Meanwhile, our understanding of how this virus spreads has developed.
We now agree that droplets (I won't get into semantics--the point is, not primarily surfaces) likely accounts for a far greater fraction of spread than initially thought.
The second day I knew we were in big, big trouble was when I realized that MASKS--simple masks--were being help up as something to resist (!)
There is something deeply wrong with our society if people see wearing a piece of cloth for a few months when indoors as "tyranny."
That leads us back to the current situation.
The President of the United States has SARS-CoV-2.
This man refused to wear a mask.
That choice has caused many deaths in others.
He hoped that marketing ploys like hydroxychloroquine would make it all go away.
He marginalized true experts like Dr. Anthony Fauci, and brought in people way out of their league and element like Scott Atlas.
(There's no better microcosm for our failures than that; Fauci does not speak at press briefings, but Adams does? This is, on its face, insane).
The President was deadly wrong on these choices.
But most prominently, masks.
I'll never understand why he didn't decide to "make masks great," or whatever marketing ploy he could use.
I sincerely hope he does not pay for this choice with his own life.
No one wants that.
Today is day 0.
Let's start over.
Masks.
Hygiene.
No indoor restaurant dining (Outdoor dining likely is okay. Invest in heat lamps!)
Prioritize school for kids 5-17 over every other thing in society. The lower the cases, the more in-person school, the better for all!
Finally, no more false idols.
No unproven drugs which never had a chance , like hydroxychloroquine.
No convalescent plasma until there's a proven benefit that absolutely shows it saves more than the 1 in 1250 it kills.
Vaccines when they are proven SAFE AND EFFECTIVE.
For more on why we failed to contain COVID-19, read what @nowroozpoor@choo_ek and I wrote this summer.
I’m pleased to share my Commentary on the newly published *positive trial* finding metformin decreased Long Covid (Dr. Carolyn Bramante + @boulware_dr)!
“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…
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...
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/