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Vincent Rajkumar Profile picture
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12 Mar, 4 tweets, 2 min read
Not approving the Astra Zeneca vaccine was a mistake. We lost 2 months.

Not releasing Astra Zeneca vaccine doses to other countries is a bigger mistake and self defeating. @RebeccaDRobbins @noahweiland nytimes.com/2021/03/11/us/…
Self defeating because COVID thrives on the weakest link. Mutant variants arise when the virus multiplies uncontrolled in many hosts. Vaccination has to be approached from a global perspective to stem the tide of newer mutants, some of which may be resistant to current vaccines.
I simply don't understand what is there to debate. We have enough vaccines for all our residents and hundred million more.
The vaccination rate that matters for long term safety from COVID is the global vaccination rate. The race is global. Emphasis: global.

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Vincent Rajkumar Profile picture
13 Mar
1/ A single pill of thalidomide taken during pregnancy can cause major birth defects.

This most notorious drug caused birth deformities in >10000 infants worldwide. It was taken off the market in 1961

But thalidomide never went away. It is sold legally today. How?? The story 👇
2/ Thalidomide was first marketed in 1957 as a sedative. By 1960 it was sold in >40 countries. Wrongly touted as the safest sedative for pregnancy.

In 1961 Widukind Lenz and William McBride independently concluded that the drug was teratogenic. It's caused severe birth defects.
3/ Birth defects occur when even a single pill is taken between days 35-49 of pregnancy.

Thalidomide went off the market in 1961. Due to the wisdom of Dr. Frances Kelsey at the FDA, the drug was never marketed in the US.
Read 15 tweets
Vincent Rajkumar Profile picture
12 Mar
1/ Cells that make antibodies are called plasma cells. When they become cancerous, you get myeloma.

Im a myeloma doctor and researcher. Even with various chemotherapy drugs, it's almost impossible to kill all plasma cells.
2/ Immunity is a strange thing. It has allowed life to be sustained all these millions of years.

The fact that we cannot easily wipe our the immune system even with lots of chemotherapy tells you how evolutionarily preserved the system is.
3/ Unfortunately the immune system needs some introduction to a new enemy. And it needs some time to mount a response.

COVID was totally new. It surprised everyone's immune system. And it was also virulent and spread very easily. So we ended up with this awful pandemic.
Read 7 tweets
Vincent Rajkumar Profile picture
11 Mar
President Biden will direct states to open vaccinations to all adults by May 1. Amazing progress.

My prediction: We will have a great summer. cnn.com/2021/03/11/pol…
I'm happy with the progress in the last 2 months since my earlier hopeful tweet. The downward trend continues. Great work by the COVID task force. @ASlavitt
And as I said earlier: I don't share the views of a brutal March or a brutal summer.

Vaccines > Viruses. #GetVaccinated
Read 4 tweets
Vincent Rajkumar Profile picture
10 Mar
More susceptible hosts = More variants emerge.

More variants emerge = More chances that some variants are more transmissible, more lethal, or both.

Biology and math at play. #COVID
Solutions:

Mask forever: unappealing
Distance forever: seriously?
Get vaccinated: A no-brainer
The more people who are vaccinated the less hosts for the virus to replicate.

Even if the virus manages to infect someone who is vaccinated, less time to replicate before the better prepared immune system crushes the virus.
Read 4 tweets
Vincent Rajkumar Profile picture
5 Mar
List of medical treatments that are associated with absolutely dramatic benefits. Please add to list.

1. Antibiotics for infections
2. H2 blockers and proton pump inhibitors for gastric and duodenal ulcers
3. Serotonin 5HT3 receptor agonists for nausea and vomiting
4. MOPP and ABVD for Hodgkins
5. CHOP for diffuse large cell lymphoma
6. Tyrosine kinase inhibitors for CML
7. Chemo for childhood ALL
8. Steroids (many indications)
9. Insulin for diabetes
10. Cladribine for hairy cell leukemia
11. Polio, measles, small pox vaccines
12. Acetaminophen (Tylenol) for fever
13. Morphine (and related drugs) for pain relief
14. B12 for pernicious anemia
15. Hepatitis C antivirals
Read 6 tweets
Vincent Rajkumar Profile picture
2 Mar
What if?

When I wrote this thread we had 5 million COVID cases in the US. Since then: 23 million more.

150,000 deaths then.
350,000 more since.

Had we greatly expanded vaccine access then, in retrospect, how many lives could we have saved? @StevenSalzberg1 @DrEricDing
Some who supported the idea had t take down their posts due to the pushback. I didn't. Because I felt comfortable this was a good discussion on risk benefit to have. So I let it stand.

The reason I post this is for experts not to be too sure, and hide under "follow the science"
COVID has surprised us many times and will continue to surprise us.

There are many unknowns about the science of the immune system.

Better to have healthy debate. Whether it's on expanded use of vaccines or delaying time between shots or adding boosters. Don't silence people.
Read 5 tweets

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