1/ I signed on to this effort from @RapidTests & a number of colleagues to urge Congress to utilize rapid antigen testing in a smart way for epidemic control. #covid19

rapidtests.org/expert-letter
2/ We wrote about this strategy over the summer @washingtonpost & some of the pros/cons-- done correctly, the benefits could be immense.

Done incorrectly without expectation setting or right strategy, can become problematic for health systems to manage

washingtonpost.com/outlook/2020/0…
3/ I spoke to @lisalsong @propublica about this topic recently

Every day, people are becoming super-spreaders without even knowing that they are

Rapid tests can stop the most infectious people from going to work/school/gatherings/public transit etc

propublica.org/article/rapid-…
4/ Rapid tests are not the silver bullet- there is no silver bullet. Not even vaccines. Multi-faceted strategy, boots on the ground public health, strong government support, strong community cohesion-- many things are needed to stop the epidemic.

But we've known this for months

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More from @AbraarKaran

24 Dec
1/
Currently reading a book about the history of epidemics and society.

“What made the bubonic plague especially fearful was that it presented communities with the antithesis of the “art of dying”...death from plague was sudden; people died alone.”
2/
Ask any doctor- especially those working ICUs— about the pandemic deaths that separated families from loved ones. Patients died with nurses and doctors by their side; but many without their families.
3/ I remember one especially terrible case I had cared for in an emergency department back in April. The whole family had been infected as they lived in a multigenerational home; a son was sick in the ED; his father died alone in an ICU at the same time.
Read 4 tweets
21 Dec
1/ Just received dose 1 of the #covid19 vaccine. Knowing I will have protection to keep working & caring for our patients means more than I can express— the epidemic isn’t close to over, but we truly needed this boost. @BrighamWomens @harvardmed
2/ At this moment, all I can think of is the thousands of American lives we have lost. Well over 300,000. Those were parents. Those were siblings. Those were mothers, brothers, fathers, sisters. Those were our patients. Those were our families. Those were our neighbors. #covid19
3/ So many who didn’t die continue suffering debilitating symptoms. Just yesterday was speaking w/ a young previously healthy colleague w/ ongoing shortness of breath and palpitations, leaving them largely unable to resume the life they had before. #covid19
Read 4 tweets
20 Dec
THREAD
1/ Finally got a day off from the wards. Finally have a chance to call out more bullshit. Frontline workers who have been risking their lives in hospitals, grocery stores, pharmacies, factories, nursing homes - the people that couldn't stay home- should be protected first
2/ Inequity is a bigger epidemic in the USA. Point blank. We talk about upstream factors for disease transmission in global health and epidemiology. What is upstream of #covid19 transmission? Inequity. It's literally why some people could stay home/stay safe. Others couldn't.
3/ I don't want to see politician selfies anymore. Not right now. I was supposed to be vaccinated this weekend & at the last minute was notified I had been exposed to a colleague who tested positive. I'm not upset about this- this is the reality. The virus is spreading. #covid19
Read 6 tweets
20 Dec
Thread

1/ Have been on wards for the past 3 weeks making it harder to keep up w/ other new developments. But today a patient told me that while we were concerned about his chief medical complaint, what *he was concerned about* was tragedy he was dealing w outside the hospital.
2/ Many times throughout the epidemic, I have felt immensely guilty knowing that as a healthcare provider, while it was not always easy, I still had it so much better than what my patients were going through. Nothing was more humbling; nothing gave me more perspective
3/ While it was hard to be away from family for months; to not see friends; to basically have my routine become home—> hospital—> home, at least I had my health. I had peace of mind. I had a roof overhead. My patients often didn’t and don’t; this eats at me.
Read 7 tweets
18 Dec
1/ As many of you know, I’m from Los Angeles. Many of my medical school classmates are now doctors out in LA— and I’ve heard the same from a number of them. The situation is really bad. @latimes
2/ One of my friends last night shared that a patient of his was discharged from an ICU straight home; was still sick; ended up being readmitted & dying (not covid) bc the beds were in such shortage that patient turnover reached unsafe levels. Filled ICUs are very bad news.
3/ And for all the #covid19 non-believers — even if you don’t believe in #covid19, I’m willing to bet most of you still believe in medicine in general.

ICU level emergencies outside of covid don’t just disappear— but beds definitely do in a deadly pandemic.
Read 4 tweets
16 Dec
1/ Kansas public health administrator from small town targeted & abused for telling people to wear masks; her own husband refused to mandate them in his store, got #covid19, gave it to her as well; her mother ended up getting it and died on a ventilator.

apnews.com/article/pandem…
2/ “Across the United States, state and local public health officials such as Coleman have found themselves at the center of a political storm as they combat the worst pandemic in a century.”

This will likely continue to be the biggest hindrance to stopping the epidemic IMO
3/ This targeting has been more than just public health administrators; practicing doctors are suffering as well. I have personally been targeted recently by right wing groups manipulating data (quite inelegantly at that) & information, leading to personal harassment. #covid19
Read 6 tweets

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