Ashish K. Jha, MD, MPH Profile picture
Nov 20, 2020 9 tweets 4 min read Read on X
Today was a very, very odd day

I testified before @SenateHomeland

They held a hearing on hydroxychloroquine.

Yup, HCQ

In the middle of the worst surge of pandemic

HCQ

It was clear how our information architecture shapes questions of science and medicine of COVID

A thread
There were 4 witnesses.

3 who strongly supported HCQ

They believed thousands of Americans were dying from lack of HCQ

And then, there was me

This split was not a reflection of evidence or the consensus in medicine

It reflected ability of the majority to seat more witnesses
The hearing was a testament to how politicized science has become

I shared evidence of studies that have failed to find benefit of HCQ

3 other witnesses shared personal experiences

And suggested my testimony was reckless because it would deny people access to lifesaving HCQ
There was an attempt to make it personal

I passed

I’m not big on personalizing disagreement

I am more comfortable talking data, evidence, science

Their engagement with data was sparse

And they were horrified that I disagreed
Most shocking?

@RonJohnsonWI, other witnesses essentially argued there is coordinated effort by America's doctors to deny patients HCQ

Why would we do this?

Because we’re in bed with Pharma

A version of the anti-Doctor rhetoric from @realDonaldTrump, his "expert" @ScottWAtlas
I tried to explain that doctors don’t want to kill their patients by withhold therapy

But evidence matters

They tried to flip the narrative: that evidence was misinformation

And “art of medicine” was what mattered

And most amzing?

That @US_FDA, @NIH, Pharma were all corrupt
On a personal note, it was disheartening to be personally attacked during the hearing

By the witnesses, @RonJohnsonWI

And on @Twitter during and after

But you may be wondering

What is going on?

Why hold a hearing on HCQ in the middle of the worst surge of the pandemic?
Why talk Hydroxy when so many Americans are dying?

Because it was meant to push a narrative

That masks and distancing don’t matter

If you get infected – no big deal – take some HCQ

Its stunning
I'm left pondering a quote from @BarackObama

An idea any American, liberal or conservative, would understand

"If we do not have the capacity to distinguish what’s true from what’s false... the marketplace of ideas doesn’t work. And by definition our democracy doesn’t work"

Fin

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More from @ashishkjha

Mar 1
OK -- so CDC has come out with new guidance saying if you have COVID

Isolate while you have a fever but...

you can stop isolating once your fever is better and symptoms are resolving

Seems right to me

What you ask? Has the science changed? Why do this now?

Good questions

🧵
So first question: has the science changed?

No -- data on infection and spread remains the same

Most of the spread happens when people are pre-symptomatic (before symptoms) or when they have symptoms. Less after symptoms resolve

So what's changed? Population immunity

2/n
The question is not whether guidance will have benefits

If we only focused on benefit

Public health would recommend

You never drive over 30 MPH
Ever drink alcohol (no amount is safe!)
Ever eat bacon (class 1 carcinogen!!)

And so on

But those would be bad recommendations
Read 7 tweets
Dec 27, 2023
What happens to patient care when private equity firms take over hospitals?

Well, there's new data out and its not great news for all you fans of private equity in healthcare

Here's the write-up in the @nytimes by @sangerkatz and @ReedAbelson

Short 🧵

nytimes.com/2023/12/26/ups…
Researchers looked at 51 private-equity (PE) acquired hospitals

And compared them to matched hospitals not acquired by PE

They found patients at PE hospitals experienced 25% higher rates of complications compared to controls

Here's the original paper

jamanetwork.com/journals/jama/…
Does this make sense?

Could quality (or in this case, patient safety) get worse after PE take over?

Yup possible

patient harms like hospital-acquired infections & falls occur when:

you have inadequate staffing

or you don't have strong processes to prevents them

3/n
Read 6 tweets
Aug 7, 2023
How should we be thinking about COVID at this moment?

Last week, I had an op-ed in @BostonGlobe to lay out what I think is a pretty reasonable way to think about it

But first, here's the state of COVID

Thread

bostonglobe.com/2023/07/31/opi…
Infections are rising in every part of the US based on wastewater data

This is exactly what many of us expected this summer

How bad is it?

Well, its up about 3X from lows of mid-June

But still only a third of last summer's peak

So its up. But not a lot.

So what to do?
The most important thing you can do is ensure your immunity is up to date

Getting an annual vaccine (for most folks) and 2X/year for vulnerable folks makes a lot of sense

But also: SUPER important to consider getting treated if you get infected

Treatments are still free!
Read 6 tweets
Mar 17, 2022
So, as they say…

Some news

For all the progress we’ve made in this pandemic (and there is a lot)

We still have important work to do to protect Americans’ lives and well being

So when @POTUS asked me to serve, I was honored to have the opportunity

nytimes.com/2022/03/17/us/…
This President has spoken the truth about this virus

Has prioritized policies based on science and evidence

Americans are going back to work and school

And it is an honor to work under his leadership

One focused on the health and well-being of the American people
We are in so much of a better place with vaccines, diagnostics, increasingly, therapeutics, and much more

Much of this because of the superb leadership of Jeff Zients

Who has used the levers of the US government to make available these miracles of science to the American people
Read 9 tweets
Mar 3, 2022
With infections down more than 90% since highs just 6 weeks ago

It is tempting to decide the pandemic is over

It is not

During this upcoming lull of infections (and falling deaths),

It's time to prepare for whatever is next

So what to prepare for -- and how?

Thread
The two questions I get asked most often these days are:

1. Will we see future variant

Answer: I don't know. No one does. Reasonable to assume we will. Let's hope we don't

2. Will we see future surges

Answer: most likely yes. Hope not

But remember: hope isn't a strategy

2/n
So with possible future variants and surges

We should focus on the playbook:

1. Surveillance
2. Vaccinations
3. Testing
4. Ventilation/filtration
5. Masking
6. Therapeutics

Much of this is in today's White House plan

(disclosure: I, others have shared our ideas with them)
Read 10 tweets
Feb 26, 2022
For two months, I've said we're entering a new phase of the pandemic

A phase marked by a lot of population immunity, a more immune-evasive but less virulent virus

This new phase requires new metrics

My @nytopinion piece on the latest CDC metrics

nytimes.com/2022/02/25/opi…
Fundamentally, new CDC metrics get it right

Why?

Because cases no longer are the most important measure

For nearly 2 years, for every 1000 cases, you could reliably predict 50-80 would end up in the hospital and about 15 to 20 people would die

That was true in 2020. And 2021
That tight link between cases --> hospitalizations --> deaths was true for original strain

And for Alpha
And for Delta

But Omicron severed that link (mostly)

Now, if you told me there were a 1000 new cases

I can no longer tell how many will end up hospitalized or dead

3/n
Read 9 tweets

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