A 🧵 on staying human in a #pandemic:

Every day I look at #COVID19 deaths in my own county. The number is always small. I can picture that number of people. I allow myself to imagine their last days, sit with the likelihood of their suffering, their regrets, their fear

/1
I have watched a lot of people die. I have tried desperately to save some. I have sat quietly with others who have asked us to stop & let them die peacefully. I have declared people dead. It’s a fact of being a doctor. It’s a fact of being an oncologist. So I can picture it.

/2
What I cannot picture is nearly 500,000 in the 🇺🇸 dead. It’s a 767 airplane full of Americans crashing every single day between now and 2028. It’s about 11 full Camden Yards stadiums. I can calculate it, but I still cannot picture it.

/3
But the one person who died yesterday in my county of #COVID19—a person whose name I don’t know—that, I can imagine. I envision that single human’s end, their loved ones. And then when I multiply that by 500,000 dead in 🇺🇸 alone, I feel the vastness. I stay human. #pandemic /End

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More from @tmprowell

24 Aug 20
Time for some #biostats. Here's how I talk about risk reduction w/ pts in #oncology clinic. If someone says, there's a 50% reduction in the risk, you need to know if they're talking about relative risk or absolute risk.
#COVID19 #MedEd
Tweet #2: I explain relative & absolute risk using coupons. A 50% off coupon on a $1 candy bar is worth 50 cents. A 50% off coupon on a $20,000 car is worth $10,000. If you don't know the starting cost (or in med, the absolute risk), you don't know how valuable 50% off is. #MedEd
Tweet 3: "50%⬇️ in risk" headlines usually mean⬇️in relative risk. To calculate # of ppl needed to treat to benefit 1, you divide 1 by the absolute⬇️in risk. Here, ppl WITHOUT the med had a 2 in 100K (0.002%) risk. Ppl WITH the med had a 1 in 100K (0.001%) risk. #BioStats #MedEd
Read 5 tweets
28 May 20
A partial list of things I've still not seen adequately explained re #COVID19:
👉What causes the thrombosis?
👉Why are pts alert & not in distress w/ severe hypoxia?
👉Why the lymphopenia?
👉Why is death so rare in kids?
👉What is different about kids who get MIS-C w/ #SARSCoV2?
👉Why is proning so helpful?
👉What characteristics of the person or virus (not activity/environment) define a superspreader (eg, #SARSCoV2 VL, genetics, etc)?
👉How does #COVID19 immune response differ in pts w/ & w/o 2nd wave of sx at d8-10?
👉How long/complete is immunity?
👉Is there a metabolic link that explains severe #COVID19 in pts w/ HTN, DM, obesity?
👉Does exp to pt w/ high #SARSCoV2 VL ⬆️ risk of transmission or severe illness?
👉What pattern of immune response predicts survival/death?
👉How do antivirals improve outcomes w/o sig ⬇️ in VL?
Read 4 tweets
26 Mar 20
HELP! I have a family member in Orange County, CA on a vent in critical condition for #COVID19. We are urgently seeking a person who has recovered from #coronavirus infxn w/ no symptoms in past 14d & able to donate plasma asap. Irvine/Tustin or LA area. DM me w/ leads. Pls RT.
Tweet #2: Thank you SO MUCH for your kindness! I'm getting many Qs, so answering them here for efficiency. People are asking what criteria they need to meet to donate plasma & which patients with #COVID19 can get plasma & how. See here: bit.ly/2WK2NT9.
Tweet #3: Others are asking if the donor has to be where the recipient is. The answer is no unless there is time urgency to get the product to the pt. Blood products are routinely collected at blood drives & shipped where the need is, but that does introduce a delay. #COVID19
Read 9 tweets
12 Mar 20
A thread on pro-social behavior: The Handbook of Social Psychology describes it as "a broad range of actions intended to benefit one or more people other than oneself--behaviors such as helping, comforting, sharing & cooperation." It will be key in #COVID19 #coronavirus pandemic.
2/X When something bad occurs, there are things that predict the likelihood of someone being pro-social. The "bystander effect" refers to the phenomenon that when there are many people around, individuals are often less likely to act. #COVID19 #coronavirus
3/X Things that can contribute to a lack of pro-social behavior include:
👉Diffusion of responsibility (many people present)
👉 How others are acting, especially if there is uncertainty about seriousness
👉Fear of judgment by peers
#COVID19 #coronavirus
Read 7 tweets
8 Feb 20
Thread: I am getting tons of msgs from fellows since a few recent talks at @hopkinskimmel, @SocTransOnc Fellows Forum, etc, + Twitter. I am happy to hear from all of you, esp the many people interested in #regulatory science. But many similar Qs, so here goes w/ resources!
@hopkinskimmel @SocTransOnc The #FDA_ASCOFellowsDay is a 1d workshop for #hematology & #oncology fellows in last yr (+ lim # of next to last yr) of training. It happens 2x/yr (fall & spring) on FDA campus in MD & 1x/yr at @ASCO Annual Mtg (1/2 day on Fri am). Applications for #ASCO20 one will open soon. 2/X
@hopkinskimmel @SocTransOnc @ASCO Our next one at the FDA campus is coming up on 3/10/20 (already full). This is a screenshot w/ high-level overview of it, and here's the link where you'll find application instructions for the next one once it opens in a few wks: asco.org/training-educa… 3/X
Read 9 tweets

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