Mini-thread on "vaccine escape mutants" and public health as a global common good. 1/
Viral mutation can lead to variants that "escape" vaccines.

High infection rates enable mutations. 2/
We don't know of any variants that can escape the vaccines (yet).

But we do have many places with the kind of high infection rates that enable mutations. 3/
The US, UK, EU, Russia, Brazil, and India in particular are not controlling transmission.

By failing to do so, they are putting all of humanity at risk of vaccine escape mutants. 4/
No one is safe until everyone is safe.

The global community of nations must demand better public health measures in these failing countries.

People worldwide must organize across borders to build pressure for these measures. 5/5

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More from @AndrewMakeTweet

21 Dec
This is good, but it is really just about emergency out-of-network care, right?

That is far narrower than what most people think of when it comes to the "surprise medical bills" they've received.
What about care that isn't covered that people were never warned about?
What about care that is covered but isn't paid for completely that people were never warned about? E.g. co-insurance payments.
Read 6 tweets
21 Dec
Cases and deaths are rising.

But there are also serious consequences of intense social isolation.

I'm hoping we can add a layer of nuance beyond the top line messaging against holiday indoor gatherings and public travel.
Specifically, offering ideas like these:

Gathering among households that are in a strict bubble together.

Gathering across households, outdoors + masked + distanced + warm layers.

Gathering across households, where everyone has done a strict 14+ day isolation period prior.
Those options aren't perfect.

Not everyone can do strict bubbles or strict pre-gathering isolation periods.

School and work and commutes can make them impossible.
Read 5 tweets
20 Dec
No.

People shouldn't be shamed away from healthcare because of past behavior.

dw.com/en/anti-vaxxer…
This line of thinking turns into:

"People who ate ice cream shouldn't get insulin"

"People who smoked shouldn't get chemotherapy"

"People who didn't take blood pressure medicines shouldn't get care for heart attacks"
And ultimately it turns into people just accepting that necessary care can be withheld if there's a justification, whether it's patient-blaming or not.
Read 4 tweets
3 Dec
It's sad but even many of the activists, health professionals, writers, and politicians I most admire aren't focusing enough on the public health policies we need to reduce transmission now...
We aren't going to healthcare our way out of the next few months.

Most healthcare happens too late in the course of infection to affect transmission.
Individual behaviors around masking, socializing, & distancing are either happening or not.

While higher rates in the community might affect how strict people are (among those who do some of these things), I doubt educational efforts will make much of a dent for those who don't.
Read 12 tweets
2 Dec
The typical period of infectiousness is days 3-10 after exposure.

So changing the quarantine recommendation from 14 days to 10 days makes sense.

7-10 days does not make as much sense.

cnn.com/2020/12/01/hea…
Testing day 7 is hypothetically helpful, though imperfect with only ~75% sensitivity then. Image
Still, most people in the US will not get test results back by day 10 even if tested day 7.

Hopefully this recommendation is used to further build the case for test results in <24 hours as being the only acceptable timeframe.
Read 4 tweets
2 Oct
1. Donald Trump has been a political monster, must be removed from power

2. I wish no illness on any person, incl him

3. He, like everyone, deserved protective public health systems, deserves healthcare

4. Don't let this distract you from election actions e.g. phonebanking
And (while I don't think in general we should treat people's purported illnesses with overt skepticism) he's a frequent opportunistic liar with nuclear weapons, personal legal trouble, and an upcoming election.

I would like to see a doctor's note.
And, since it might not be obvious, I'm definitely not asking anyone to pray for him and I don't think anyone who deeply or fleetingly wishes him ill deserves any shame.

People are entitled to their rage. Trump has caused so much death and suffering.
Read 4 tweets

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