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Dr. Abraar Karan Profile picture
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26 Dec, 12 tweets, 9 min read
New #covid19 variant #B117 has led to vastly different responses around the globe.

Japan, for instance, has stopped all foreigners from entering until the end of January— they had detected cases of B117 as of Friday. washingtonpost.com/world/2020/12/…
2/ Canada as of now has restricted all incoming flights from the UK until January 6th #covid19

gov.uk/foreign-travel…
3/ France eased restrictions for certain categories of people as below #covid19

gov.uk/foreign-travel…
4/ Brazil has also restricted UK travel. #covid19

usnews.com/news/world/art…
5/ Israel also restricts all travel from UK amidst cases of new variants #B117

#covid19
gov.uk/foreign-travel…
6/ Important consequences of any policy decision; for instance, travel ban —>thousands of trucks on way to France from UK were suspended; aid groups deployed to bring food/water to truck drivers, as well as testing #covid19

nytimes.com/2020/12/24/wor…
7/ Important executive summary from @CDCgov on new #B117 variant— comment on unlikely possibility of evading vaccine-induced immunity below #covid19

cdc.gov/coronavirus/20…
8/ Thoughts on the cost/benefit of implementing travel bans with new variants; some have argued that costs outweigh benefits once there has been enough spread (“too late”); others have felt differently- answer (to me) doesn’t feel clear #covid19 ⬇️
9/ generally seems that new #covid19 variant #B117 spreads more effectively but does not cause more severe disease from limited info that we have

Marginally more efficient spreading changes certain thresholds, incl # need to vaccinate for HIT by a notable amount (poss millions)
10/ Spain, Switzerland, Sweden, France, Canada, Japan, Denmark, Germany, Italy, Netherlands, Australia all w/ confirmed cases of new #B117 #covid19 variant; likely has spread much further than that but limiting factor seems to be rate of genetic sequencing
bbc.com/news/world-eur…
11/ “In the end, how quickly the virus spreads depends on many factors, including people's behavior in a community. That is, whether they wear masks, physically distance and avoid big gatherings.”

**Yes- but much of this tied to gov response + support**

npr.org/sections/goats…
12/ Important reporting from @kakape on new #B117 #covid19 variant; mutations in the gene that encodes the spike protein & impacts entry into human cells may account for increased transmissibility concerns.

sciencemag.org/news/2020/12/m…

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More from @AbraarKaran

Dr. Abraar Karan Profile picture
26 Dec
Some thoughts on new UK variant #b117 (not a virologist- purely from a public health response view)

1/ Seems this was inevitable & we will see more variants of concern over time. We will constantly have to re-evaluate response measures #covid19
2/
if vaccines turn out to be less effective against new variants (big “if” here), this will be another reminder that fundamentals of public health + multilayered strategy always name of the game— a vaccine is one part of that- not the whole strategy. No short cuts #covid19
3/
Better masks & personal protective equipment for the general public is well overdue; we know masks work; we know aerosols contribute to spread; we know not all masks have effective aerosol protection- better masks are a win-win, & aren’t affected by new variants
#covid19
Read 9 tweets
Dr. Abraar Karan Profile picture
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
Dr. Abraar Karan Profile picture
23 Dec
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-…
Read 4 tweets
Dr. Abraar Karan Profile picture
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
Dr. Abraar Karan Profile picture
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
Dr. Abraar Karan Profile picture
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

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