1/ Been saying this for a while, but I’m going to say it again. Do not indoor dine right now. Order takeout. Tip restaurants. Support businesses. But I would not be dining indoors. Last night, there were no ICU beds left at a hospital where I work in Boston. #COVID19
2/ Policies reflect many things— but they don’t always reflect what is safest from a health perspective. With exponentially rising cases, hospitalizations & deaths, high risk activities are high risk. Just because something is open doesn’t mean it is “safe”. #covid19
3/ Is this recommendation I am making fair to restaurants/ staff? What’s actually most unfair to them is that they are forced to remain open & send workers in high risk settings bc they aren’t receiving enough $ protections in a runaway pandemic.

#covid19
4/ Don’t let anyone tell you this is abt “economy v virus”
Wealthy powerful people are the last people that are going to be doing the high risk activities that they are saying are safe for everyone else. Listen to health experts- listen to doctors who have no beds left. #covid19
5/ What do hospitals do when they have no ICU beds? Great question. They either have to start diverting sick patients elsewhere or they have to start moving slightly less sick ICU patients back to general med floors to make space. Either way, system breaks down quickly #covid19
6/ The other key pt to rmr— while I stated restaurants here— private social gatherings at your home w/ people outside your family bubble introduces new risk as well.

This isn’t just restaurants- it’s any place you have your mask off around multiple others. #covid19

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More from @AbraarKaran

10 Dec
“Eating indoors at a restaurant is one of the riskiest things you can do in a pandemic,” she said. “Even if there is distancing, as this shows and other studies show, the distancing is not enough.” @linseymarr

latimes.com/world-nation/s… Image
2/ Diagram of airflow in a South Korean restaurant in which those who were sitting in the path of the air downstream from infected case got infected (incl more than 6 feet away)

Those facing away from the airflow did not

#covid19 Image
3/ Thread below — just because something is open right now doesn’t mean it’s safe. High risk activities are high risk activities. Over 3,000 Americans died yesterday from this virus. #covid19
Read 7 tweets
9 Dec
1/ Trying to reconcile many thoughts but realizing they aren’t fundamentally at odds

Yes, we must avoid shaming each other- kindness is key

Yes, we all need more support from our governments/institutions

Yes, our personal actions do matter; they do make a difference

#covid19
2/ Recently wrote about stigma & why that kept some of my own friends from telling each other they had been exposed to #covid19

Shame is a losing strategy; it may transiently make us feel morally superior; it hurts others; it spreads more virus silently

bostonglobe.com/2020/11/30/opi… Image
3/ Wrote about fatigue @WBUR — it’s hurting all of us. We still need to believe even our seemingly small, insignificant choices do in fact matter. We won’t know if we avoided becoming the next super spreader- but we may have & that’s a big deal #covid19

wbur.org/cognoscenti/20… Image
Read 4 tweets
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
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
4 Dec
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:
Read 6 tweets
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

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