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By now, everyone is familiar w/ the exponential new case growth curve. I'd like to introduce another if clinicians are not #PPE protected. Not only will we lose their service (Infection, sick, death) but non-#COVID19 patients will be hit; each clinician cares for tens of patients
We can start with getting every #healthcare worker tested now. And again if negative. And again.
And demand the right protective gear for all now.
There is simply no excuse.
Proof point thehill.com/policy/healthc… via @DanjkimMD
Data on #COVID19 infections for #healthcare workforce
Graph via @ScottGottliebMD (note S Korea)

In @TheLancet paper on Italy's Lombardy region it stated "that 20% (N=350) had become infected and some have died" (diff't denominator) thelancet.com/journals/lance…
You can add 20% of of those infected in Portugal are #healthcare workforce
That 90% of #healthcare workforce infections are asymptomatic (Why testing is essential) and other symptoms to note
Thanks to @diogosimaolemos and see his thread 👇
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Eric Topol
@EricTopol
So far there's been lots of speculation for #COVID19 asymptomatic carrier rate
—Mild or no symptoms: 60% nature.com/articles/d4158…
—"Some degree"—Fauci wsj.com/articles/why-i…
—Mild or no symptoms: 86% science.sciencemag.org/content/early/…
We really need to know this for people w/o symptoms
1/2
To resolve this we need a random mass screen of a diverse (age, gender, ancestry, geography) group without symptoms and shouldn't this undertaken straight away?
Thoughts?
@mlipsitchn @K_G_Andersen @trvrb @florian_krammer @CT_Bergstrom @JustinWolfers @Laurie_Garrett @mtosterholm
This essay from @mlipsitch reinforces how little we know compared with testing done in Asian countries, the very high asymptomatic rate
washingtonpost.com/outlook/2020/0…
"The feckless federal response created such delays in testing that most cases here are not being confirmed, even now"
Read 5 tweets
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Eric Topol
@EricTopol
The new curves for 21 March:
US deaths very steepen, now approaching Iran
US case curve has surpassed even Spain
It just keeps looking worse.
Thanks @jburnmurdoch @FT who is all over this each day
Here you can see what has happened for the US deaths curve for the past 6 days
It's still hard to interpret the US case curve because of the marked delay for #COVID19 testing.
@COVID19Tracking just updated shows remarkable 4X increase in testing in 1 day. Tests still have ~48 hr turnaround
✓ @JustinWolfers "Extremely grim":
Read 4 tweets
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Eric Topol
@EricTopol
Deconvoluting #COVID19's historic big miss in the US
theatlantic.com/health/archive… a sharp and thorough analysis by @alexismadrigal and @yayitsrob @TheAtlantic via @AdrienneLaF @edyong209 w/ storytelling curves
What I refer to as "historic big miss" are the 2 months of not doing any #COVID19 testing.
Essential to get ahead of the outbreak:
Testing anyone in the US w/ pneumonia or symptoms, do extensive contact tracing, find carriers, get #healthcare workers protected, limit the hit
This from Italy. How many super-spreaders were missed in the US for 2 months by coming to the ER and being sent home with no testing possible?
nytimes.com/2020/03/21/wor…
Read 3 tweets

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Daniel Sinclair
@_DanielSinclair
A really heartbreaking sight. The sacrifices from health workers in China have been immense.
This is the context of that video, reportedly related to the death of hospital director Liu Zhiming.
This is making the rounds, claiming to be Chinese escaping the country into Vietnam. I'm almost certain that it is misrepresented, and that this is not true.
Read 2899 tweets
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Daniel Sinclair
@_DanielSinclair
If containment fails, and this projection comes true, the hardships that the world would experience during the onset of the first coronavirus pandemic would be hard to comprehended through our current eyes. A first for the modern world.
That’s further out, but if COVID-19 does break through to influenza scale, the benefit would be in a substantial population of immunity & antibodies. Those prospects are now where China is focusing. Antibody donation could improve outcomes; that’s moving from secondary priority.
The best outcome of a worst case scenario would be herd immunity. But, millions would die, medical infrastructure would be overwhelmed at even a fraction of the early generational spread, & the world would be on pause. Transfusion is not the golden ticket; you need a lot of infra
Read 2852 tweets
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Daniel Sinclair
@_DanielSinclair
Unsurprisingly, more information was withheld by the Chinese government. COVID-19 had reached Guangdong by January 4th. Wuhan's lockdown only began on the 23rd. This is a probelm far bigger than Hubei and China.
Alternate reality: Theranos Ends Pandemic
It's so sad to read these stories of China's state of unrest. Trust is degraded. This is not a society that will return to normal with a snap of fingers and bans lifted. China is damaged, could be for years, & we're not even near the end of this epidemic.
Read 2850 tweets
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Daniel Sinclair
@_DanielSinclair
If you're looking for someone compromised on China, you have this theater and its 'unbreakable friendship.' news.yahoo.com/china-declines…
Xi's latest appearance on a call with Trump this morning is a different story, merely parroting the "People's War" language that state media has orchestrated in recent days
This question has only deepened for Chinese and the world in recent days, with the tragedy only growing day after day, and Wuhan's whistleblower now fallen: where is Xi Jinping? time.com/5778994/corona…
Read 2810 tweets
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Daniel Sinclair
@_DanielSinclair
@CDCgov While I wait for more info to develop in the coming days, make sure to follow @JaneLytv's fantastic coverage of the misinformation that is spreading:
@CDCgov @JaneLytv This is absolutely untrue and there is no reporting to validate it. What is happening in Wuhan is not related to a biological weapon, or a human-caused accidental release, and this emergent reporting of a Chinese national being removed from a Canadian lab is in no way related. Image
@CDCgov @JaneLytv This is trash reporting that is by definition fake news. The Wuhan coronavirus was not released by a lab, and there is no evidence to in any way suggest that. washingtontimes.com/news/2020/jan/…
Read 2700 tweets
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Daniel Sinclair
@_DanielSinclair
Now Japan too 👀 https://t.co/9yeEsUGHDx
It’s probably a good time to remember that the 2002 SARS outbreak killed 774 people across 37 countries and it had a 10% mortality rate. This one looks less deadly, but also looks ripe to — and actively is — going global. on.ft.com/2u6G7zV
Umm, any of y'all have room in your bunker? The Chinese government was withholding the severity of this outbreak & transmission capability, and the number of coronavirus cases has exploded😷
Read 2391 tweets

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