I have a few things to say this morning. A small but mighty 🧵.
First , I can't say thank you enough to @KatherineJWu for writing this amazing piece highlighting the crucial work of clinical laboratory scientists/medical technologists. Please read it: nytimes.com/2020/12/03/hea…
The article captures a piece of the talent, expertise, and dedication of these healthcare workers. This is especially true of my dear friend @darcyavelasquez, who works relentlessly day in and day out at @ChildrensColo to provide the best care possible to Colorado's children.
Sometimes it feels like the @KatherineJWu's, @kmess44's, and @jesscataldi's of the world are one-in-a-million. The failure to recognize the clinical laboratory (and people within it) for its importance in how healthcare works is not just a #COVIDー19 issue.
I started as a lab assistant @ChildrensColo at 20 years old while going to college full time. It was a stepping stone to applying for PA or Medical school, since that's all I had ever been told were my options as a biology major.
I would finish my lab assistant tasks for the day and spend the remainder of my shift watching the medical technologists...in awe of their work. How had no one ever told me about this job? Why didn't I hear about them and the cool+important work they did daily?? Blew my mind.
Becoming a certified clin #microbiologist was one of my greatest accomplishments to date. I loved my 12.5 years of work in the micro lab at @ChildrensColo. Like so many other med techs, I was PROUD of my work-- regardless of how poorly we were treated sometimes.
But the work is not easy. Our society doesn't explain our roles in the lab, respect is limited at best. I am so lucky to have worked at a hospital w/ a collaborative and wonderful team, but that is not always the case. It's true... "no one sees us."
I spent several years running the clinical education program for our #microbiology lab. Sure, teaching clinicians is great, but that's wasn't the whole reason I did it. Our students will only remember a fraction of the material they are taught, but here's what they do remember:
1. Ppl in the lab are really smart. Many of them hold advanced degrees. They have keen attention to detail and care about your patient just as much as you do, even though they have never met them.

2. The lab isn't just full of machines.
3. Good lab relationship= good medicine
The #lab is critical to good patient care. The lab's role in diagnostic and antimicrobial #stewardship is huge. This is why engaging with the lab in the form of shadowing, teaching or rounding is SO important
asm.org/Articles/2020/….
So, if I love being a clinical lab scientist so much, why did I leave my position to pursue a Ph.D full time?
Why, thank you for asking!
The answer lies in many of the topics covered by @KatherineJWu's article:
1. There is a GAP. A huge, scary, unacceptable gap between the clinical #lab + clinical practice. This is rooted in lack of understanding, lack of communication, lack of team science. Silos everywhere. I see lots of research that affects the lab w/ no lab person involved.
2. I chose a Ph.D in translational science for the opportunity it provides me to mix my public health, microbiology, infectious disease and clinical science/research experience in a way that improves health outcomes for children and ALWAYS keeps the #lab in mind.
Time after time I find myself in a position where I am told "this hasn't been done before" or "we aren't sure what to do with someone like you." That's ok! But it's also sad.
It just reminds me that although clinical lab scientists are capable of contributing in the most amazing ways, the paths for us are not clear (so we need to continue to pave them ourselves). BUT: this is the most important part...
Medical Technologists/Clinical lab scientists DO NOT need to go get Ph.Ds to be important or do tremendously impactful work. That's just my path because I see problems I would like to fix (and I LOVE learning new things), but not necessary. YOU ARE ENOUGH.
I hope everyone reads this article. Every clinician that has screamed at a tech on the phone, hung up on them, got angry because they were asked for their last name and credentials (as required by all sorts of regulators). Every member of the public that is angry about testing.
Every highly-educated person with a fancy platform that loves to use the them "THE LAB" to spread blatant disrespect about a CAREER they don't fully understand. All of you. Please read the article and sit quietly with yourself.
I think this all has brought some important issues to light:
1. There are so many careers we don't understand or honor enough. Our society loves to hail the most glamorized things. Everyone has a role to play. At the heart of it, I really believe everyone is doing their best.
2. Clinical lab scientists are being run into the ground by #COVIDー19 , that's true. However, other diseases and ailments have not stopped. On top of it all, these people are continuing to be involved with the diagnosis and treatment of everything other than COVID19.
Clinical lab scientists: I see you, I know you, I am you.
Thank you for everything you are doing now and ALWAYS.
#IDTwitter #MedTwitter @CUMedicalSchool @CCTSI @ASCLS @ASMicrobiology @JClinMicro #Lab #LabEveryday @ASCP_Chicago
This ended up being a NOT SMALL 🧵😬

