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What they are doing in Washington appears to be working.

@UWMedicine has posted all of their protocols and are updating regularly:
covid-19.uwmedicine.org/Pages/default.…
Their first line antiviral is Remdesivir, Gilead's experimental medicine. Second choice hydroxychloroquine.
Earlier version of this document had AbbVie's Kaletra included. Not sure if @UWMedicine removed it because they found it less effective or ran out of supply.
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Phil Kerpen
@kerpen
Looks like Italy may be overcoding COVID-19 deaths.
telegraph.co.uk/global-health/…
This is a good point. Not sure what the Italian government is trying to claim here, really.

It mostly seems to be: "they were old and sick and were going to die soon anyway."

If their coding practice is so inaccurate why don't they change it?
Then again:
Read 3 tweets
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Phil Kerpen
@kerpen
I am confident docs will keep following the best protocols based on available evidence, which does indicate hydroxychloroquine if a patient cannot qualify for Remdisivir trial or compassionate use.

Should not be moved toward or away from HCQ by the president's hyperbolic tweets.
The science is moving very swiftly with so many ongoing clinical trials.

Kaletra was promising and pretty widely used until it failed its trial, and now nobody is using it.
Replies indicate I was unclear.

My main concern about the POTUS tweet is that describing an unproven but promising treatment as a proven cure will discourage its use, which doctors now think is indicated in many cases. I hope that does not happen.
Read 3 tweets
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Phil Kerpen
@kerpen
Imagine how much worse the economic shutdown would be without the big Internet companies facilitating online communications and commerce... it's insane the government is still putting the screws to them.
axios.com/techs-antitrus…
I mean, of all states...

"The tech investigations continue and their priorities haven't changed due to the coronavirus, according to a spokesperson for the New York AG's office."
And Texas thinks Google is the economy's problem? What in the world?

Paxton spox: "Our investigation and the resources committed to it remain ongoing and unchanged... We do not anticipate that this health event will affect our ability to pursue the investigation as planned."
Read 3 tweets

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Gabriel Brat
@bratogram
1/8) THREAD. Six take-aways from emergency gen surgery case on pt w concern for COVID-19. Team anxiety & uncertainty so everything more difficult. Plus, lacking protocols for surgeon protection. @AnnalsofSurgery @aneelbhangu @dnepo @DrJohnScott #COVID19 #COVID19Surgery
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Maralyssa Bann, MD
@mbann_md
1/Week 2 of #COVID disaster response here in Seattle. King County has reported 420 cases and 37 deaths. We are seeing more volumes in our hospitals, though I think we it may be the tip of the iceberg and anticipate more to come.

A couple of additional lessons this week:
2/1. Your PPE supplies are directly related to the time it takes to rule out COVID19. @JohnLynchID has denoted this the “MAK unit” (named after the inimitable @molsenmoose) and it represents the time from initiation of PPE for a patient to negative test and de-escalation.
3/ It is CRUCIAL. A large amount of your patient volume initially will be rule-outs and being efficient here will save your resources.

Low "MAK" time allows you to have low threshold to test inpatient and keep your care moving forward.
Read 11 tweets
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Kira Newman, MD, PhD
@KiraNewmanMDPhD
After a week of working in the #ICU here in #Seattle caring for patients with #COVID19 (and other illnesses), here are some thoughts. #medtwitter (1/10)
We try to have a high index of suspicion for #SARSCoV2 and test critically-ill patients broadly. However, this means that many patients we test are actually negative. This presents a challenge for clinical reasoning. (2/10)
It takes more energy than usual to avoid anchoring too early and to keep a broad differential.

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Read 10 tweets
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巴丢草 Badiucao
@badiucao
landed in Melbourne
sore throat，sneezing and coughing on place
not sure fever
passengers from Italy sits right beside me…
the whole plan has coughing sound through the flight
I am doing the right thing to report myself to a airport medic now
I will do a test of #COVIDー19
2/ taken to a room for temperature test no fever
went through a question list 4 symptom history，if i met anyone from high risk country China italy
i told them i was in Prague 4 film festival & met many people around world.
but seems they are about letting me go.
3/ airport medicals are calling authority to ask about my measurement，go home or stay for test maybe…
seems phones got difficulty to go through…
personally i wish to stay and have test asap.
but i need to respect their decision.
#COVID2019
Read 33 tweets
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Chicago Community Bond Fund
@ChiBondFund
This is a thread about why it is absolutely essential that we get people out of jails, prisons, & immigration detention during the #COVIDー19 pandemic. It will include information & demands for how to #StopCOVID19inJails .

The health of people inside & all of us depends on it.
This piece by @premaldharia explains how #COVIDー19 could spark a humanitarian crisis inside prisons and jails. slate.com/news-and-polit… #StopCOVID19inJails
Jails and prisons are the perfect incubators for #COVIDー19. Health care in these facilities is often abysmal. This article from @nhbaptiste explains what jails and prisons should be doing to improve access to healthcare. motherjones.com/politics/2020/… #StopCOVID19inJails
Read 34 tweets
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euzkera ❌
@euzkera
141. A la hora del montoneo fashionista jashtaguero, resulta que todos son fulanita o fulanito; hasta el perro son. Pero cuando toca revisar el nivel de responsabilidad personal en el crimen de la #PederastiaEclesiástica, no hay quien se apunte con el #TodosSomosCómplices
142. aciprensa.com/noticias/papa-…

⬇️
143. #Bergoglio da consejos de qué hacer con un hijo homosexual; sin embargo este "Padre espiritual" está atiborrado de hijos espirituales homosexuales -curas-, a los que les solapa sus abusos en contra de seminaristas:

Todo está claro en el enlace del tuit 135 de este hilo.
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