And it's time for the Tony Fauci live stream, now starting at 7 AM!
If you're not on yet, here is the link! bit.ly/3bzPjOZ
If you're not on yet, here is the link! bit.ly/3bzPjOZ
2/ "This is not our first experience with coronaviruses"
The four listed coronaviruses are responsible for 15-20% of all common colds. #HMGR
The four listed coronaviruses are responsible for 15-20% of all common colds. #HMGR
4/ "It is very likely that the four circulating coronaviruses very likely were once pandemics"
WHAT?!
#HMGR
WHAT?!
#HMGR
5/ Over 900,000 deaths ... and the USA in the worst hit country in the world. Over 190,000 deaths in the US alone #HMGR
6/ "This is a very telling slide"
Dr. Fauci goes over the failure of the United States to control our outbreak compared to the EU. The peaks were initially similar, but the US has a "disturbingly high" baseline.
#HMGR
Dr. Fauci goes over the failure of the United States to control our outbreak compared to the EU. The peaks were initially similar, but the US has a "disturbingly high" baseline.
#HMGR
7/ "An extraordinary unacceptable baseline"
How well did we will shut down? Both in looking at parks and workspaces, you can see that our shut down was far less complete.
#HMGR
How well did we will shut down? Both in looking at parks and workspaces, you can see that our shut down was far less complete.
#HMGR
8/ Now going over the virology. The spike protein likely explains the many "protean manifestations of the disease."
#HMGR
#HMGR
12/ There are far more super spreader events than super spreader people -- it's the circumstances, not the individuals
#HMGR
#HMGR
14/
The good news is that personal protective equipment, physical distancing, and public health interventions actually make a difference -- and already have prevented a substantial increase in new cases
#HMGR
The good news is that personal protective equipment, physical distancing, and public health interventions actually make a difference -- and already have prevented a substantial increase in new cases
#HMGR
15/
Loss of smell and taste is very common and precedes the onset of respiratory symptoms.
There's an extraordinary range of disease severity. 15-20% have severe disease, with case-fatality rate ranging a lot. If you're ventilated, CFR ~20%
#HMGR
Loss of smell and taste is very common and precedes the onset of respiratory symptoms.
There's an extraordinary range of disease severity. 15-20% have severe disease, with case-fatality rate ranging a lot. If you're ventilated, CFR ~20%
#HMGR
16/
Older adults and those with chronic medical conditions are most at risk of severe disease.
#HMGR
Older adults and those with chronic medical conditions are most at risk of severe disease.
#HMGR
19/
Why just protecting people in nursing homes won't help -- these risk factors are present THROUGHOUT the population.
#HMGR
Why just protecting people in nursing homes won't help -- these risk factors are present THROUGHOUT the population.
#HMGR
21/
Dr. Fauci going over the various types of diagnostic tests, including the new Abbott 15-minute test
#HMGR
Dr. Fauci going over the various types of diagnostic tests, including the new Abbott 15-minute test
#HMGR
22/
Two recommended therapies for COVID-19 -- remdesivir and dexamethasone, shown by RCTs to be effective.
What about convalescent plasma? "There's still a lot of questions about that"
#HMGR
Two recommended therapies for COVID-19 -- remdesivir and dexamethasone, shown by RCTs to be effective.
What about convalescent plasma? "There's still a lot of questions about that"
#HMGR
24/ "With vaccines you never say never and you never say always" but Dr. Fauci is cautiously optimistic that we will have vaccine(s) by the end of the year
#HMGR
#HMGR
26/
And a final slide going over what lessons we have learned from COVID-19 -- and what we can do for future epidemics.
#HMGR
And a final slide going over what lessons we have learned from COVID-19 -- and what we can do for future epidemics.
#HMGR
And now it's time for the questions and answers! #HMGR
27/
A question from the @BIDMC_IM MICU! Does the burden of the exposure contribute to severity of disease? #HMGR
A question from the @BIDMC_IM MICU! Does the burden of the exposure contribute to severity of disease? #HMGR
28/ "Humbling working in this field how much we don't know"
Innoculum might play a role, but he doesn't think it's the case. Might be genetic factors we haven't realized.
The thing that puzzles him is, is it all immunologic that makes a person asymptomatic? Can't believe that
Innoculum might play a role, but he doesn't think it's the case. Might be genetic factors we haven't realized.
