If we knew who is transmitting, and who’s not, we would have stopped COVID a long time ago with preventive measures.
COVID is a pandemic precisely because most people who get it are asymptomatic and transmission occurs silently. Now we have new data on viral shedding. See below
The other study is from Iquitos, Peru which was badly affected by COVID. Even assuming some confirmed cases had COVID, the vast majority were likely asymptomatic: 71% seroprevalence.
This is why a lot us started calling for universal masking for everyone, with or without symptoms, in late March— before the national task force, CDC, or WHO recommended it.
This is why we have to be careful with lots of people in indoor places especially when daily new cases are high: It’s impossible to know who has COVID by looking at them. Leaders have to take this into consideration whether it’s with regards to closing bars, or opening schools.
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1) @costplusdrugs — where you can get >2000 prescription meds at lower price than almost any other pharmacy in America. Has revolutionized the generic prescription drug market. @mcuban costplusdrugs.com
2) @PayorDieFilm — the story of lives lost due to the high price of insulin in America. Likely contributed to why all 3 big insulin manufacturers have now cut the price of insulin by >70-80%. @scottaruderman @NSmithholt12
Watch on @paramountplus @mtvdocs
3) Inflation Reduction Act provisions to cap Medicare Part D copays.
For 2024, the out of pocket max for Part D drugs that a patient pays in copays is capped to a max of ~$3250. A huge relief to many.
Two days ago I did 60 ABIM MOC questions in Heme and Onc (against my will).
Almost all were esoteric/ irrelevant questions. Rare things that doctors rarely see. #MedTwitter
What’s my opinion?
1/
I spend a lot of time in medical teaching and writing. I write for UpToDate for 20 years, and all of the major Hem Onc textbooks.
In my opinion, the MOC questions are useless for routine Hem Onc clinical practice. Useless to assess “walking/ essential knowledge”.
2/
What’s worse: Every 3 or 4 questions that I spent time and answered, I would get a note that it was a “test question”. No answer was given at the end, making it a complete waste of time and making me an unwilling partner to test questions for the ABIM. @DavidSteensma
3/
Top 10 reasons why ABIM MOC should be abolished. #MedTwitter
10. It’s a bad life experience that physicians almost unanimously don’t like.
9. The questions asked in the MOC LKA or MOC exam are not what we face in practice. They are often vague zebras or designed to trip people up. (Experts get questions in their own field wrong)
8. MOC depresses morale. When you take a profession where people are committed to life long learning, do plenty of hours of CME each year, and force them to a multiple choice test every 3 months: You know what it does to morale.
1. Dex: 40 mg once a week age <70; 20 mg if age >70 or frail
Stop Dex at around one year if good response.
Days 1-4, 8, 15, 22 schedule for 1st cycle only in cast nephropathy; or VDT-PACE type regimen
Velcade:
Once a week and SQ is my default.
Twice a week for 1st cycle only in acute in cast nephropathy, or with VDT-PACE type regimen
Revlimid:
25 mg standard. But reduce starting dose to 10-15 mg for the following groups: elderly, frail, patients with body weight less than 60kg, renal failure, and patients of Asian or South Asian descent.