1/ Important point from @K_G_Andersen — variant #B117 in San Diego; may not change what we need to do— but is an urgent reminder that we are not even doing what we need to do well enough as it is.
2/
▪️testing— unable to scale rtPCR; have not utilized rapid testing correctly

▪️tracing— cannot keep up w current spread; digital tracing attempted but never picked up enough

▪️isolating— safer isolation spaces outside the home were built- many patients did use, many did not
3/
▪️masks— better masks never produced at scale; cloth masks still most common; hospitals w ongoing N95 shortages

▪️ventilation— talked about; unclear that any major at-home breakthroughs introduced (aside from opening windows, which helps)

▪️vaccines— inefficient rollout
4/
▪️trust building— long way to go here

▪️equity— the epidemic exposed our biases, racism, classism; doesn’t feel like much has changed; Nebraska Gov just today saying undocumented frontline workers won’t get access to vaccine

• • •

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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 12 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…
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
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
4 Jan
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…
Read 10 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

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