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Abraar Karan Profile picture
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4 Dec, 6 tweets, 3 min read
I'm concerned that history is about to repeat itself

We need to stop home-based spread of the virus

This means quarantining & isolating safely; this may even mean needing to stay out of the house for a few days. Not possible for everyone!

A quick thread
washingtonpost.com/outlook/2020/0…
2/ I have seen this happen over and over; almost every patient I cared for in the #covid19 ED in April was infected by someone who had the virus that they lived with.

This is why we tried to implement isolation options outside the home like Boston Hope

bostonglobe.com/2020/04/12/nat…
3/ But- we can't force people to leave their homes; & a number of patients did not feel comfortable or safe going to outside facilities/ many preferred to stay at home

I can understand this sentiment, & building that trust is key/is hard to do in an emergency

Thus:
4/ If you are home & you or someone else is either infected OR exposed (!) ...

it is key that they take the same precautions as if they were infected

Even if they have no symptoms. Even if they "feel fine"

#covid19
5/ This means eating separately

Using a separate bathroom (if you have the privilege of having one)

Masks in the house

Avoiding leaving the house to go do errands etc (again, not everyone has the support needed for this! People need to groceries; get meds etc-need support)
6/ All of this is contingent upon having the right support systems in place to allow you to safely quarantine or isolate

This is where federal + state leadership comes in!

If we could solve the safer quarantining/isolation problem --> slow down home-based clustering

#covid19

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More from @AbraarKaran

Abraar Karan Profile picture
6 Dec
1/ The year before #covid19, my academic focus was largely on Ebola & epidemic response in the global health setting. From Feb 2019 to Jan 2020, I worked as the editor of the @JournalofEthics theme issue on the ethics of pandemic response.

journalofethics.ama-assn.org/issue/culture-…
2/ We had the great privilege of contributions from many experts—- and we covered topics ranging from how anthropology can help us better understand how to work alongside communities during an epidemic...

journalofethics.ama-assn.org/article/how-sh…
3/ to the ethics of emergency vaccine distribution— both immensely relevant again. (@BhadeliaMD co-authored the latter; @Real_Ironist - you may find the former ⬆️ interesting)

journalofethics.ama-assn.org/article/making…
Read 11 tweets
Abraar Karan Profile picture
5 Dec
“The CDC is urging “universal mask use” indoors for the first time”

This is pretty unbelievable if this is 1st time they have recommended this. For *months* many of us have been pushing for a mask mandate for indoor spaces. #covid19 washingtonpost.com/health/2020/12…
2/ While we can’t regulate what people do in private settings — although even here masks are so important— a public indoor mask mandate is long overdue

#covid19
3/ We know spread is most efficient indoors, yet our current mask mandates end up leading to people masking outside where risk is much lower, and then taking those masks off either in the workplace or during social gatherings #covid19
Read 4 tweets
Abraar Karan Profile picture
4 Dec
THREAD
1/ This was tough to read— everything from threats of violence against scientists- some who I know personally- to real feelings of despair from others

But we have to keep pushing & believing that what we are doing is making a difference #covid19
bostonglobe.com/2020/12/04/nat…
2/ Pandemic nihilism will affect every single one of us at different times & different ways. Change happens slowly even when we need it to happen quickly. It will probably take saying the same thing over & over again but in different ways until something actually gives. #covid19
3/ As a global health doctor, the most important lessons I ever learned in the field taught me unending optimism- you begin to focus on the specific people, families, communities that you care about most & you support them in the ways that you can, no matter how “small”
Read 7 tweets
Abraar Karan Profile picture
3 Dec
1/ One of the challenges we will see more of -- as #covid19 finds its way into hospitals discretely (patients coming in for other conditions & initial test negative)- we will have exposures that furlough healthcare staff quickly who were seeing patients w/ only surgical masks on
1.5/ Its unclear how much discrete spread as described is happening, but anecdotally this type of exposure has already happened to me & others; & with more spread in the community overall, this type of discrete spread will increase as well. #covid19
2/ Being able to get exposed staff tested quickly; & to serially test them even if first test neg is critically important

We can't afford to lose limited staff for 7-10 day quarantines at a time; we also can't afford to have unknowingly infected staff working on wards #covid19
Read 5 tweets
Abraar Karan Profile picture
30 Nov
1/ With high rates of viral transmission all over the country, people who have traveled should be advised to quarantine when they return. Many people will not know that they’ve had an exposure, but they can still stop onward transmission chains by quarantining. #covid19
2/ But important to remember that quarantining does not mean walking around your house as if things are normal.

It means avoiding contact with others in the home and wearing a mask if you need to leave your separate space.

#covid19
3/ Some places allow people to end quarantine if they have had one negative test. Important to remember that one negative test does not mean you are “safe”— the best bet would be to get tested upon return and again within a few days to cover a longer incubation period. #covid19
Read 6 tweets
Abraar Karan Profile picture
29 Nov
Back again to stigma— have had multiple friends disclose in confidence to me in different states that they contracted #covid19 but didn’t want to tell anyone because of the fear of how they would be perceived. This is a real problem, & it *will not be solved by judgment & shame*
2/ If this makes you angry—this won’t be solved by your anger. In fact, that will make this worse. How someone else got infected is not for you to judge even if you feel like it is. That’s a tough thing to hear when people are making sacrifices.
3/ I get that- I’m a doctor, I too have sacrificed. But when I treat patients, if I sat there judging them/how they got sick— I’d quickly become a pretty bad doctor. So let’s start reframing this as something that no one wants to get- even if they sacrificed “less” than you did
Read 7 tweets

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