Here's one of the points I made in this #COVID19 lecture: When I see a politician taking drastic action that is not supported by data, I ask myself, "How did this person respond to warnings in March?"
An example: 1/
While most of the world was focused on mitigation in mid-March, the United Kingdom implemented “delay.” As many experts noted at the time, this was a mistake. The UK inadvertently served as the placebo-controlled arm of a global study aimed at limiting death and disease. 2/
Delay has been widely criticized. Coronavirus moved unchecked throughout England until the prime minister was forced to reverse course and implement harsh restrictions. We're still feeling the repercussions today. 3/
bloomberg.com/news/features/…
Leaders who were inactive in March try to be proactive today. (We saw this with the arbitrary closing of NYC public schools). The result: Severe restrictions are implemented based on weak data. There is no experimental evidence that the new variant is 70% more transmissible. 4/
I discussed one of the unusual lessons of the pandemic: Swift & decisive action is not always the answer. Sometimes nuance is necessary. It's okay to ask for more evidence before making sweeping decisions. That is true leadership. But some are haunted by their decisions in March.

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More from @DrMattMcCarthy

23 Dec
UPDATE: Coronavirus has mutated into a new variant, B.1.1.7, that has the world's attention because it may be more contagious.
Some thoughts on where this came from and how it impacts patient care: 1/
The novel #coronavirus typically acquires a mutation every few weeks. The new variant is interesting because it seemingly developed a bunch mutations all at once: 17 mutations in viral proteins, including 8 changes in spike protein, the target for all of our vaccines.  2/
Why would a flurry of mutations suddenly emerge? The focus now is less on unique properties of #coronavirus and more on unique human hosts: patients with impaired immune systems who are chronically infected and unable to clear the virus.  3/
sciencemag.org/news/2020/12/u…
Read 10 tweets
21 Dec
UPDATE: Countries are scrambling to contain a new variant of #coronavirus that's reportedly more contagious. Some key points: 1/
Mutations are expected. This variant was detected months ago and there's no evidence it's more deadly or resistant to recently-authorized our vaccines. Viruses are constantly drifting into new shapes and the vaccinated immune system has a variety of ways to contain it. 2/
To justify lockdowns and travel bans, some are citing a figure that the new variant is 70% more contagious. How did we arrive at that number? It's based on mathematical modeling, not experimental evidence. Founder effects confound our interpretation of this noisy data. 3/
Read 5 tweets
19 Dec
UPDATE: Here’s one way #COVID medicine has changed since the spring: We now know how #coronavirus can invade and destroy muscle. This has relevance for patients who have profound fatigue, difficulty walking, or weakness that just won’t go away. 1/
The new insights may also help us unravel Long COVID, to understand why some people have such a hard time recovering. It all began several months ago, when a link was established between the virus and muscle injury: 2/ 
wwwnc.cdc.gov/eid/article/26…
We now know that in a subset of people, #coronavirus can manipulate a signaling molecule, interferon, to trick the human body into making proteins that are toxic to muscle tissue. 3/
nejm.org/doi/full/10.10…
Read 6 tweets
19 Dec
UPDATE: There are now 2 #COVID19 vaccines authorized for emergency use in the United States. Although both use an mRNA platform and have similar safety and efficacy profiles, they are not interchangeable. 1/
You can't get one dose of Pfizer and then, several weeks later, take a shot of Moderna. The vaccines use different nucleic acid constructs, dosages, dosing intervals, storage & handling requirements, & lipid formulations. You want to boost the immune system with the same vaccine.
Some vaccines are interchangeable. You can start the Hepatitis B series with a vaccine made by one manufacturer and, in some cases, complete it with another. Not so with COVID. We don't have experience combining Pfizer with Moderna, and it is not recommended to switch.
Read 5 tweets
18 Dec
UPDATE: New guidelines were published today to help clinicians identify cases of Long #COVID (symptoms lasting 4 weeks or more) to ensure proper diagnosis, treatment, & rehabilitation. It's an important step forward, but it's not without controversy: 1/
nice.org.uk/guidance/ng188
The new guidelines include a name change from Long COVID to post-COVID-19 syndrome. Some are not happy about the switch, which implies a degree of recovery from the virus. Given the relatively poor understanding of Long COVID, the switch may be premature.
marlin-prod.literatumonline.com/pb-assets/Lanc…
The condition potentially impacts millions of people worldwide. It's been estimated that one in five people have symptoms that persist after 5 weeks, and one in ten have symptoms for 12 weeks or longer. We still don't know if this condition is a group of several unique syndromes.
Read 4 tweets
18 Dec
NEW: Study finds death rate for patients hospitalized with #COVID19 is nearly 3x higher than death rate for patients hospitalized with influenza. This is one of the many ways coronavirus differs from the flu: 1/
thelancet.com/journals/lanre…
In this French study of more than 100k people, #COVID19 patients more frequently developed respiratory failure, blood clots in the lungs, or brain bleed than patients with influenza, but less frequently developed a heart attack (myocardial infarction) or abnormal heartbeat. 2/
COVID patients were more likely to need intensive care and spent nearly twice as much time in the ICU as influenza patients (15 days vs. 8 days). 3/
Read 6 tweets

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