Thread by @lstrnad5

(1/x) Day 7: Pinch hitting for @BonuraErin on this tweetatorial for the #COVID intercession she masterfully designed! On 5/6, we had me discussing the international pandemic responses (2-9) & Dr. Kelsey Priest (@kelseycpriest) talking #syndemics Re addiction dz & COVID19 (10-18).

(2/x) Session 7.1 (Strnad): COVID - Comparing the World’s Responses: We attempted to discuss this topic w/ language highlighting the ways that understandable and changeable actions that countries, businesses, & people perform have influenced different national stories of COVID.

(3/x) Comparing data like national deaths, or even national deaths/per capita can be misleading during a pandemic that is influencing different countries at different times. When did #COVID really hit the countries? Where are you in the epidemiological curve? Eg)

(4/x) In pandemic science, in a world that is always political, with leaders who are going to various lengths of incredulity to make their response to the pandemic seem appropriate, one has to be skeptical about a country leader’s own evaluation of their work. Eg)

(5/x) Meaningful cross-country comparisons are difficult without a “baseline”, particularly as politics influence reporting. But since all of this is inherently political, there is a strong argument that we have engage to understand what is happening, has happened, & will happen.

(6/x) COVID Testing: We see that countries that tested aggressively early, not just who tested a lot eventually, are actually the ones winning at testing. One potentially useful marker is how many tests are done per positive case (you should have lots!).

(7/x) One way to try to understand what responses are working, or which countries are “succeeding”, is to compare similarish countries with different tactics, or countries with similar political structures but different healthcare systems… #Sweden will be provocative over time!!

(8/x) The African countries have a unique set of challenges & limitations created by history, colonialism, & inequitable worldwide distribution of resources. We may never know the true COVID toll… But some countries are showing aggressive responses anyway.

(9/x) While we may never fully understand all of what worked & what didn’t in the COVID response, there are provocative themes emerging around the nature of a country’s leadership structure & the effectiveness of it’s response… #Autocracy #WomenInLeadership

(10/x) Session 7.2 (Priest): A #Syndemic - The Drug-related #Overdose Crisis & #COVID19: Dr. Priest masterfully outlined how the COVID pandemic + #opioid, #amphetamine epidemics, & USA drug policy responses have all the makings of a syndemic.
@drdrtsai @DavidBangsberg

(11/x) First off, overdose deaths are growing much faster in the Black, Hispanic, & First People communities than in the White community where they have started to decline. What current pandemic dz also has different epidemiological curves by race/social class…?
#Racism #SES

(12/x) As #COVID ravages inner cities, SE USA, & Navajo reservations, similar vulnerabilities impacting the spread of the virus also impact addiction medicine care.
@DrIbram @AdamSerwer

theatlantic.com/ideas/archive/…

(13/x) Dr. Priest walked us through how profoundly the viewing of #addiction through the prisms of class and race have created drug policy that is non-sensical if one were trying to design it for the public good of ALL the country’s people.

(14/x) The baseline vulnerabilities of those populations hit the hardest by addiction are formed by the same factors that outline many of the baseline vulnerabilities to COVID… & their addiction may increase the COVID ones, & their COVID may increase their addiction ones...

(15/x) What is being done to address the increased risks of the syndemic? Better access to #OpioidReplacementTherapy (OAT) is clearly needed to lower the risk that pursuing addiction treatment is a coronavirus life sentence, given risks of daily congregate OAT-related visits.

(16/x) Some regulatory responses have helped ease the burden of OAT prescribing & acquisition. One could editorialize & wonder why it took a pandemic… if you want more on this evolving topic, type Kelsey Priest into PubMed (she seemingly publishes a new piece weekly).

(17/x) Massive needs & opportunities for treatment policy reform remain in the USA: @Health_Affairs
healthaffairs.org/do/10.1377/hbl…

(18/x) Many of us are overwhelmed by #addiction, #COVID19, & especially the #syndemic… What can you do today? Do, in addition to telling the truth to “bring justice to the vulnerable, to protect people from further harm.” @sarahkendzior

(19/x) Communal well-being, searingly outlined in this piece by Dr. Kendi, has in the USA (& in the larger league of nations), whether for #addiction or #covid, been guided by “a civil war over the very meaning... of freedom.”

theatlantic.com/ideas/archive/…

(20/x) An ending charge to: “be here dedicated to the great task remaining before us… that we here highly resolve that these dead shall not have died in vain -- that this nation shall have a new birth of freedom… and not perish.” Abraham Lincoln (Gettysburg, PA, Nov 19, 1863)