📣ATTENTION VACCINE HUNTERS:
After weeks, I got lucky and got the shot for a high risk 1b senior! NOT easy so sharing long🧵w tips from multiple sources while looking in 2 states (Maryland & Illinois) AND on national drugstore websites. #ThisIsOurShot #vaccinehunters
First, does where you get care have it? If no-this is a big inequity. If yes, make sure your online portal is active. While places prioritize their patients, some do say supply limited so keep looking.
KEY🔑sign up for any and all registrations you can. wbez.org/stories/black-…
Next, do you live in a place with an aggregator like Chicago @zocdoc which shows where vaccine available? Great if you do. But does it have all sites? Chicago’s missed some so I use @IMPACT4HC links curated by @halleh13 BOOKMARK LINKS! CHECK MANY TIMES/DAY impact4hc.com/vaccine-genera…
Almost all websites are first come first serve especially the retail pharmacies so you need to know when site “opens”. This was REALLY hard and a lot of trial and error.

@alikhan28 and I have said this was a problem that breeds inequity. chicagotribune.com/opinion/commen…
While social media has dark sides it also can bring the light - and who knew that @Facebook saves the day! People created Facebook groups in Chicago and Maryland for “Vaccine Hunters.” Thousands of people are literally are crowdsourcing where spots open.
baltimoresun.com/coronavirus/bs…
So I joined both Facebook vaccine hunters groups and still no luck but I FELT BETTER. WHY? When you stay up to try and it’s 1AM and get so close on @GiantFood website to getting an appt in Maryland but lose it at other last second, you realize bc of the group YOU ARE NOT ALONE.
If you check Facebook groups every am and pm like I do (you need to) you realize some times are just inhuman...like Rite Aid had spots open up 2am or 4am ?! Talk about sleep loss. I was already staying up late and getting up early. But I did better w tips to beat the websites.
Why do I say “beat the website?” The Maryland Vaccine Hunters Facebook has an expert whose been super successful. Her first rule “THINK LIKE A GAMER..”

that’s right she’s a gamer and has spent hours on these websites gaming them! I was frustrated but I decided I need to try.
Goal of the game she says: GET TO NEXT LEVEL. Don’t give up. Keep pressing 100x to get to next level. I embraced my inner Nintendo. That’s in fact how I “won” at the Holy Cross site for Dad in Maryland which at least tells you when the site opens. Process is unjust though
The Facebook groups also sometimes post backdoor links that allow you to skip the queue so you can try to “hack in” to the appointment site..if it’s open. Regardless of the site, most people say if you can get to the calendar level keep clicking bc you may get lucky...
By the end of this week, I was 😴 and losing hope. I was on @WBEZ talking with @MariahWoelfel about how hard it was to get a vaccine and I mentioned how nice Chicago vaccine hunters Facebook group was...and several posted there that they heard me. podcast-stream.wbez.org/recast/wbez-fe…
Bc I liked the fb post I got notifications the next morning (yest). my daughter miraculously had no school so was asleep and I just finished talking aging/tech w @meganhuisingh @vgpress13 @cybulsky when I saw someone post Cook County open.....

wait for it.....

ON THE PHONE ☎️
So I actually CALLED and was on hold but got someone after a few min who in 10sec flat said they were out of dose 1 and before she was about to hang up...
I SCREAMED into phone “We need dose 2!!!”
And she said “well ok then...” and took the info and appt booked for TODAY!
If you’re angry by now, imagine everyone trying! Sure it’s a crisis of supply which hopefully improves 1 day...but regardless, many seniors and those without tech access/knowhow or time will be left out.

Why work of @Eugenia_South @alikhan28 CRITICAL!

chicagotribune.com/opinion/commen…
This process is broken. I strongly encourage everyone to read this @Health_Affairs piece by ethicists @WF_Parker @DrMonicaPeek @GovindPersad and demand a better system from our elected officials!

