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Abraar Karan Profile picture
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26 Feb, 4 tweets, 3 min read
🧵 1/ So I read this @BostonGlobe story today about what is going to be reopening in Massachusetts on Monday - restaurants will have *no capacity limit* and can host *musical performances*(??)

Hmm interesting.

So I decided to check again what % we have vaccinated #covid19 ...
2/ So we are at 6.2% in terms of people who have received two doses; 16% for those who have received one dose

So...we aren’t even close to where we need to be for vaccinations, we got lucky to see a rapid decline in cases, but now we are rapid reopening

nytimes.com/interactive/20…
3/ I then took a look at the waste water surveillance data, which tends to precede detected cases— possibly a slight uptick here in the last few days?

All this to say: a decrease in cases should still mean—> scale up vaccinations while temporizing spread

mwra.com/biobot/biobotd…
4/ I don’t think it should mean: reopen as fast as possible, incl having higher risk venues w/ masks off + indoors now being at no capacity limit (AND musical performances)

I’m saying this as someone who is fully vaccinated, but concerned for those who are not yet. #covid19

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More from @AbraarKaran

Abraar Karan Profile picture
25 Feb
🧵1/ So CDC published a couple of outbreak investigations from gyms yesterday— heavy breathing, incomplete mask use, aerosols 🗣 —> superspreading #covid19

But we knew this was risky from a May 2020 outbreak in exercise classes in South Korea already...

washingtonpost.com/nation/2021/02…
2/ This was published in May 2020 in the @CDC_EIDjournal - they found that rigorous exercise was associated w/ transmission whereas low intensity (Pilates, yoga) was not.

I think many of you would remember this.
#covid19
3/ What I’m getting at— why is something that isn’t surprising/that we already somewhat knew being presented as novel?

We already could guess from nearly a year ago that gyms- esp w/ heavy exercise- were risky.

Yet ventilation & aerosol risk only recently being highlighted?
Read 4 tweets
Abraar Karan Profile picture
25 Feb
🧵1/ Sometimes when you push for an idea for long enough (#BetterMasks) & when the logic makes sense to you- but you are continuously told by other “experts” (CDC leadership) that it’s not needed; you begin to wonder if you yourself are missing something. #covid19
2/ But- the other factors at play- the political ones- make me think otherwise.

If CDC said “yes better masks are better; yes they protect you more”, they are now on the hook for getting these to people.

But- if they don’t have the bandwidth or political backing to do it...
3/ Then they can’t acknowledge it.

But- because we (many of us) pushed for #BetterMasks incessantly, they probably had to do something.

So they did a study with two masks, which worked better than one mask; two masks is easy bc it’s still on the public to figure it out.
Read 7 tweets
Abraar Karan Profile picture
24 Feb
Another @CDCgov report today on #covid19 from unmasked exercise classes

The secondary attack rate of infection from instructors to class participants for classes taught within 1 day of symptom onset was 95% (20 of 21)!

And again here, we have CDC 🗣 about aerosol transmission
2/ Transmission despite 6 feet apart w/ instructors yelling during stationary cycling class #covid19
3/ One of the instructors was teaching kickboxing & personal training - two of the infected participants wore masks and were *still infected*
#covid19
#BetterMasks
Read 4 tweets
Abraar Karan Profile picture
24 Feb
THREAD

1/ New CDC report on #covid19 outbreak -55 cases in a week- among those attending an exercise facility in Chicago in August 2020...

22 people (40%) attended on or *after* the day their symptoms started

76% reported wearing masks *infrequently*
cdc.gov/mmwr/volumes/7…
2/ Right in the abstract here under "implications for public health practice", CDC says:

"To reduce SARS-CoV-2 transmission in fitness facilities, attendees should wear a mask, including during high-intensity activities when ≥6 ft apart."

So the 6 foot rule has limits...why?
3/ Because of smaller particles- aerosols- that spread farther than six feet, & hang around for more than 15 minutes.

And CDC acknowledges that; but is still hesitant to send people #BetterMasks (announced today they are sending cloth masks)? C'mon man. What is going on?
Read 8 tweets
Abraar Karan Profile picture
24 Feb
1/ Last night had a conversation w/ a close friend about #covid19 & life— one of the points we kept coming back to—> risk aversion is a *privilege*

The risk you are willing to take at the end of the day depends on how badly you need to get food on the table. Period.
2/ When we think about #covid19 & we look at who was getting sick, we saw two main groups emerging early on— vulnerable nursing home residents and essential frontline workers w/o the privilege of ‘staying home’

Folks w/ either high health risk or high exposure risk
3/ From that latter group, many who ended up being my direct patients— life wasn’t about how do I avoid #covid19 as much as it was about how do I keep the lights on; how do I continue to feed my kids; how do I find another job if this one is shut down etc
Read 14 tweets
Abraar Karan Profile picture
23 Feb
Thread 🧵
1/ Have been thinking about this story all night (was working overnight at the hospital).

Japan appointed a Minister of Loneliness. So much of this year has been a deep well of isolation.

For some of my patients, this was worse than #covid19

insider.com/japan-minister…
2/ I have treated people who have suffered from #covid19 but said that actually losing their job, relapsing to substance abuse, being afflicted by depression/suicidality was even worse.

For some, it was not even a life worth living at all.
3/ I have also seen a ton of shaming around social activities on Twitter.

“Can’t believe this person did that” etc

We don’t know what other people are going through.

That doesn’t mean condoning all social activities- but it also doesn’t mean stigmatizing all of them either.
Read 7 tweets

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