Unfortunately, I have come to the conclusion that I need to resume publishing weekly excess mortality reports for Massachusetts.

I‘ve been monitoring this all summer but stopped publishing when we had many weeks without excess deaths.

Today, I see signs that our streak ended.
In addition, I should add that I believe our relatively long shelter in place and phased re-opening meant that we could see this coming.

Cases were <200 per day for a while.

Now we see that doubled.
The point of reopening when cases are low is to be willing to make behavioral modifications (partial shutdown/restrictions) in MOMENTS LIKE THIS.

@MassGovernor.
We need to ban indoor dining immediately.

We need some other restrictions as well for a few weeks.

If we don’t, our R could skyrocket and a full shutdown may become necessary.

That would be bad.

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More from @jeremyfaust

Jun 8, 2023
I’m pleased to share my Commentary on the newly published *positive trial* finding metformin decreased Long Covid (Dr. Carolyn Bramante + ⁦@boulware_dr⁩)!

The therapeutic validation of long COVID. Lancet Infectious Diseases ⁦@TheLancetInfDisthelancet.com/journals/lanin…
“First, to our knowledge, this is the first high-quality evidence from a randomised controlled trial to show that the incidence of long COVID can be reduced by a medical intervention, metformin—an inexpensive treatment with which clinicians have ample experience…
“Second, the authors have, perhaps inadvertently, made an important contribution to medical epistemology…
Read 6 tweets
Jun 7, 2023
Quick poll.

Stop what you’re doing.

Put your hands in your lap.

Don’t move for 5 seconds.

Can you feel your hands or fingers tingling?

Even a tiny bit?
If you answered yes, were you aware of this before?
Thank you!
Read 5 tweets
Dec 22, 2022
Breaking: Covid-19 antiviral Molnupiravir not effective in preventing hospitalization and death among vaccinated patients with high risks.

It did shorten recovery time...

But that's not even the most interesting part...

open.substack.com/pub/insidemedi…
This is the first randomized controlled human trial that has studied Covid-19 outcomes among *only vaccinated* people that we’ve ever seen.

That’s an absolutely astonishing fact, if you think about it.

(Assuming I am correct here. Am I wrong?)
This gives us an unusual chance to look at all-cause mortality and all-cause hospitalization among infected vaccinated people during the Omicron era...

And to compare that the pre-Omicron and pre-vaccine era...
Read 14 tweets
Sep 12, 2022
The asymmetry of anecdote.

If you aren’t seeing a disease whose true prevalence is ~1% of the population and has a 10 day course, consider the fact that if you see 20 patients in a day, your odds that none will have it is about 82%.

And yet 3m Americans would have it.

1/
This means that your small sample size is fooling your “I can’t think beyond what I can see” big brain energy.

Proceed with caution before making any declarations.

It’s to notice and even share it. It is not okay to tell people “it’s over.”

However… 2/
However, if, say, 2 or 3 of your patients (out of 20) are positive 10%-15% of your patients!) and that happens to you more than once this week, the asymmetry of anecdote becomes important.

Your anecdotal experience could have at least 3 possible meanings.

3/
Read 5 tweets
Apr 28, 2022
Moderna files for emergency use for its Covid vaccine for children 6 months to 6 years.

They are saying 51% effective against symptomatic Covid for ages 6 months to 2 years and 37% for ages 2 to 6.

Sounds mediocre but here's why it may be MUCH better than that....
🧵
The data reflect a lot of cases during Omicron.

We know these vaccines provide very good short-term protection against infection, but that's a honeymoon phase.

That's important. But the way these vaccines were designed, and how they work best, is not really about infection...
What these vaccines have been shown to really do, over and over, is protect against severe disease and hospitalization, longterm consequences.

A pediatric trial can't be large enough to detect that. But the "immune bridge" strategy used both by Moderna and Pfizer has worked...
Read 11 tweets
Nov 22, 2021
Our new paper on deaths among adults ages 25-44 in Texas is out.

I want to highlight some key findings...
🧵

Causes of Death Among Young Adults by Race and Ethnicity in Texas During the COVID-19 Pandemic, 2020 ja.ma/3CChpFb via @JAMAInternalMed part of @JAMANetwork
Among Texas adults ages 25-44:
1. Covid-19 was the leading cause of death in July and December of 2020.

2. Covid-19 was the 2nd leading cause from the start of the outbreak thru December 2020.

3. Covid-19 was *by far* the leading cause of death among Hispanic residents.
4. Covid-19 was the leading causer of deaths among Black residents for July, and 2nd in December.

That level of data is more clearly shown (link): insidemedicine.bulletin.com/15084746495095…

5. Covid-19 broke into the top 5 leading causes of death among White residents just once (#5 in December).
Read 12 tweets

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