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More from @andreaprinzi

17 Aug
Ok, sort of weird to say...but today I'm dedicating some time to SPIT (formally known as #Saliva). It's the super hot topic this week in the ever-changing #COVID19 diagnostic landscape we are living in, so let's take a quick peek at some of the evidence out there (thread)
I completely understand the importance of testing saliva, particularly as it relates to lack of supplies and resources. It can be a feasible option that basically eliminates HCW risk of infxn during collection. It can also save supplies: no swabs, media, possibly fewer reagents.
First paper is here: DOI: 10.1128/JCM.01659-20
-53 paired samples from OP and/or NP swabs, and saliva were collected
-Standard RNA extraction methods were used for the swab samples, a quick extraction method was used for saliva. Handling high-viscosity samples is discussed.
Read 20 tweets
26 Jul
I just want to be clear: while I understand and have similar frustrations with turnaround times for #COVIDー19 testing, I'm afraid the angst is falling on the laboratories...and I do not feel that is fair or appropriate. (Small thread)
The clinical laboratory is full of living, breathing, intelligent human beings. The work takes skill and time. Often, labs are understaffed and there has been a shortage of trained clinical lab scientists FOR A WHILE. There are only so many tests a person can crank out in a day.
Even if a lab has all the staff they need, there's only so much testing that can be done when a) your instruments are full b) you cannot get the supplies you need to run these tests. Seems like many people think labs have unlimited access to very expensive instruments...nope.
Read 8 tweets
23 Jul
Hey, friends. Here's what's up in the world of #COVID19 literature from the last 24 hours (7/23). Simple summaries provided, as always, follow the link for original manuscripts. BE WELL! #IDtwitter #MedED #MedTwitter #Microbiology #InfectiousDiseases
1. Title: Addendum to: Children are not COVID-19 super spreaders: time to go back to school
Link: adc.bmj.com/content/archdi…
Brief Study Design: This is a letter (addendum) to the author’s original research paper (cited in the letter and can be accessed from it).
Simple Summary: Contact-tracing studies have demonstrated that children have a significantly lower attack rate of COVID-19 compared to adults.
Read 43 tweets
21 Jul
I had a request from a friend to provide some literature on the use of #masks. I am happy to provide that here today. As always, the original manuscripts can be accessed by clicking on the link provided. Stay well!
#COVID19 #MedTwitter #IDTwitter
1.Title: COVID-19: in the absence of vaccination – ‘mask-the-nation’
Link: doi.org/10.2217/fmb-20…
Brief Study Design: Editorial
Simple Summary: Without an effective vaccine and/or antiviral agent, best way to prevent the spread of the SARS-CoV-2 is to physically block spread. At this time, droplet spread is considered to be the primary form of transmission of the virus.
Read 26 tweets
20 Jul
In some roles I currently have, I review #COVID19 literature several times a week and summarize the findings. There are thousands of studies to review, so it's impossible to get to them all, but I think sharing some easy-to-digest summaries on #Medtwitter doesn't hurt (thread)
Below are brief summaries of a handful of papers released within the last day or so. Click the links to go to the article and read more if you desire.
Title: Comparing Chinese children and adults with RT-PCR positive COVID-19: A systematic review
Link: doi.org/10.1016/j.jiph… (full text is available for free)
Read 25 tweets
15 Apr
Thoughts on upcoming #COVID19 #serology tests:
This is actually quite a challenge! (#Diagnostics often involve a lot of complexities). There is a lot of pressure to roll these tests out, but they need to perform well, or we do more harm than good. #MicroRounds (A thread)
WHY we need these soon:
1. Contact tracing.
2. Can be used to test if a vaccine is working during a clinical trial (70 of them ongoing right now, I believe)
3. Inform public policy makers about rate of asymptomatic cases + previous infections/exposures =informed decision making
How is developing a #PCR different than developing a #serology test?
1. #PCR tests detect viral RNA/DNA (in this case RNA) and can be pretty straight-forward in terms of development
2. #Serology relies on knowing about the #SARSCoV2 structure and how the human body responds.
Read 13 tweets

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