PS I am not done looking but tips important to share
healthaffairs.org/doi/10.1377/hb…

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More from @FutureDocs

18 Jan
As someone who has studied healthcare handoffs for a while, I can’t stop thinking about the Presidential one coming up. I see I’m not the only one. But this is not like any handoff. My nerdy 🧵 #MedTwitter #Inauguration2021
Handoffs come in many flavors in medicine. In general, the highest risk handoffs are when the patient is really sick and the handoff is permanent and not temporary. So in some ways, yes has elements of a risky handoff. America is definitely sick and the handoff is permanent.
Ideal handoffs are a transfer of content and a transfer of professional responsibility. The goal of content transfer: to achieve a shared mental model or shared vision of the patient. Professional responsibility usu= does receiver accept? Now it’s been will sender relinquish?
Read 13 tweets
4 Jan
OUR NEW STUDY out @JAMAInternalMed is on personal attacks & sexual harassment of physicians on social media.

Authors on #MedTwitter here and 1st author med student 👏🏽@traependergrast & @ShikhaJainMD @MDaware @MikeGisondi @ShikhaJainMD @NikiWoitowich
jamanetwork.com/journals/jamai…
This paper is the result of a survey we did on social media in Feb-Mar 2019 so pre pandemic. We posted a @Bitly link daily on our accounts to track engagement. 464 completed our survey of 1103 views (42%).
~1 in 4 physicians on social media reported being attacked. No diff by gender. Most common reason: advocacy on vaccines & other public health issues like gun control. Attacks on race & religion too. Reports of employers being called, getting doxxed, and even death threats. Image
Read 12 tweets
20 Dec 20
Despite positive vaccine news, with record high #COVID19 hospitalizations this past week:

National Academy of Medicine & 8 national orgs call for "immediate action to save lives and fairly allocate limited resources" on CRISIS STANDARDS OF CARE.
🧵

nam.edu/national-organ…
NAM, AMA, ANA, NMA, AAMC & more:

"The crisis is now..Hospitals across most of the US are experiencing alarmingly high surges in #COVID19 patients..many ICUs across the country are already over capacity and many more will be so in the coming weeks." 2/x
#medtwitter #nursetwitter
"We have reached a point in the crisis at which critical decisions must be made in order to do the most good possible for the largest number of people with limited resources. These decisions effectively signal a shift from conventional to crisis standards of care." 3/x
Read 7 tweets
9 Dec 20
I was watching some news stories this week featuring hospital leaders and healthcare workers talking about how things are in surge states. Reporter always asked if they were 'overwhelmed' and did 'they have beds/staff?"

Sadly, you won't get the real answer this way.

THREAD
The thing is that hospital leaders can't go on TV and scare people with how bad things are because of the real concern that patients who are indeed sick won't come in leading to more deaths. They also are managing concerns of risk management and reputation/financial damage too.
So they may say something like "our staff are doing our best" or I am "so proud of our teams" This is true! Everyone IS trying their best.
But please know that's not a business as usual signal.
"everyone is doing their best" is code for "yes s*(& hitting the fan but we trying"
Read 7 tweets
30 Nov 20
Saw news stories saying "despite months of preparation" hospitals/healthcare facilities not ready for surge. While preparation is key,

* Months cannot create trained staff

* in surge, "No STAFF" for beds = "No beds"

* Worst in rural areas with staff shortages.

THREAD
Staff not in bubble. When circulating virus is high in community, staff exposed/get sick/care for others. "Run out of beds" because you essentially run out of staff. Also why # beds on a website doesn't always match the reality of what staff see. spectrumnews1.com/oh/columbus/ne…
Surge in rural/underserved areas is plagued by staff shortages at baseline. @CleseErikson shared this @GW_Workforce graphic shows baseline supply ICU docs across country. Assuming no attrition, most flyover states are "inadequate supply for any demand" gwhwi.org/estimator.html
Read 14 tweets
27 Nov 20
BLACK FRIDAY:

You're looking for a deal.

Hospitals are looking for ICU beds...anywhere they can.

THREAD
*St. Louis ICUs "at capacity"
*Hospital leaders calling a list of hospitals btwn St. Louis to Chicago find any ICU bed
*Patients being flown up ~100 mi away for ICU care

kmov.com/news/at-capaci…
Another Missouri: Patient in need of neurosurgery ends up in Iowa. "The hospital spent the next 25 hours trying to find a health center in a six-state area that had a neurosurgery ICU bed available."

ky3.com/2020/11/17/hou…
Read 9 tweets

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