Slowly some CDC scientists and others are now coming out on the failures of the agency. It’s a little too late. We have lost >217,000 lives. Many of us called this out months ago. That’s when we needed scientists to speak up. @PSampathkumarMD @chadinabhan @CarolineYLChen
Here is @DrSidMukherjee offering to help the CDC make a website. 👇
Here is me lamenting about the failures of CDC in March.

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More from @VincentRK

15 Oct
There is a group of people with excellent health insurance who hardly see a doctor or use healthcare resources: Doctors.

I don’t agree with the notion that people will abuse the healthcare system if they have good affordable healthcare coverage.
People go see a doctor if they have a health problem. They take medicines if they have a health problem. They get admitted to a hospital if they have a health problem.

There are better ways of having fun than going to a hospital.
There are always exceptions. For any system you create there will be a few people who abuse the system. But we can’t build systems around exceptions.

We need affordable universal healthcare. COVID shows us how your health affects others, and the health of others affects you.
Read 4 tweets
14 Oct
1.5 million US households have a net worth >10 million. They could pay for their own healthcare.

For the remaining 100 million, healthcare is so expensive one serious illness can wipe out your entire fortune. Not something you can save enough for. We need universal healthcare.
For example, for the disease I treat, multiple myeloma the annual cost of medicines alone is $200,000 to 300,000 or more. This can go on for >10 years. Each new treatment costs $20,000 to $30,000 a month.

Add to it cost of doctors fees, hospitalizations, lab tests, and imaging.
We depend on being able to be insured, having affordable premiums, and having adequate coverage.

Any one piece that’s affected will be a huge problem.

All 3 are threatened.
Read 5 tweets
14 Oct
Dusting of an old tweet. Trying to get to herd immunity as a planned strategy is sheer madness and will lead to a huge loss of life. @DrEricDing
1/ Wear a mask and try not to get COVID. By doing so:

You have a chance at avoiding COVID till we have a vaccine.

You delay COVID, & over time we will have better treatments that reduce chance of dying.

You will reduce viral dose if you do get exposed, and make COVID milder
2/ Young people have a much lower chance of dying of COVID. But it’s not zero. Some can become critically ill. You also run the risk of transmitting to older more vulnerable people.

I’m not arguing for lockdowns. Just try to social distance as much as possible. Wear a mask.
Read 5 tweets
23 Sep
Amazing exchange between @RandPaul and Dr. Fauci.

1) As one of the first people to raise the possibility that not everyone may be susceptible to COVID, and that cross reactive immunity may be protecting some people from severe infection, I agree with those points by @RandPaul
2) I’ve also been on record that seroprevalence underestimates the proportion of people who are immune & that we may be closer to herd immunity in prior hotspots than the 5-10% seroprevalence indicates. But that number (~2 times seroprevalence) is still far short of herd immunity
3) Having said here are 3 comments I disagree with.
-The comparison of NY to Sweden is not correct.
-The statement that flattening the curve does not reduce number of deaths is not correct
-We are doing as well as S. America & so mitigation strategies don’t help is not correct
Read 14 tweets
22 Sep
After the multiple problems and flipflops we have seen this year with recommendations and guidances in COVID, the public must be aware that medical recommendations are only of value if they come from real experts.

Here are some thoughts on how to evaluate medical expertise.
First, recommendations should always list names of the experts on the panel so that we can evaluate whether or not guidelines or determinations are made by people with genuine expertise. Anonymous posts are not helpful & lack accountability. If names are not listed, I move on.
Second, do not fall for fancy leadership titles. While some titles reflect true expertise and academic leadership, some people with glowing titles may be far removed from research or patient care for a long time. Things change fast in medicine. Look past administrative titles.
Read 7 tweets
22 Sep
Why generic lenalidomide is delayed: Celgene sued generic companies citing patent infringement. Now BMS has reached agreement with 3 companies limiting sales to <10% volume each— effectively prolonging Revlimid monopoly till 2026. Not good for patients. @DavidP4AD @matthewherper
Or the public— because Revlimid is one of the top drugs in the US for Medicare spending. >2 billion a year. @peterbachmd @a_kaltenboeck…
The argument that new drugs go generic after 10-15 years & become inexpensive is not a reality in cancer. Patent life is prolonged by a variety of methods:

Pay for delay
Volume limited agreements with generic companies
Introducing “me too” drugs as novel replacements
Read 6 tweets

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