The thing that puzzles him is, is it all immunologic that makes a person asymptomatic? Can't believe that
29/
Relative expression of ACE-2 receptors? "Somehow I've got to believe" that this plays a role.
"Whenever I wave my hands more than I want to, I realize I don't have a good idea"
#HMGR
Relative expression of ACE-2 receptors? "Somehow I've got to believe" that this plays a role.
"Whenever I wave my hands more than I want to, I realize I don't have a good idea"
#HMGR
30 /
"Uncertainty is the major theme"
Should we expect a worse influenza season, or will it be better because of hygiene?
Why should we think there would be a second wave?
#HMGR
"Uncertainty is the major theme"
Should we expect a worse influenza season, or will it be better because of hygiene?
Why should we think there would be a second wave?
#HMGR
31/ "I keep looking at that curve and get more depressed that we never get to the baseline. I don't talk about second surges because we never got to the end of the first surge."
#HMGR
#HMGR
32/
"As we get into the fall and do more indoor things, we are going to see upticks in COVID-19."
"As we get into the fall and do more indoor things, we are going to see upticks in COVID-19."
33/
Looking at the Australian example re: influenza - the lightest influenza season in history, because they are physically distancing, washing hands, wearing masks.
"I would hope this... prevents us from having a bad influenza season." #HMGR
Looking at the Australian example re: influenza - the lightest influenza season in history, because they are physically distancing, washing hands, wearing masks.
"I would hope this... prevents us from having a bad influenza season." #HMGR
34/
"I hope common sense things will keep us safe until we get a vaccine at the beginning of 2021. We need to hunker down and keep us safe for the rest of the year"
#HMGR
"I hope common sense things will keep us safe until we get a vaccine at the beginning of 2021. We need to hunker down and keep us safe for the rest of the year"
#HMGR
35/
"It's whack-a-mole!" Every time restrictions are lifted, it flares in other states.
Now the big worry is two-to-three weeks with the Labor Day holiday.
#HMGR
"It's whack-a-mole!" Every time restrictions are lifted, it flares in other states.
Now the big worry is two-to-three weeks with the Labor Day holiday.
#HMGR
37/ Two big issues w/ health system and #vaccines:
1. Vaccine confidence -- esp in communities that haven't been treated well well with prior vaccine in past & unfortunately highest risk
"We haven't been doing well w/ getting those populations even into vaccine trials"
#HMGR
1. Vaccine confidence -- esp in communities that haven't been treated well well with prior vaccine in past & unfortunately highest risk
"We haven't been doing well w/ getting those populations even into vaccine trials"
#HMGR
38/
2. Logistics - with MULTIPLE vaccines, we have to track that the 2nd type of vaccine a patient gets is SAME as 1st vaccine
but will be hard with #EMRs that don't communicate & fragmented health systems!
#HMGR
2. Logistics - with MULTIPLE vaccines, we have to track that the 2nd type of vaccine a patient gets is SAME as 1st vaccine
but will be hard with #EMRs that don't communicate & fragmented health systems!
#HMGR
39/ What lessons will we take away in yrs? Panelist:
1. Continue to rely on basic principles we know about disease transmission
2. Humility: What we think is true today might not be true tmrw
3. Hope we look back and see this was how we changed the way approach #SDOH
#HMGR
1. Continue to rely on basic principles we know about disease transmission
2. Humility: What we think is true today might not be true tmrw
3. Hope we look back and see this was how we changed the way approach #SDOH
#HMGR
40/ Fauci:
We should always do ethically sound, controlled trials during the outbreak!
Be #flexible as data evolves. If see what we knew in Feb vs. now: role of mask, aersol, indoor vs. outdoor
If ever have to make a commitment to address #SDOH, its gonna be now!
#HMGR
We should always do ethically sound, controlled trials during the outbreak!
Be #flexible as data evolves. If see what we knew in Feb vs. now: role of mask, aersol, indoor vs. outdoor
If ever have to make a commitment to address #SDOH, its gonna be now!
#HMGR
41/ Sincere THANK YOU to Dr. Fauci and panelist with over 6,000 (!) people that live streamed this morning
We will be back live tweeting #HMGR on Oct 15th!
We will be back live tweeting #HMGR on Oct 15th!
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