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Andrew Junkin, MD

@Dr_Junkin_MD

Jul 14, 2020 • 5 tweets • 2 min read • Read on X

@MichelleObama

I’d like to use some #popculture to highlight a truly awful, but yet-unmeasured impact of the current #COVID19 pandemic in the U.S.: restrictions on visitors to hospitals.

I’m currently reading Becoming by @MichelleObama. It’s fantastic.

Finished chapter 10 and...

...I couldn’t help but think of the countless people who've been robbed of this type of moment in their own lives because of COVID-19’s effect on hospital visitor policies. Perhaps it is just another unquantifiable tragedy in the midst of many in this pandemic...

...but I think it’s worth highlighting that the human costs of COVID-19 have and will go far beyond the mortality statistics, lost QALYs, etc. COVID-19 will also leave scars on many who never directly encountered the virus.

Just imagine if chapters 9 & 10 of #BecomingMichelle...

...instead finished with, “and s/he went into the hospital. Visitors weren’t allowed at that time due to the pandemic, so we tried to talk to on the phone, but s/he was too sick to talk. S/he never made it home.”

It's a heartbreaking scenario to even contemplate...

...but it's happening all across our nation today because we have thus far failed to fully contain and control COVID-19.

We must work together to #beatCOVID19 so we can put an end this and all the other uncounted COVID collateral damage.

#HumanismInMedicine

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Andrew Junkin, MD

@Dr_Junkin_MD

Oct 3, 2020

Given recent events with #POTUS, there's a renewed interest in the typical clinical course of #COVID19.

Here is a quick refresher for all audiences:

1) Symptoms severe enough for patients to seek hospital care often don't occur until 5-7 days after symptom onset.

a med🧵
1/

Week 2 of #COVID19 symptoms is, on average, the "danger window" when some patients become abruptly and critically ill.

2/

Week 3 of #COVID19 symptom--for patients who have been hospitalized with moderate or severe symptoms--is typically when we see them turn the corner and start improving.

3/

Read 5 tweets

Andrew Junkin, MD

@Dr_Junkin_MD

Aug 10, 2020

@MACSports

Kudos to @MACSports for stepping up and postponing #CollegeFootball.

The fact is we still don’t know what the long-term complications of #COVID19 will be, so student athletes cannot yet make an informed choice on the risks and benefits of playing.

(thread)
1/3

We know that if the Big 5 conferences decide to go ahead with football this fall, despite the unknown (but potentially serious!) risks to the athletes, many athletes will have circumstances that, rightly or wrongly, compel them to participate.

2/3

@theACC

No scholarship is worth permanent disability from, say, cardiomyopathy from #COVID19.

@theACC @SEC @Big12Conference @bigten @pac12 ought to follow the lead of @MACSports and postpone football until player safety [from COVID and its long-term complications] can be assured.

3/3

Read 4 tweets

Andrew Junkin, MD

@Dr_Junkin_MD

Jun 29, 2020

@statnews

Great opinion piece in @statnews co-authored by my colleague @Ateevm re: why #telemedicine is already losing it's precarious foothold in the U.S. healthcare system. Below is a summary of their line of reasoning in 3 tweets 🧵💡

statnews.com/2020/06/25/tel…

1) In any business, uncertainty in future conditions dampens interest in investing resources 💰 to establish a new, long-term capability.

2) Most US healthcare organizations are run as businesses that have limited resources and must make a profit to survive.

3) TEMPORARY regulations ⬆️⬆️uncertainty.

4) Regulations re: telehealth payments 💸 in the #COVID19 pandemic have been explicitly TEMPORARY.⏱️

5) As such, it would be misguided to expect US healthcare organizations to invest the significant resources 💰necessary to establish...

Read 4 tweets

Andrew Junkin, MD

@Dr_Junkin_MD

May 24, 2020

@CDCMMWR

How COVID-19 spread like wildfire 🔥 via a series of well-attended indoor church events in a town in rural Arkansas.

A #MedTwitter summary of this paper in 7 tweets:

James A, Eagle L, Phillips C, et al. in @CDCMMWR
DOI: dx.doi.org/10.15585/mmwr.…

🧵(thread)

1/
2 persons attended church events while symptomatic on March 6-8 and later tested (+) for COVID-19 (primary cases).

The church pastor and his wife also attended these events and became ill ~4 days later (Mar 10-11) (index cases).

2/
The church was closed on Mar 12, but prior to that 92 people had attended church events from Mar 6-11.

Of those 92 people, 35* (38%) tested (+) for COVID-19.

Notably, this was 35 of the 45 people tested, representing a 77.7% positive test rate (!!)

Read 9 tweets

Andrew Junkin, MD

@Dr_Junkin_MD

May 17, 2020

A lot of people have been asking: “Should I be wearing a surgical #mask?”

Q: While running?
A: No. Use a cloth face cover, NOT a surgical mask.

Q: While going on a walk?
A: No. Use a cloth face cover, NOT a surgical mask.

Read 5 tweets

Andrew Junkin, MD

@Dr_Junkin_MD

Apr 18, 2020

@CDCgov

1/
Is my hospital workstation contaminated with SARS-CoV-2?

Here’s: #HowIreadThisPaper from @CDCgov's J of Emerging Inf Diseases on aerosol and surface distribution of the virus that causes COVID-19 in a hospital in Wuhan, China.

wwwnc.cdc.gov/eid/article/26…

#Tweetorial 🧵

2/
Study goal: systematically assess contamination of hospital environment w/ SARS-CoV-2. Areas studied were a COVID+ ICU and an isolation general ward (“GW”). Authors stated the ICU had 15 pts w/ “severe” dz, and GW had 24 pts w/ “milder” dz. No mention of mechanical ventilation

3/
SETTING

🔦HIGHLIGHT #1: the layout of their COVID+ care units is pictured here. Does this look like your hospital’s COVID+ units?
I suspect the answer is a strong no. Take a look. This will be important in applying any of their results to your own hospital.

Read 26 tweets

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