1/ So we know that we need to vaccinate a lot of people, preserve hospital capacity, & buy time

& we know that we have ⬆️ spread all over the country & even more w/ recent holiday travel

We need an emergency 🛑 on spread, w/ more drastic policy measures hbr.org/2020/08/the-u-…
2/ We need to implement absolute, not incremental, restrictions on nonessential venues. Those businesses need additional $$ protections in return. Anything that needs to remain open (grocery, pharmacies) needs to operate at regulated capacity w/ ⬆️protection for frontline staff
3/ Need to repurpose hotels/dorms etc as safer & better isolation & quarantine spaces; & $$ incentivize people to use them (punitive measures don’t work as well here & tend to become regressive)

Mandate masking in any indoor public space that remains open washingtonpost.com/outlook/2020/0…
4/ Stop wasting time/energy harassing people outdoors (in places where weather even permits, keep beaches, playgrounds, parks etc open; the cost of restricting these —> people gathering indoors in private anyways which we can’t regulate without invading privacy)
5/ Schools are more complicated which others have debated in diff threads. Costs to children even in short term are large; benefits of closing primary schools on spread are unclear; would focus on the previous tweets before making strong assertion on schools. #covid19
6/ The biggest diff b/w benefits of “lockdowns” or w/e you want to call smarter epidemic policy now vs earlier?

Vaccines

We have a major deployment underway

We need to slow spread quickly; also need to repurpose large parts of workforce toward vaccine deployment #covid19
7/ And remember- if we have more LA county situations around the country, politicians will eventually be pushed to doing something drastic anyways bc people dying without ever making it into the hospital isn’t exactly going to win votes. Why wait until that happens? #covid19
This ⬇️⬇️ safer outdoor alternatives for social gathering is key to a sustainable plan over next few months - see thread above #covid19
Made the same point here for the US ⬆️⬆️— biggest difference between these “lockdowns” & prior ones— > we have a vaccine; we have a tangible goal that we can reach. We need to slow spread #covid19

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More from @AbraarKaran

6 Jan
✈️THREAD✈️

1/
Outbreak of #covid19 on an 18 hour flight in September flying from Dubai to New Zealand now officially published

7 ultimately infected; 4 likely in flight, sitting within 4 rows of one another, 2 of them while reportedly wearing masks ImageImage
2/ 5 out of the 7 had been tested **before the flight** and tested negative

2 didn’t report getting tested before the flight but are *not* thought to be the index cases (those who started the outbreak)

BUT Index case was tested **5 days** before the flight! Image
3/ I circled the days that index case *should have been tested* — 24-48 hours before flight, when they had likely started incubating the virus; when detection could have happened; when the outbreak could have been prevented Image
Read 10 tweets
5 Jan
THREAD
1/ I initially hesitated sharing this video clip- its hard to watch & fear mongering is not my goal. This is reality.

But it brings up another point.

Many patients I've cared for have wanted to share their stories & warn the public

Hospitals v hesitant on this #covid19
2/ My own hospital among others was fined for TV filming in 2014/15 as a violation of HIPAA and patient privacy.

I get this is a major issue & the privacy of our patients is of utmost importance.

No argument there

modernhealthcare.com/article/201809… Image
3/ With that being said, in parts of the country (not all), there are many who are not sure about the virus

The vehement #covid19 deniers are a minority (I think)

People on the fence about "is it really bad", or about day to day decisions on social gatherings etc is much larger
Read 7 tweets
5 Jan
Having to text my family to completely hunker down in Los Angeles

Someone dying of #covid19 every 10 minutes in LAC

1 in 5 tests returning positive

Not all patients are brought to hospitals at this point to conserve resources Image
Read 4 tweets
4 Jan
1/ A quick rundown of some of my recent tweets/thoughts in this @BostonDotCom article

We need to stop spread quickly to buy time & healthcare resources while vaccines roll out

Need to repurpose workforce toward all hands on deck vaccination effort

boston.com/news/coronavir… Image
2/ Term “lockdowns” can instill fear & memories of first surge

New efforts shouldn’t be this- must take advantage of virus’ weaknesses such as outdoors, masks, ventilation #covid19

hbr.org/2020/08/the-u-…
3/ key is protecting frontline workers

PPE, $$$, staggering shifts, better isolation options

Policing & punitive measures are regressive & target the poor

Not going to police our way out; must support people and protect them #covid19
Read 4 tweets
3 Jan
1/ I wish we could get better masks for frontline workers.

I had another patient test positive unexpectedly for #covid19 who had presented for something unrelated.

Thankfully I had the right protection- an N95 mask & a face shield on the entire time.
2/ Throughout this epidemic, from March until today, I have directly taken care of more #covid19 patients than I can count. Since day 1, I have worn an N95 mask + face shield w/ every encounter. I have been w/in inches of those infected & coughing for several minutes at a time.
3/ In multiple hospitals where I work, staff & friends have gotten infected.

Many of those infections may have been acquired in the community; but some were in the hospitals themselves.

Some of these were well publicized in the media as well.

bostonglobe.com/2020/10/19/met…
Read 10 tweets
2 Jan
THREAD
1/ Important article by @skarlamangla

Some of the key factors with what went wrong in LA

Fundamentally, LA county was set up to do poorly- structural inequities (surprise) were almost a guarantee of this

But this is unacceptable

#covid19

latimes.com/california/sto…
2/ “But in L.A., it is common for a working-class family of four, five or even more to share a costly one-bedroom apartment.

Among the 25 biggest metropolitan areas in America, L.A. has the highest percentage of overcrowded homes”

*Need safer isolation options*
#covid19
3/ “L.A. County has a huge manufacturing sector and two of the biggest ports in the nation — industries staffed by people who work in the kind of close quarters that can facilitate spread of the virus”

Article notes big outbreaks here. Why weren’t these workers protected?
Read 4 tweets

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