THREAD
1/ A reminder that the epidemic won't be solved by people around a table in the White House. Yes-- we do need that as well; and we need those people to know what they are doing; & it looks like we finally have that now.

But the epidemic will be solved in our communities.
2/ From the start of the epidemic, there have been battles between experts; battles over who is & isn't an expert; battles b/w political parties; battles between fringe ideologies- these battles are actually important-- they should remind us that the opposite-cohesion- is the key
3/ We need not defer the solving of problems to elites somewhere else-- when the solution is actually going to come down to us; our families; our communities; our neighbors; our neighborhoods.

W/ the right support from our leaders, the epidemic will be solved by us.
4/ What this actually means-- not as simple as making the right choice.

For many, such as the most vulnerable, there was no choice but to keep working. Choice is a privilege.

For these groups, federal protection is imperative; paid time off; hazard pay; PPE; testing etc
5/ For those of us who may inadvertently be spreading this by our choices to socialize; here too I would say socializing is important; it is vital to our health & our lives-- so we must do it as safely as we can.

We know this virus spreads in clusters.
6/ We know that stopping that clustering has been essential; particularly avoiding crowds; closed spaces; close contact-- particularly choosing outdoors when we can; improving ventilation in the ways we can; wearing masks, *especially indoors*; these are all things we can do now
7/ There are so many parts to stopping the epidemic; federal leadership is a massive part of that; but so too is social cohesion; so too is trust amongst one another; so too is sticking to the basics consistently; so too is avoiding high risk situations when we can
8/ I wrote this early in the epidemic; I still stand by it: it will not be the brilliance of experts alone, but the brilliance of every day people coming together & supporting one another in the little ways they can that will ultimately stop this. #covid19
blogs.bmj.com/bmj/2020/03/26…

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More from @AbraarKaran

9 Nov
1/ Important article here from @SciFleur- when a #covid19 vaccine is approved, we must prioritize our most vulnerable communities; our frontline workers of color among those

Yet, we have an ugly medical history of using vulnerable groups as "guinea pigs"

statnews.com/2020/11/09/hea…
2/ Furthermore, as @LawrenceGostin mentions in this piece, there may be regulatory/legal roadblocks if the vaccine is prioritized in certain ways.

The messier this process becomes, the more trust will be lost among those looking to get vaccinated.
3/ In this @statnews poll from October- only 58% of surveyed Americans said they would get a vaccine as soon as available.

Analyzed by race, only 43% of Black participants would v 59% of White participants.

statnews.com/pharmalot/2020…
Read 7 tweets
8 Nov
Getting notifications from friends all over the world celebrating— unreal.

But also unreal that one single person could do this much damage; still, if there’s one lesson among many, *never give up*

Just keep pushing the dial toward justice, in every small way that you can.
2/ I came to this country as a baby- as an immigrant from India. I was & still am motivated always by the grit & perseverance of my parents. They never gave up— & they instilled that fight in me; most importantly to use that force to do good—to lift up those who were struggling
3/ That’s what we will keep doing; as docs, nurses, as frontline providers— we aren’t here to give up.

We’re here to kick some viral ass.

And we will fight for you as long as we can. Knowing we have a President & Vice President who will support us feels damn good.
Read 4 tweets
5 Nov
THREAD
1/ NEW CDC report on secondary attack rate of #covid19 in the home — overall above 50% in this study; families prospectively followed out for 7 days w/ daily tests; important implications for safer isolation options/rapidity of spread right at home

cdc.gov/mmwr/volumes/6…
2/ During my time working in the #covid19 emergency room during the first Boston surge in April, the *majority* of cases that I personally saw were likely infected by someone at home who was already a known case. See op-ed here : washingtonpost.com/outlook/2020/0…
3/ issues with home based transmission—> psychologically people may feel safer at home than they actually are; less likely to mask up; bad combo if strict isolation of cases is not possible (largely isn’t for most people)

But isolating outside the home also not popular
Read 10 tweets
4 Nov
THREAD
1/ Wasn’t able to sleep a wink last night. It’s a strange feeling when change feels so close, yet so far all at once. This year has been an eternity; headed into yet another huge wave of #covid19 infections, hospitalizations, & deaths, it’s exhausting fighting...
2/ Exhausting fighting against a viral pandemic- yes. But also exhausting fighting forces within our own country; political, cultural & more. Still, giving up is not an option. Not now, not tomorrow; regardless of who is in the White House, the onus will still be on us
3/ “Us” as the public; as individuals, as families, as communities, as counties, as states— neither Biden nor Trump can single handedly stop this epidemic.

It’s just not the way it works.

There will always need to be a certain level of public participation & cohesion.
Read 6 tweets
2 Nov
1/ New #covid19 executive orders in #Massachusetts today from Gov Baker + team in setting of #covid19 hospitalizations being up 145% since Labor Day. While there is now a mask mandate & curfews, I want to focus attention on *private indoor gatherings* (limit 10 people right now)
2/ We need to do multiple things right now— *one* of those is to make people realize this is getting serious again; cases & hospitalizations are going up. We are heading in the wrong direction. Executive orders may help do that in part.
3/ But additionally, we need to stop transmission. Now- restricting people from being out after 10 pm; I don’t think many people are out after that time anyways esp as the weather gets much worse. But— they still very well may be congregating at home, possibly w/ friends etc
Read 13 tweets
29 Oct
1/ One of the big failures in our epidemic response is expertise that is rightfully concerned with all the nuances and details but fails to see the bigger picture— so many people in this country are still unclear on even the basic aspects of #covid19 transmission. #covid19
2/ Honestly I see this as a big disconnect between academia & every day people; I would be willing to bet the average person in this country doesn’t give a shit about how much contribution is from aerosols v droplets as much as they care about *what they need to do to stay safe*
3/ If even we as “experts” are unclear on the relative contributions of aerosols and droplets and we are recommending the same safety measures— let’s focus our energies hammering those home in more accessible and clever ways. We are at over 80k cases a day right now.
Read 4 tweets

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