Craig Spencer MD MPH Profile picture
Oct 3, 2020 7 tweets 2 min read Read on X
I’m getting a lot of questions about how fast COVID19 progresses:

I’ve seen 90 year olds test + and not have a sniffle for days.

I’ve seen 40 year olds come in stable and VERY rapidly decompensate.

There’s a lot of speculation right now. But the realm of possibilities IS vast.
I don’t know the specifics of the President’s case - but the American public should.

Maybe it’s all an abundance of caution? Or not.

Point being he could be stable. Or not. This virus is always fickle & sometimes ferocious.

I wish him a speedy recovery. And we need more info.
This timely transmission just in!

Reportedly not on supplemental oxygen.

Remdesivir started.

‘Doing very well’.
The initial FDA EUA in May limited remdesivir use to patients receiving supplemental oxygen.

This changed in the updated Aug 28 EUA: Remdesivir "may be effective for the treatment of suspected or laboratory-confirmed COVID-19 in all hospitalized adult and pediatric patients."
Again, I don't know that this tells us much.

It may be the kitchen-sink approach. Remdesivir isn't innocuous, but it's pretty well tolerated.

And every ER doc knows that VIPs don't always receive 'better care' - but they often get MORE care. More tests, more treatments.
If steroids are started in the coming days, that's an indication of more concerning moderate-severe illness.

Otherwise, it's still speculation until we have more details.

Let us wish him and everyone else struggling with this disease all over the world a peaceful rest tonight.

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More from @Craig_A_Spencer

Dec 22, 2024
It’s being reported that the Trump administration plans to withdraw from the World Health Organization on day one.

This is not a huge surprise.

But it IS an absolutely stupid and self-defeating move.

And I say this as a longtime critic of the WHO…🧵
The first time the Trump administration tried to withdraw from the WHO back in 2020, I wrote for @USATODAY what we needed to do was build up, not tear down, the WHO.

Despite its faults, the WHO plays a huge role as ‘our eyes and ears around the world.’

usatoday.com/story/opinion/…
There is no other organization with the relationships and buy-in to do the critical work needed to keep us ALL safe—including us here in the U.S.

The WHO also has critical partnerships & programs that we benefit from for vaccines and critical health data

who.int/initiatives/gl…
Read 6 tweets
Dec 19, 2024
Hey @elonmusk, that’s not ‘bioweapon labs’

I’m (unfortunately) very uniquely qualified to tell you why this is important. And why you’re very wrong here.

I assure you, with 100% certainty, that cutting this is pure stupidity

(Also, did you read a few more lines to Sec 2315c?)
For anyone paying attention (is anyone still actually even here??)…

THIS 👆👆👆 is exactly how overconfidence mixed with a stunning lack of expertise and stubborn unwillingness to listen to people who actually know what they’re talking about will directly put you at risk.
I could happily speak on the congressional floor for hours about why we need BSL-2, BSL-3 (and BSL-4) labs. So could a lot of really qualified folks, many way smarter than me.

We could also talk about what happens if we don’t have them, and how that puts us all at risk.
Read 6 tweets
Dec 6, 2024
"What's happening with this mystery illness in the Congo"

I've gotten this text dozens of times in the past few days.

Here's what we know. What we don't.

And what really matters 🧵 Image
Since the end of October, there have been just under 400 cases of an 'unidentified' illness in the Kwango Province of Southwest DR Congo.

And 79 reported deaths.

Symptoms include "fever, headache, coughing, breathing difficulty, and anemia".

Kids under 5 appear most affected. Image
Breathing difficulties and other signs suggest a respiratory disease and likely respiratory transmission.

Epidemiologists have been sent to the area.

Testing is in process, with results expected in the next few days.

BUT we don't know anything for certain...
Read 11 tweets
Nov 12, 2024
10 years ago today I walked out of the hospital after surviving Ebola.

Back then I begged the world to strengthen our response to that crisis and prepare for others.

I’ve been reflecting on what we’ve learned over the last decade.

And the role of the U.S. in global health🧵 Image
The international response to Ebola in 2014 was way too slow and weak.

Too many people died because we didn’t have the experience, coordination or willpower to address the crisis quickly and head on.

In the aftermath, we focused on lessons learned. We made changes.
We created new ways to fund outbreak response at the global level.

The Africa CDC was created to help the continent better prepare for and respond to disease threats.

And changes were made in U.S. government to allow better coordination among agencies.

africacdc.org/about-us/our-h…
Read 15 tweets
Sep 30, 2024
As news of the Marburg cases in Rwanda spreads, I want to share some thoughts on where the outbreak stands, what will likely come next, and why this outbreak may (hopefully) end up being unlike other viral hemorrhagic fever outbreaks in the past 🧵
For those just tuning in, Marburg is a viral hemorrhagic fever, very similar to Ebola.

This is the 18th Marburg outbreak since 1967.

Most outbreaks fizzle out fast. This one, despite being just announced days ago, is already among the largest.

Although the incubation period, symptoms, and spread are very similar to Ebola, there are some really important differences.

Most importantly, we have FDA/WHO approved vaccines and treatments for Ebola.

But we only have experimental therapeutics and vaccines for Marburg.

fda.gov/emergency-prep…
Read 15 tweets
May 22, 2024
I teach a class on the history of humanitarian response.

We talk about how a field full of dead soldiers in 1859 in Solferino led to the ICRC, Geneva Conventions, & international humanitarian law.

Every year, my students always ask “the ICC seems useless, why do we need it?” 🧵
In the aftermath of World War II, the Nuremberg Trials was the first international war crimes tribunal.

I think we can all agree that prosecuting those responsible for the atrocities of the Holocaust was an important endeavor.

There were calls for a more permanent tribunal…

cfr.org/backgrounder/r…
But the ICC wasn’t established until 2002.

In the last 22 years, it has indicted 40 people and convicted only 10.

Given that it seems like bad guys get away with doing bad things with impunity all the time, many will question the ICC’s role and impact.

icc-cpi.int/about/the-court
Read 13 tweets

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