Nebraska has a test positivity rate of 20% - indicator for adequate testing is 5% or less - and over the past 2 weeks, cases have gone up by 24%, hospitalizations by 41%, and deaths by 105% (NYTimes).
The good news is that this is outdoors. The bad news is the close-packed crowed, the lack of masks, the extended time period, and the fact that 1/3 of the 64,000 cases in Nebraska thus far have been here, in Douglas County.
It's an exercise of vast carelessness and bravado, shot through with an utter lack of compassion.
Douglas County has 2,214 staffed hospital beds and 317 ICU beds. According to this article h/t @emlitofnote, 79% of the metro area hospital system ICUs are already full:
In other words,

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More from @choo_ek

27 Oct
Do what you need to do to cope in the short term and then come back with the memory of this sham, rushed process and every hypocrite who supported it.
Read 5 tweets
25 Oct
Doctors Have Been Working Hard In This Pandemic And Do Not Appreciate Being Slandered: A Thread
First, @ACEPNow, which represents my specialty of emergency medicine:

“ACEP is appalled by President Trump's reckless and false assertions that physicians are overcounting deaths related to COVID-19. Emergency physicians and other health care workers have risked their lives...
“...day in and day out... battling the greatest public health crisis in a generation—all while watching countless patients die alone, going to work without sufficient protection equipment, and struggling with crushing anxiety about getting sick or spreading the virus...”
Read 13 tweets
24 Oct
There are always people who will argue against science and public health. Medical treatments for addiction, vaccines, speed limits, seatbelts, smoking bans, condom use ... all of these had and have die-hard opponents with their individual rationales for opposition.
I guess I’m saying this for those of you who feel frustrated and hopeless against the loud voices of those who oppose public health measures. There is always an uphill battle to diffusion of health innovation. Most times, the actions that save lives advance over time.
I definitely feel that frustration... I'm shopping for punching bags for my home (seriously). Stay in the part of the ecosystem you believe in, be steady, and focus on being a helper.
Read 4 tweets
22 Oct
Mitch is a hard stick is all I can say for sure. (I know that sounds like a character description but it’s a medical one)
Probably on anticoagulants too. Sometimes old fragile papery skin does that when the veins are elusive. But the lip argues anticoagulants.
Also clinically possible that he touched the cursed horcrux as others are suggesting on this thread. Just spitballing here so may as well keep the differential broad.
Read 16 tweets
21 Oct
Scientists are trained to look for evidence of their own biases, and to consider the possibility that their hypotheses are wrong. In fact, hypotheses are framed in terms of the "null" - the baseline assumption that the thing you think is true is not.
In every grant, you have to:
- lay out your safeguards against bias, point by point
- discuss what happens if your initial hypothesis is wrong
- guard against linked Aims that rely on assumptions that your hypothesis is right
You basically can't get funded unless you show rigor and an ability to roll with unexpected findings.
Read 6 tweets
21 Oct
Medicine fails to acknowledge the depth of these losses from academia ... we lose talent, the leadership stays what it is, we reinforce the status quo. What is best for our patients? What is best for the science? statnews.com/2020/10/21/map…
Here's the direct link to the brave open letter from @AnuAnandaraja
After yesterday's Zoom session with @thenephrologist @kdc_md @DrAyanaJordan and @DrOniBee I am in mourning for what is lost when Black women and other WOC cannot stay and thrive in academic medicine. And I see all of you who stay but at cost to your own health and well-being.
Read 5 tweets

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