Those Nerdy Girls Profile picture
Jun 3, 2020 10 tweets 5 min read Read on X
1/ Q. I hear that communities of color are experiencing more severe illness and death from #Covid_19. How does the healthcare system contribute to worse outcomes?

A. One way to think about the #healthcare system is "links in a chain."
2/ Researchers have used a framework like this (“cascades of care”) to improve clinical outcomes for other diseases.

The following are a few of the links in the chain of care for #COVID, which can shed light on weaknesses that put communities of color at greater risk
3/ HEALTH INSURANCE: Even before the pandemic, Blacks and Latinos were more likely to have inadequate #health #insurance (or none at all). When the #pandemic came along, millions lost their jobs—and, along with that, their health insurance. (pewsocialtrends.org/2020/04/21/abo…).
4/ Without insurance, families often put off seeking care, so that when they do show up, their disease is so far advanced that treatment is less effective.
5/ TESTING: In many cities, predominantly Black and Latino neighborhoods have fewer testing sites (npr.org/sections/healt…) Many states also require a referral from a doctor to get tested. This further limits access for individuals that don’t have a regular care provider.
6/ ACCESS TO CARE FACILITIES: Access to ambulatory care and pharmacies is more limited Black and Latino neighborhoods (jamanetwork.com/journals/jaman…). People of color are also less likely to have a usual place of care or regular provider, which leads to more delays in seeking care.
7/ TREATMENT: Once in care, communities of color face a myriad of other challenges to quality of care and treatment. For example, implicit prejudices of healthcare professionals are proven to impact patient-provider interactions and treatment decisions (pubmed.ncbi.nlm.nih.gov/26469668/).
8/ In emergencies when seconds count, language issues have also led to delays in administration of care: propublica.org/article/hospit…
9/ A “cascades of care” approach can be a useful tool to visualize the gaps along the healthcare chain that contribute to more severe illness and death from #Covid_19 in communities of color. However...
10/ It’s also important to stay mindful that healthcare is just ONE component of a broader array of social factors that place Blacks and Latinos at higher risk of death from #COVID19 and other diseases.

#BlackLivesMattter #FactsMatter #healthy

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More from @DearPandemic

Dec 22, 2022
How can I stay safe during the holidays?

➡️Think in terms of harm reduction. Don’t let the perfect be the enemy of the good.

dearpandemic.org/safe-holidays/

#covid #rsv #flu #HolidaysAreComing

1/
2/ Just in time for Christmas, #COVID is again on the rise.

#Flu and #RSV may be peaking—but remember that there are often as many cases *after* a peak as before it.

dearpandemic.org/are-cases-peak…
3/ How can we enjoy moments w/ family & friends & lower the risk of illness?

💥 Small steps you take to reduce risk are worthwhile. A little bit better…is a little bit better.

Prevention steps that work for COVID will reduce the risk of RSV, flu, & many other nasty viruses.
Read 14 tweets
May 4, 2022
1/ Q: Has almost everyone been infected with COVID by now?
A: Recent estimates suggest around 58% of the population in the US and over 70% in England have been previously infected, with BIG increases during the Omicron wave.

dearpandemic.org/numbers-infect…
2/ A recent @CDCgov MMWR report estimated seroprevalence from a convenience sample of blood collected for medical tests.

➡️Roughly 58% of Americans showed evidence of previous SARS-CoV-2 infection in their blood by Feb '22.

cdc.gov/mmwr/volumes/7…? Image
3/ ➡️ During the Omicron wave from December 2021-February 2022, this estimate increased from 33% to 58%.
➡️ Rates vary a lot by age, ranging from 33.2% for those over age 65 to 75% for those under age 18.

cdc.gov/mmwr/volumes/7… Image
Read 15 tweets
Apr 29, 2022
1/Q: Did getting exposed to fewer germs for the last 2 years weaken our immune systems?

We've been hearing this question a lot.
dearpandemic.org/fewer-germ-exp…
2/ Not likely. If your kids are suddenly getting sick a lot, this is likely due to “catching up” on exposures rather than a weakened immune system.
3/ Many families w/ young kids have been hunkered down for the better part of 2 years– a good % of a young child’s entire life. While isolation had *many* downsides, we can agree that not having to suction snot out of infant noses or clean up norovirus puke was a happy upside.
Read 18 tweets
Jan 27, 2022
1/ Q: Are cases peaking? That means it’s all downhill from here, right?

A: Sort of…. Remember that even if cases come down as quickly as they rise, there will be as many cases *after* the peak as before (think area under the curve).

dearpandemic.org/are-cases-peak…
2/ ➡️ And if the downward slope is *slower* than the rise, we will see *more* cases during the decline from a surge.
3/ Burning fast could be a silver lining of super transmissible #Omicron. Cases rose & fell quickly in S. Africa (w/ hospitalizations & deaths still lagging). The UK appears to have turned the Omicron corner. Many US states appear past their peak in cases, w/ regional variation:
Read 17 tweets
Dec 30, 2021
1/ Q: Case numbers are jumping QUICK! What should I be doing?

A: Share your gifts without sharing COVID. Helpful gestures come in many shapes.

dearpandemic.org/what-should-i-…

#Omicron #ThoseNerdyGirls
2/ One HUGE help: Cancel non-essential plans.

Unfortunately, this includes New Year’s Eve plans. The perfect storm of a new variant & holiday get-togethers is hitting communities & health care w/ FORCE! Testing is in short supply.
3/ Health care is under extreme pressure with surging cases. If you can avoid even one additional contact, you are helping. This is a temporary and urgent request (from a health care provider).

#MedTwitter #HCWs @IMPACT4HC
Read 10 tweets
Dec 21, 2021
1/ Q: Is it true that #Omicron is less severe than previous variants?

A: We HOPE so, but we don’t know yet. The evidence so far is mixed.

dearpandemic.org/is-omicron-les…
2/ We are WAY past due for some good variant news. But pinning our #Omicron hopes on a less virulent variant is not wise for 2 reasons:

1) It might not be less severe in those who are “immune naïve” (neither vaccinated nor with a previous infection—still millions of people).
3/ 2) Many more infections *even* if less severe can still lead to an avalanche of hospitalizations and deaths, and the risk of long Covid.

@AdamJKucharski raised this last December w/ the rise of Alpha:
Read 25 tweets

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