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Abraar Karan Profile picture
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13 Nov, 4 tweets, 1 min read
There should be no talks about schools closing until every bar and restaurant and gym is put on pause & there is a mask mandate for public indoor spaces.

We have been through this before; every single day we lose is worse than the last!

nytimes.com/2020/11/11/opi…
2/ This is *not* to say that businesses should tank or people should be out of jobs. The economy matters. The government needs to step up; one time stimulus checks aren't enough.

But if spread is happening at these venues, then alternatives need to be implemented ASAP.
3/ Keep in mind that this wasn't a surprise that is suddenly popping up. We have been through this twice before already.

We knew this was coming again.

And yet we are once more faced with politicians who are *stalling* when the epidemic is running away again.
4/ Need indoor mask mandates in all public spaces; high risk venues where masks need to be removed (restaurants, bars) should have been the first to be restricted.

Furthermore, blaming the public isn't going to cut it. If you leave venues open, people will assume it is safe.

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More from @AbraarKaran

Abraar Karan Profile picture
14 Nov
1/ Really appreciate @DrTomFrieden piece on more nuanced epidemic control based on local epidemiological data. @RanuDhillon & I wrote a similar piece back in August called “Smarter Lockdowns”— the problem is implementation. So many ideas, so little action

theatlantic.com/ideas/archive/…
2/ At a point, we recognize that there are so many ways to get R<1; the issue is that doing any of them well and consistently requires coordination, the right policies, & enforcement of those policies. We don’t have that. We needed that for 9 months.

hbr.org/2020/08/the-u-…
3/ We wrote a follow up piece @WBUR @NPR ⬇️— but admittedly, writing op eds generates ideas but if those ideas end up in a Twitter abyss, then they fail to influence what actually happens (hopefully @DrTomFrieden excellent piece gains traction/moves dial)
wbur.org/cognoscenti/20…
Read 5 tweets
Abraar Karan Profile picture
14 Nov
Are you quarantining correctly?

For people that have been exposed to someone with known #covid19 or with symptoms and are awaiting a test result— you need to be quarantining *as if you have #covid19*

This doesn’t just mean stay home. It means stay away from people *at home*
2/ With incubation anywhere from 3-14 days (median ~5), one single negative test is not enough evidence that you are “safe”

I’m not sure this message has been clear. And I fear that many people think their home is “safe”, yet we have been seeing home based clustering since April
3/ If you’re not staying in a separate room and masking any time you are outside of that room, you are introducing possible viral spread if in fact you are infected.

This has been a problem for many of my patients that didn’t have multiple rooms or spaces to quarantine in
Read 7 tweets
Abraar Karan Profile picture
13 Nov
1/ Excited *& frustrated* to share this new work

*This is the epidemic* — inequity is the driver of #covid19. It has been since the start

It’s not surprising- it’s how every infectious disease outbreak spreads

And it isn’t central enough to our response
npr.org/sections/healt… Image
2/ cc @RanuDhillon @drdavidwalton @IngridKatzMD ; as global health doctors, inequity is the focus of how we fight poor health outcomes. It isn’t some sub-plot; this is the whole damn story. And we have seen this play out in #covid19 from the start.
3/ From when we said “stay home”— there were so many people that could never afford to stay home; that were expected to show up and keep working without PPE, paid time off, hazard pay, or any other protections. I know- many of these people ended up being my #covid19 patients
Read 10 tweets
Abraar Karan Profile picture
13 Nov
1/ True story of two personal friends- let's call them Jim & Bob- & #covid19. I share this not to shame but to say-- this is likely happening more than we are acknowledging because there is stigma associated with having #covid19 in many social circles.

Short thread
2/ Bob was exposed to a #covid19 case recently while socializing.

He didn't quarantine, nor did he tell Jim that he had been exposed.

While they were hanging out, he was notified by phone that his partner tested positive- & he still didn't say anything about it to Jim.
3/ When Jim asked, Bob eventually revealed that he had an exposure (while still not revealing his partner had just tested positive).

Jim was pissed & told Bob to immediately get tested.

Bob did-- & ended up testing positive for #covid19.
Read 12 tweets
Abraar Karan Profile picture
10 Nov
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.
Read 10 tweets
Abraar Karan Profile picture
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

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