A *beautiful* explanation of the usual course of #COVID19, and why the timing of DJT's positive test matters from @ariabendix @businessinsider

And of course, the White House still refuses to tell us the timeline of testing. This matters for #publichealth and for public confidence.

To me, the continued lack of truthfulness implies they either don't trust or don't respect the American people.

And the continued purposeful ignoring of basic infection control procedures - including reports that DJT has been *in the Oval Office* *with other staff* despite being only 1 week s/p reported + test - is just infuriating.
Nb: His +IgG is almost certainly bc he received exogenous antibodies, not because of his own immune response

And *this* is why this pandemic continues to spread.

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More from @meganranney

10 Oct
I am leaving the ER right now and reading @edyong209's newest masterful piece on #covid19 for the second time.

I have to say - tonight, this piece is everything.
Because ---

My patients with #COVID19 are still afraid. They may be "strong", but they are scared. With good reason.

And so are we, the healthcare providers: bc PPE & testing are still in short supply, yet the 2nd wave is here.

And the rhetoric makes us feel like failures Image
So this piece!!!

It reinforces that REAL strength is so very far apart from the toxic salespitch of Trump & co.

He suggests that the strongest amongst us are not those who boast the most. It is those of us who can hold space for uncertainty, and then move forward.
Read 8 tweets
9 Oct
Appreciating the challenge from @lindaginzel during @WIMSummit to write down our own, personal definition of #leadership.

Great leadership is listening, empowering, and bringing what is possible to life. It requires stewardship of resources, development of vision, empathetic candor, & impeccable vulnerability.
It can occur at any level of an organization or a hierarchy. At any age. At any title.

It just requires being present, being honest, and creating space.

It requires championship for what is right, and what is better.

It requires elevating others.
Read 6 tweets
7 Oct
This piece @_HarryPaul_ is a must-read. As we obsess over #TrumpCOVID, it would do us well to take a step back:
"The importance of protecting those with hidden disabilities, such as my restrictive lung disease, who are similarly vulnerable to poor outcomes from #Covid19 get lost"
He warns, re #LongCOVID: "individuals will face additional barriers as they seek accommodation in work, school, and their social lives"

[[editorial NB by me: This will be worse if the #ACA is repealed]]
Additionally, he cautions "Clinicians are not usually accustomed to talking about states of disability for which there is no clear biomedical explanation or treatment plan."

[[editorial NB by me: Esp for women & minorities]]
Read 4 tweets
5 Oct
I've now watched it x2.
What we know from today's press conference on #TrumpCovid:
- Trump is going back to the White House
- The WH has high-quality care, perhaps as good as at some hospitals [but then why was he ever at Walter Reed?]
- He is still on dexamethasone & remdisivir
What we can deduce:
- His kidney function was not good at one point ("he was dehydrated")
- His lung function is impaired (no answers re CXR/CT scan; received dex; & many of us have seen the "happy hypoxia" of severe #COVID19)
What is mystifying:
- Why they won't tell us the date of the last negative test
- Whether he will actually isolate
- Why he would insist this is no big deal, when it has killed 209,000 Americans & required him to be in the hospital for 3 days
Read 4 tweets
3 Oct
I said to @AnaCabrera and @yasminv today that we all suspected, based on the press conference, that Trump had received oxygen.

It has now been confirmed by @nytimes as well as @AP.

It's time to get real:

Based on data from clinical trials in the UK, this suggests that he has about a 23-26% mortality risk, depending on whether he received dexamethasone.
And based on my clinical experience, I and many other physicians across the country are quite concerned.

(Caveat: we haven't examined him. We have however seen lots and lots of patients like him.)
Read 6 tweets
3 Oct
Watching the press conference on #TrumpCovid.

That he is not on oxygen is a good sign. They will not answer whether he was on O2 yesterday.

The use of remdesivir this early is unusual, but - he is the president.

"Cautiously optimistic".
They admit that he is getting treatments earlier than others get it.

This is the truth of our broken healthcare system: there are special treatments for special people. (Nb, VIP treatment doesn't always help.)
Lots of refusal to answer specifics about tests, fever, and oxygen levels.
Read 7 tweets

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