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Vincent Rajkumar Profile picture
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7 Jan, 10 tweets, 10 min read
2020 was rough from an academic standpoint. We couldn’t get clinical or lab research done as planned. I did get some work done. Here are some I feel good about.

1. RCT in Newly diagnosed myeloma of VRd vs KRd. ENDURANCE @myelomaMD @eaonc @TheLancetOncol thelancet.com/journals/lanon…
2. RCT of Len vs Observation in Smoldering myeloma. @SagarLonialMD @eaonc @ASCO_pubs ascopubs.org/doi/full/10.12…
3. RCT of Ixa-Rd vs Rd in Newly diagnosed myeloma. TOURMALINE MM-2 @MayoMyeloma @ASH_hematology #ASH20 ash.confex.com/ash/2020/webpr…
4. Commentary on the high cost of insulin and a call to action. #Insulin4All @MayoProceedings @MayoClinic mayoclinicproceedings.org/article/S0025-…
5. Commentary with @choo_ek on medication shortages in the COVID pandemic. @MayoProceedings @MayoClinic mayoclinicproceedings.org/article/S0025-…
6. Multiple Myeloma Current Treatment Algorithms. #BCJ @MayoMyeloma nature.com/articles/s4140…
7. Commentary on need for universal masking for healthcare workers in both clinical and non clinical areas with @a_kaltenboeck @sloan_kettering @MayoProceedings @MayoClinic mayoclinicproceedings.org/article/S0025-…
8. The screening imperative for myeloma. @nature @MayoClinic @MayoCancerCare nature.com/articles/d4158…
9. IMWG risk stratification for smoldering myeloma. #BCJ @mvmateos @myelomaMD @SagarLonialMD @BrianDurieMD nature.com/articles/s4140…
10. Characteristics of exceptional responders to stem cell transplant in myeloma. #BCJ @MayoMyeloma @myelomaMD nature.com/articles/s4140…

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More from @VincentRK

Vincent Rajkumar Profile picture
8 Jan
CDC says asymptomatic transmission may be responsible for more than half the COVID cases. Kinda little late to come to this conclusion. Don’t you think?

We came to this conclusion almost from the outset of the pandemic.
cc: @ASlavitt
google.com/amp/s/www.wash…
There is simply no way for COVID to become the pandemic it did unless there was a lot of asymptomatic spread. Yet we had leaders from WHO on wanting “proof” before they would commit to anything. That’s like saying that cars without headlights are dangerous but we need proof first
In our anxiety to seem scientific, we forgot logic and common sense. I say it because I saw it happen over and over again.
Read 4 tweets
Vincent Rajkumar Profile picture
6 Jan
I agree. This is not good. We are only as strong as the weakest link. Politicians will not realize this.

I heard from a friend overseas last week. On New Year’s Day. That everyone in his country, rich or poor, citizen or immigrant, legal or illegal, will all get free vaccine
We are in dangerous times. Physicians need to speak up.
The reason we need to make sure everyone has the vaccine is for public health. If we don’t achieve high rates of vaccination there will be no herd immunity, the virus will continue to find susceptible hosts to attack and continue to mutate.
Read 4 tweets
Vincent Rajkumar Profile picture
4 Jan
2020: 20 million Americans got COVID.

How well could we have done?

If we had done as well as
Germany: 14 million fewer;
South Korea, Australia, New Zealand: >19.5 million fewer.

@ASlavitt had a thread on this 6 months ago. It’s still holds true.
We had 350,000 deaths due to COVID.

How well could we have done?
If we had done as well as Germany: 200,000 fewer deaths;
South Korea, Australia, New Zealand: >300,000 fewer deaths.
What went wrong? What could we have done better. The overriding problem was failure of leadership, lack of strategy, and mixed messaging.

We lost our standing as a country to look up for expertise in solving a public health problem. That’s going to be hard to get back.
Read 6 tweets
Vincent Rajkumar Profile picture
20 Dec 20
“Worrying is like rocking a chair. It give you something to do. It doesn’t get you anywhere”. Famous saying.

Worried about mutant COVID? Just follow what’s in our control: Masks, social distance, and get as many people in the world vaccinated as soon as possible.
Some of us discuss the mutant strains just to increase awareness and to keep people informed. The goal is also to make sure leaders are appropriately concerned and act. And to not make the same mistakes of months past. Not to make the public anxious.
My feeling remains the same. Once people are vaccinated even if the virus mutates the probability that it will have the ability to evade immunity from infection or vaccination adequate enough to cause severe illness and consequently this type of pandemic will be very rare.
Read 5 tweets
Vincent Rajkumar Profile picture
19 Dec 20
Even today someone is arguing that COVID death rate is only 0.1% & so it’s not a big deal.

Facts:
-True mortality is 1%

-Mortality is much higher if hospitals are overwhelmed

-0.1% of the US has already died from COVID

-310 million Americans are still at risk of getting COVID
-Young healthy people do have a very low mortality rate from COVID. Especially those less than 25.

-But the nation is not full of young, healthy people.

-We are in this together. For everyone around us. Our friends, family, neighbors, and fellow citizens.
-All restrictions are temporary.

-We have highly effective vaccines. Whatever concerns people had of long term harm to their freedoms is no longer valid. We do have end in sight.
Read 5 tweets
Vincent Rajkumar Profile picture
17 Dec 20
One common question in recent days: How come places with mask mandates & restrictions have also been affected with high rates of COVID?

A few thoughts:

1) We are dealing with an enemy that doesn’t play fair. So unless there is high compliance, it exploits the weakest link.
2) Unfortunately masks are only one piece of the puzzle needed to stop COVID. They work in concert with other measures including border control, testing, tracing, ventilation, social distancing, protecting vulnerable populations etc. They work as part of a coordinated strategy.
3)Some places did do well for months. But then when they relaxed, the virus came right back. Until we have herd immunity from vaccines, the COVID virus does not magically disappear with just a few months of compliance. Needs to be sustained. Thankfully we have an end in sight.
Read 9 tweets

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