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Vincent Rajkumar

@VincentRK

13 Nov

Whether it is masks or meds consider 𝙬𝙝𝙖𝙩 𝙞𝙛 𝙬𝙚 𝙖𝙧𝙚 𝙧𝙞𝙜𝙝𝙩, as well as𝙬𝙝𝙖𝙩 𝙞𝙛 𝙬𝙚 𝙖𝙧𝙚 𝙬𝙧𝙤𝙣𝙜

For benign interventions (eg., masks for COVID) if we say masks work & they don’t, consequence is small. If we say they don’t when they truly do, it’s tragic

For any intervention we have to always consider the consequences of a Type I error relative to the consequences of a Type 2 error.

For many medicines, the consequences of a Type 1 error in terms of toxicity, harm, & cost usually outweighs those of a Type II error. We need RCTs.

Sometimes there are interventions where consequences of erroneously concluding something is effective when it is not (Type I error) is small compared to concluding it’s not effective when it actually is (Type II error). Eg., hand washing to prevent COVID. Masks are like that.

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Vincent Rajkumar

@VincentRK

11 Nov

COVID thoughts

I’m happy that we rapidly found stuff that works:
-Masks
-Proning
-Dexamethasone
-Monoclonal antibodies
-Upcoming vaccine

I’m disappointed about the many mistakes:
-Lack of a comprehensive strategy
-Mixed messages
-Politicization of masks
-PPE shortage

As a result of our success we have lowered the number of deaths. But the daily death toll is unacceptably high: ~1000 per day. How can we possibly lower it when the number of new cases is skyrocketing?

If you compare to Europe, you could come to the conclusion that nothing matters. It’s just the way COVID is. But we have to ask, have they made the same mistakes as us?

Read 7 tweets

Vincent Rajkumar

@VincentRK

7 Nov

Want to control COVID? The Top 3 things we can do

Individuals
-Wear a mask when indoors with people u don’t live with
-Social distance as much as possible
-Good ventilation indoors

Governments
-Communicate above 3 measures clearly
-Provide tests & PPE
-Leaders set examples

This is my judgment call. These are basic things essential things. There is a lot more we can do as individuals and governments. But first things first. And also these are the realistic measures possible with such a high incidence of new cases compared to lockdowns.

What more can you do if you are already doing the Top 3?
Here’s what I’m doing.

- I’m wearing a mask even outdoors if I’m talking to people I don’t live with
- Hand sanitizer outside of home, periodically but not obsessively
- Limiting social gatherings greatly

Read 8 tweets

Vincent Rajkumar

@VincentRK

2 Nov

Why I call it an epic failure of leadership in the US.

-Some countries had great leadership & are winning.

-Other countries failed despite trying their best.

We failed but didnt even try. Instead leaders mocked masks, disobeyed rules, insulted scientists, & tarnished CDC

We can live with an all out strategy that failed. Where we tried our best to test, trace. Where we clearly told people about important of masks once it became obvious that masks were important. Where we provided PPE & resources to hospitals.

But we don’t have a plan in November

But we have a unrelenting series of mixed messages.
A never ending stream of leaders minimizing the pandemic. Multiple events where safety rules are broken by people who should be implementing and promoting them.

That’s the difference between not trying and trying.

Read 6 tweets

Vincent Rajkumar

@VincentRK

30 Oct

@elpaisinenglish

How COVID spreads indoors. Nice graphics and description from @elpaisinenglish

6 people are in a room for 4 hours. One has COVID but no one knows. @el_pais
@jeremyphoward @zeynep @trishgreenhalgh
1/

english.elpais.com/society/2020-1…

Even with safe distances, if no one is masked, after 4 hours talking in a closed room, almost everyone can get infected.

2/

If everyone wears a mask but spends 4 hours talking indoors with no ventilation, many are still at risk of infection.
3/

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Vincent Rajkumar

@VincentRK

27 Oct

@eaonc

EQUATE: Our next @eaonc randomized trial for newly diagnosed myeloma is now open.
PI: @myelomaMD
#EAA181 #EQUATE
@SagarLonialMD @mtmdphd @NorthTxMSG @nsc_natalie @JanssenUS @NCICTEP_ClinRes

@NIH

This investigator-initiated, @NIH @theNCI funded trial addresses the role of quadruplets in myeloma. It tests the hypothesis that adding a 4th drug will mainly benefit patients who are MRD+ after triplet induction, and may not be needed in those who are MRD-

@SWOG

Colleagues from @SWOG @ALLIANCE_org @BMTCTN helped design this trial and will work collaboratively.

@sgiraltbmtdoc @Myeloma_Doc

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