.
All Bitcoin needed was the right to exist.

Technological decentralization ensured it couldn't be easily shut down by any state. And then once that alternate pathway existed, it started outcompeting* the Fed's dollar over the long-term.

* Yes, down now, but up >10000X since '10
Read 7 tweets
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Balaji S. Srinivasan
@balajis
The 2020s will be the decade of biomedicine. Almost everything else may crash but budgets for this will be unlimited.

Founders should consider joining Illumina, Roche, GSK, etc to learn skills. And learning how to "biohack" at home.
medium.com/@ThatMrE/a-gui…
What the internet was to software, or crypto was to finance, the virus will be to biomedicine.

It is going to decentralize it, accelerate it, make it highly personal, cause an enormous surge of new talent into the area, and (most importantly) change the risk calculus.
The risk calculus part is important. Up until this point, the cost of biomedical delay was invisible and deniable.

But what FDA's CDRH division did in terms of delaying EUAs for lab tests has now very publicly cost us trillions of dollars and likely many American lives.
Read 7 tweets
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Balaji S. Srinivasan
@balajis
Quarantine theater?

It appears the US right now is doing half-ass TSA-ish things.

Rather than a short, sharp, universal lockdown it is taking huge economic damage without the full health benefit. If we're doing this, we need to do it like Asia or Israel would do it. ImageImage
Measuring success requires:

1) massive diagnostics capability for the foreseeable future
2) centralized site to collect these stats

We need (1) because this is an infectious disease, so people will need to be retested many times. We need (2) to get a scoreboard.
US government dysfunction means we'll need to do this the hard way: the decentralized response.

Testing is ramping now that it's finally outside the FDA/CDC bottleneck (see below).

Our general mental model must be: the state will mess it up, so we need to monitor & decentralize Image
Read 6 tweets

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Meredith Greer
@EmmGeezee
A #tweetorial on ANA, for non-immunologists.
As a medical student, I was taught ANA = lupus.
As a resident, I was taught ANA = red herring.
As a fellow, I have learned ANA can mean nothing or something, but if you miss the something, it could be bad.
So what is that something?
2/ ANA stands for “anti-nuclear antibody”. This just means an antibody against anything in the nucleus! It is not specific, as there are many things in the nucleus, things I’d long forgotten resided there.
3/ Things like dsDNA (SLE), histones (drug-ind SLE), centromeres and topoisomerases (scleroderma), ribonucleoproteins (MCTD), RNA polymerases (remember those?!), and so much more!
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Shawn McGuirk 👨🏻‍🔬👨🏻‍💻📝☕🔜🤺💀 ➡️👨🏻‍🎓
@ShawnMcGuirk
My #CSPC2019 live tweeting #THREAD starts here!

I'll reply to this tweet w/ each panel I attend, creating a thread under each w/ live notes

My schedule: 🔗cspc2019.sched.com/shawnmcguirk

And, ICYMI, see the new CSPC magazine for my op-ed about @DSP_SPE & #CapacityBuilding in #scipol!
I wasn't intending on tweeting the symposium, but 2 really good points on skills:

🔹 For communications, the ability to be brief (tweet length summaries!) is key

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🔹 Skills development has strong socio-economic dimension. Accessibility to good schooling even as early as Kindergarten can have large impacts later in life. The foundation of transferable (read: critical) skills stays with you as you later develop expertise.

#CSPC2019 #skills
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The Epoch Times
@EpochTimes
What if I told you that #BigTech and #SocialMedia platforms are manipulating you, steering you toward #Health information that they think is right, rather than letting you evaluate content for yourself?

Commentary by @MaryamHenein (Thread 👇) theepochtimes.com/google-censors…
Accredited professionals, meanwhile, who stand for #Health freedom and who criticize Big Anything, are losing posting privileges, getting banned, being buried, finding themselves deranked, and getting digitally assassinated.
Content is literally disappearing from the Internet along with our #Health choices.

It sounds conspiratorial because it is. Independent #Journalists and health experts are blowing the whistle. But it’s become a silent one.
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Lone Wolf Ratnakar
@GabbarSanghi
Today is also Jayanti of Pingali Venkayya, the designer of our national flag. While he is known as a freedom fighter, not so well known is the fact that he was an equally good geologist and agriculturist too.
Pingali Venkayya was born on August 2, 1876 in a village near Machilipatnam. His father Hanumantha Rayudu was the village Karanam of Yarlaggada , while his grandfather Adivi Venkatachalam was the Tahsildar of Challapalli Samsthanam
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Sapna Kudchadkar, MD, PhD 👩🏽‍⚕️
@SapnaKmd
Citation counts come from OTHER RESEARCHERS. They are important, yes.

But, sharing #science on #SoMe=broad & instantaneous dissemination to those who focus their time AT THE BEDSIDE. Which may surprise some- but is MOST OF MEDICINE especially....#anesthesiology.(Thread) #AUA2019
A metric like the “Kardashian Index” *MAY* be relevant in genome biology where the proportion of basic/translational science is significantly higher and no immediate bedside application for a general practitioner is there. (and I’m making an assumption here) #medtwitter #aua2019
When your #research is relevant primarily to other #scientists who are also writing research papers then citation counts do more wholly reflect the paper’s impact. But in clinical research, it’s different. Bedside clinicians are looking to the literature for guidance & new ideas.
Read 13 tweets
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Iatrogenic
@Dr_Blackjack
#Science vs #BJP

Bjp is party very educated party consisting of scientists , researchers,doctors , IITians , Oxford topper economist.
Here we have some of important theories nd reserch done by important organisation.
One of our very intelligent after a years of hard work in his lab with his Braille book found out dat natural calamities can b prevented by reading hanuman chalisa.

Another important member of our research team.after working yr on theory of evolution,he concluded dat theory is false. few of illiterate were unhappy about his remark.

Read 19 tweets

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