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Wanted to address a question I've heard repeatedly today after writing why I'm taking #COVID19 so seriously: Why should we be reacting this way to #COVID19 when H1N1 (swine flu) triggered far less panic in 2019? 1/x
This has become a trope for @realDonaldTrump, a dangerous one--and it's responsible for resistance today to the important public health messages needed to #FlattenTheCurve. 2/x



First, an acknowledgement: H1N1 was labeled a pandemic by WHO (cdc.gov/h1n1flu/who/) and it sickened between 14 million and 34 million people, per CDC estimates. cdc.gov/H1N1flu/estima… BUT... and there are huge caveats 3/x
The spread of H1N1 was much slower and the mortality rate was far lower than #COVID19. reuters.com/article/us-flu… 4/x
As @washingtonpost notes, "the swine flu had a mortality rate of 0.02 percent — about one-50th of the lowest rate health officials are citing for the coronavirus today (1 percent)." washingtonpost.com/politics/2020/… @AaronBlake 5/x
"The first influenza pandemic of the 21st century is considerably less lethal than was feared in advance." UK chief medical officer Sir Liam Donaldson said in 2009. news.bbc.co.uk/2/hi/health/84… 6/x
More than that, Trump's claims about the Obama administration's response to H1N1 have been thoroughly debunked. 7/x

From @factcheckdotorg: factcheck.org/2020/03/trumps…

From @AP: usnews.com/news/politics/…

From @npr: npr.org/2020/03/13/815…
But based on the responses I've received today, the trope of H1N1 being similar to #COVID19 has caused serious damage to the public health messages today. The two are very different. #covid19 is more virulent and spreads more quickly. That is why it must be taken more seriously.
Correction. H1N1 was in 2009, not 2019.
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#covid19 #FlattenTheCurve

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Charles Ornstein
@charlesornstein
So, who should you be following on #COVID19? First, thanks for trusting me. Also: @ScottGottliebMD @ASlavitt @drJoshS @HelenBranswell @trvrb @mlipsitch @CarolineYLChen @DrTomFrieden @marynmck (and that truly is only a start.) So sorry for leaving folks out. Help me add to this.
I will add to my own list: @MartyMakary
Oh my gosh, how could I leave off @ashishkjha?!?! I feel completely embarrassed. He's all over #COVID19
Read 4 tweets
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Charles Ornstein
@charlesornstein
Lots of questions this morning about mortality from #covid19. For my money, best place to look is China where we have a large denominator. This @JAMA_current summary tells us a lot. ja.ma/2U49cFK 1/x
Let's start with spectrum of disease. Looking at 44,415 cases, here's the breakdown:
Mild: 81% (36 160 cases)
Severe: 14% (6168 cases)
Critical: 5% (2087 cases)

So yes, most folks are going to be OK. Look at @tomhanks and @RitaWilson. 2/x
How about mortality? In China, the mortality rate in the first 44,672 cases was 2.3% (1023). But that is not distributed evenly at all. The rate is 14.8% in patients aged ≥80 years (208 of 1408) and 8.0% in patients aged 70-79 years (312 of 3918). 3/x
Read 6 tweets
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Charles Ornstein
@charlesornstein
I've heard a lot from some folks (both online and by phone) that concern about #covid19 is overblown because the vast majority of folks who get it recover after feeling crappy for a few days. While this is true for many/most, it misses the big picture. 1/x
First, as Dr. Fauci and others have said, #covid19 is deadlier than the flu. Far deadlier. It's deadlier for young adults. Its deadlier for older adults. 10 times deadlier. This chart from @businessinsider shows this. businessinsider.com/coronavirus-co…
The curve is stark. If 1/12 people age 70-79 who get the virus and 1/7 people age 80+ who get the virus die, and the virus spreads to 20%, 40% or 70% of the population, we're talking massive death tolls, the likes of which we have never seen before in our lifetimes. 3/x
Read 10 tweets

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PeriodsforPence
@Periods4Pence
Yesterday I came in contact (6 feet maintained!) with a woman whom I do not know. We were discussing the insanity of “the #COVIDー19 “ “thing.”
We were not having the same conversation.
Thread.
“This is so crazy!” she said. I agreed, thinking she means just the overall, general insanity of actually living through a pandemic.
“I know,” I said. “I’ve never seen anything like it. I just hope everyone who is buying all the stuff actually stays home and uses it there.”
She waved her hand. “Oh, honey, this isn’t anything but a bad flu. A few people will get it and it’ll be fine.”

