Important @apoorva_nyc piece. Highlights bigger issue

Hospitals rightly prioritized for vaccines because of front-line workers: nurses, doctors, staff

But many vaccinating non-front-line staff, administrators, even wealthy donors on their Board

Thread

nytimes.com/2021/01/10/hea…
I have mixed feelings here

We need to get shots out

Reasonable to vaccinate folks working in hospital lab

But administrators? donors on boards? Their families?

There is a better way

Hospitals should use left-over doses for elderly, at-risk folks in their community

2/3
Hospitals are getting mixed messages

Told to use their vaccines quickly (good)

Told to not let any cut in line (appropriate)

Told not to give it to non-hospital folks (ugh)

Hospitals have doses left over (due to staff hesitancy)

They are worried about not using it right

3/4
So states need to send a clear message

Get vaccines out

Obviously prioritize front-line workers

But with left-overs, start vaccinating community members at high risk

It doesn't have to be perfect

But we can do a lot better than we are doing now

Fin

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More from @ashishkjha

11 Jan
Just spoke with a close colleague, thought I'd share his story

Have changed minor details to protect him

He's an ER Doc, working in a hot spot

Few days ago, early evening, vaccine team showed up with a bunch of extra doses of Moderna vaccine

Thread
They were looking for unvaccinated employees

Most employees there had been vaccinated. Rest were unwilling

Found several EMTs & patients who were excited to be vaccinated

But hospital policy was clear: non-employees aren't eligible

My friend, ER Doc, incensed, intervened

2/4
He tried to persuade vaccine team but they wouldn't over-ride hospital policy.

He called ER leadership. They wouldn't over-ride

Next, hospital leadership. They initially said no, claiming state mandate

He is persuasive and persistent....so they eventually relented

3/4
Read 5 tweets
8 Jan
Things are very concerning with the pandemic

Not just vaccine distribution but outbreak itself

It's bad

Yesterday we had more than 4,000 deaths from COVID19

Highest single day ever

But story is worse when you look at cases, hospitalizations

And thus, urgency to act

Thread
Let's talk data -- via @COVID19Tracking

7-day moving averages from yesterday

Daily deaths 2761: highest ever

Daily new hospitalizations: 4284: highest ever

Daily new cases: 224K: highest ever

% positive: 16.6%: highest since Apr 21

You know what's not highest ever? Testing
So this is a problem for lots of reasons

Obviously, having more Americans dying is horrible

But yesterday's deaths represent infections from mid-December

Before the holiday surge

And back then, cases were lower

And the percentage of tests positive was lower

3/8
Read 8 tweets
3 Jan
I've been thinking about the debate of delayed vs. immediate 2nd dose for some time

Over past week, have become convinced that getting all doses out now is better

Its NOT a no-brainer

Reasonable people can (and do!!) disagree

So here's why my thinking evolved

Thread
Obviously, if you want to stick to the trials (reasonable position), then stay with standard interval

But soon, we'll be confronted with question -- do we give 2nd shot to some people or 1st shot to more people

Is there clinical trial evidence that 1 dose is helpful?

Yes

2/n
Yes

There is compelling data from Pfizer and Moderna trials that after about 10 d after 1 dose, you get 80-90% efficacy

fda.gov/media/144245/d…

nejm.org/doi/full/10.10…

So the BIG question is -- is that going to be durable beyond 21 to 28 days?

We don't know for sure

3/n
Read 10 tweets
30 Dec 20
Really important news out of UK

Important for UK and the world

But I have mixed feelings about the science here

So what's the news?

UK MHRA (their FDA) has authorized the Oxford Astra-Zeneca vaccine

Why such a big deal & why am I conflicted?

Thread

gov.uk/government/new…
First, the data

UK regulators suggesting that the data they evaluated suggests vaccine has 70.4% efficacy

gov.uk/government/pub…

With zero hospitalizations & zero severe disease in vaccine arm

So that’s good

But not as good as Moderna or Pfizer vaccines (in efficacy)
So why is it such a big deal?

1st, UK will start vaccinating people next week at large scale

2nd, India, other countries will likely now approve this vaccine

And India likely has tens of millions (if not more) doses ready to go

3/n
Read 9 tweets
29 Dec 20
So a lot of chatter happening on the slow vaccine roll out

Personally, I'm incredibly frustrated.

Did we not know that vaccines were coming? Is vaccine administration a surprise?

Several complex issues so lets break things down a bit

Warning, this is a bit of a rant

Thread
First, we were told in October that we'd have 100 million doses by end of December

100 million

Who said that? @SecAzar

In The Hill. Like 10 weeks ago

Then, by november, Azar was saying 40 million doses ready to ship out by end of December

thehill.com/changing-ameri…
Here's Azar in @thehill saying 40 million by end of the year

In December, Operation Warp Speed says 20 million doses will be out by end of year, they'll keep the other 20M in reserve for 2nd dose. Fine

3/n

thehill.com/changing-ameri…
Read 14 tweets
12 Dec 20
Michigan vs. Ohio State Football today postponed due to COVID

But a comparison of MI vs OH on COVID is useful

Why?

While vaccines are coming, we have 6-8 hard weeks ahead

And the big question is -- can we do anything to save lives?

Lets look at MI, OH for insights

Thread
On 11/15, Michigan announced series of restrictions

Ohio didn’t

We can compare the two to see if Michigan policies helped

Why is Ohio a good comparison?

OH a neighbor of similar size, make-up (urban/rural, etc)

Here's COVID cases through 11/15

(OH in red, MI in blue)
The two states have tracked very closely

Similar states

Similar policies

But then, things changed mid-November

So let’s talk data (@COVID19Tracking 7-day moving avgs)

3/9
Read 8 tweets

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