“Unless, like me, you’re immunocompromIsed. I’m the one who will get it and it won’t be fine.”

She got a little uncomfortable.
Read 7 tweets
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✌🏼𝙻𝚊 𝙲𝚊𝚋𝚛𝚒𝚝𝚊 𝙵𝚒𝚏𝚒
@lacabritafifi
Para los que opinan que “estamos exagerando” los que queremos medidas más estrictas, van los datos duros:

-Se espera que se contagie entre 40-70% de población mundial
-#COVIDー19 tiene R0 ~2.2
-Mortalidad entre 2-4% (95%CI)
-~5% tienen enfermedad crítica y requieren ventilador
Ahora, hagamos los cálculos con 125 millones de mexicanos👇🏼

Imaginemos que se infecta 60% de la población 👉🏻 75 millones

En el mejor de los casos, imaginando que el sistema de salud está como López cree que está, tendríamos mortalidad del 2% de infectados 👉🏻 1.5 milones
En el peor de los casos, considerando que en el sistema de salud, hoy día, no hay ni medicamentos y mucho menos ventiladores e infraestructura suficientes, entonces podríamos esperar tener una mortalidad del ~4% 👉🏻 3 millones de mexicanos
Read 16 tweets
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Ameya Kulkarni, MD
@ameykulkarnimd
Lots of talk about the expected surge in ICU and hosp beds with #COVID. I’ve been hearing about reducing elective case burden (great thread from @ajaykirtane about that). We should also be rethinking our hospital approach to conditions that will continue in the covid era 1/n
Most obvious is with #STEMI care. If your hospital doesn’t have an ED bypass protocol for stemis - probably a good time to develop one. Ours at @VHC_Hospital has 1 min pitstop in ed w ems txp to cath lab - less pt exposure time to ED and less burden on ED resources 2/n
Also with #STEMI care - No icu for stable pts w normal EF should be standard. For most of these pts ICU is not necc and creates unneeded exposure for pt and occupies much needed ICU beds. (I think @agtruesdell had a great thread on this a while back) 3/n
Read 11 tweets
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François Heisbourg
@FHeisbourg
A back-of-the-enveloppe thread on the spread of #COVIDー19:

1) HUBEI province (ca 60 million people) has had close to 3000 deaths. It still has an active caseload of ca 20 K patients & some 130 new cases a day, & ca 30 daily deaths. So I expect up to 3500 deaths, assuming...1/9
...a winding down of the epidemic there by end March. If,stress IF, the rest of the world became like Hubei (0.8%of world population), the death toll could be of ca 400 K with a cumulative number of cases of ca 8 million.This possibly sets the outer bounds of a Covid pandemic 2/n
Of course, active measures in the world may prevent Hubei-scale outbreaks so this is unlikely to happen (conversely, late but tough measures in Hubei have also limited Covid's spread in that province).

2) GOOD NEWS though in rest of mainland China ( minus Hubei, HK,Macau): 3/n
Read 9 tweets
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New Scientist
@newscientist
How bad will the #Covid-19 outbreak get? A leading epidemiologist has claimed it could infect 60% of the world’s population. It seems to be more contagious than 2009 swine flu, which it is estimated infected 24% of the world’s population. bit.ly/39Elhrt
The death rate is hard to calculate without knowing the true number of cases. Epidemiologists think many mild cases are going undetected. If so, the overall death rate may be only 1 per cent. #Covid-19
newscientist.com/article/223326…
Wuhan, the centre of the epidemic, has been locked down since 23 January. The streets are largely empty, but supermarkets remain open and well stocked. #Covid-19
newscientist.com/article/223245…
Read 10 tweets

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#KimJongIl #BoycottNickiMinaj #SocialismWorks #USWarCrimes #EndColonialism #Smile #NeedNotGreed #Libyan #Technology #DemDebate2 #csweet #MIGRANT #RedArmy #GlobalWarming #Ecuadorians #moral #Paris #Lincoln #REFUGEES #MarxismLeninism #COVIDー19 #cyber #Japan #DontTestDontTell #PROOF

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