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Eric Feigl-Ding Profile picture
@DrEricDing
Mar 21, 2021 • 34 tweets • 19 min read • Read on X
PAY ATTENTION—There is one crisis we all needs to pay attention to—and that is the unprecedented Brazil 🇧🇷 surge of the #P1 variant, overloaded hospitals, & sharp mortality spike. If more contagious #P1 out of control worldwide, we are all endangered. 🧵

#SOSBrazil #COVID19 ImageImage
2) I cannot overemphasis how serious the crisis in Brazil is. It is virtually impossible to find any ICU bed, and many hospitals running out of sedative medications to perform intubation with—so doctors are intubating without any analgesic meds. Hospitals are in collapse.
3) I’m not exaggerating that hospitals in Brazil are in collapse. This is the headline of a major newspaper. Image
4) Don’t just listen to me. Listen to the reporting on the ground. This report was filed last week by @MattRiversCNN — he says it has gotten only worse.

5) Nobody can deny the pandemic when hospitals are completely overrun. Don’t let anyone dismiss #COVID19 and what is happening in Brazil - hospitalizations and deaths DO NOT LIE. Image
6) The crisis is described by the @fiocruz @fiocruz_en foundation as the **worst sanitation and hospital collapse in the history of Brazil** Image
7) I’m told by reporters that even “we're also hearing very consistently, that in Brazil more and more young people are dying on the virus. doctors keep telling us that their patients keep getting younger, no comorbidities” - from doctors across many cities. @MattRiversCNN
8) But also more concerning — Brazil experts analysis says P1 is potentially 2-2.5x faster transmission (more contagious) than the old common strains. That means it is also faster than #B117 sweeping the world.

We need to get serious about Brazil crisis. ?
9) Another Brazil research group puts #P1 transmission at 2x faster than old strain (instead of 2.5x above), but they estimate a way worse whopping 25-60% reinfection rate. That’s serious.

bbc.com/news/amp/healt… Image
10) How good is are the mRNA vaccines against this #P1 variant menace? Only semi— it has moderate neutralization- better than the SA #B1351, but worse than #B117 (which responds well to vaccine).

FYI earlier Pfizer-conducted study said okay, but this bigger study disagrees.
11) But the problem for Brazil is that it doesn’t have the mRNA vaccines. It has the AstraZeneca and SinoVac vaccine. We don’t know the exact efficacy yet for #P1, but SinoVac vaccine showed a much lower 50% efficacy in Brazil trials, before P1.

google.com/amp/s/www.bbc.…
12) Now 50% is still good, and for severe disease, it’s 78% for SinoVac, so that’s decent.

J&J vaccine shows mid to upper 80% for Brazil, but J&J isn’t available in Brazil yet either.

Main problem is Brazil doesn’t have enough! google.com/amp/s/amp.cnn.…
13) state of Rio de Janeiro suspended its vaccination campaign because it had run out of vaccine supplies.

"This is a disaster, a total disaster," a woman told CNN after being denied her vaccine. "Who is to blame for all this? I think our leaders, our politicians suck."
14) “less than 10 million people in the country of about 220 million had received at least one dose, according to federal health data. Only 1.57% of the population had been fully vaccinated.”

THIS IS AN EPIC DISASTER in the making for Brazil. google.com/amp/s/amp.cnn.…
15) How the hell did Brazil screw up its vaccine supply so much?

“multiple experts say the ineptitude of the federal government, led by Covid-skeptic Bolsonaro, has sabotaged. They point to a distinct lack of urgency on the fed govt to secure supplies”
cnn.com/2021/02/01/ame…
16) Brazil is in talks with the US to import some vaccines. The US already “loaned” 4 million doses to Mexico & Canada. But the talks with Brazil started March 13th and still have not reached any deal. Brazil needs it soon. Hope Bolsonaro is playing ball.
google.com/amp/s/www.voan…
17) Even with vaccine imports, and the delay in rollout and immunity kicking in, the next month will be brutal for Brazil. We might see what unmitigated full onslaught with a downplaying Bolsonaro looks like.

Meantime, Brazil ordering 3x the coffins.

metropoles.com/brasil/covid-a…
18) But I also want to offer a message of hope to the people of Brazil 🇧🇷— the world sees your struggle and your pain. I talk to colleagues at the WHO and in DC. The world has not forgotten you—even if your leader maybe sometimes has. The world needs to care and does care.
19) Meantime, Bolsonaro is the one person that world leaders need to call out and pressure. He is literally stopping all efforts to improve the situation. This is untenable.

If this Brazil crisis keeps going, I worry for its stability. google.com/amp/s/amp.cnn.… Image
20) I don’t believe in doomed fate. “There is no fate but what we make.”

Brazil needs help, Brazil needs change. Brazil needs leadership that will put human lives first, and to end suffering of its poor.

May God & the world help the people of Brazil.
21) To the rest of the 🌎—please don’t be selfishly withholding aid/vaccines. If Brazil’s #P1 crisis grows, so will the risk for the world. We rise as fall as one planet & civilization. We need to remember the motto—“All for one, one for all”—let’s all find our inner humanity. 🙏
22) p.s. the Oxford-AstraZeneca reported to be is efficacious against the #P1 variant. But the study hasn’t be released yet by researchers - details forthcoming.

US has a stockpile over over 30 million doses of AstraZeneca—it needs to release now.
cnbc.com/2021/03/05/oxf…
23) UK Imperial team:

⚠️“data show #P1 variant is 1.4-2.2 times more transmissible than other variants & original #SARSCoV2 strain, and 25%-65% more likely to evade existing protective immunity from previous non-P.1 infections—susceptible to reinfection.”
edition.cnn.com/world/live-new… Image
24) The catastrophe in Brazil is the worst in its history. And likely will be the worst in the annals of this pandemic — we desperately need to urgently send aid and vaccines to Brazil 🇧🇷.

Please help @WHCOS @aslavitt46 @ASlavitt @JeffZients @DrTedros @mvankerkhove @gabbystern
25) good news - vaccine deals inked by Brazil to buy more.

Bad news—most of the vaccines ordered aren’t coming for many many months.
26) Vaccine inequality is the great inequality that will lead to more tragedy in this pandemic.

We need to send vaccines urgently to Brazil, Mexico, and all of Latin America. #COVID19 #COVID19Vaccine

(HT @fibke) Image
27) The longer we neglect to vaccinate low and middle income countries (LMIC), the longer this crisis will continue.

#VaccinEquity for Brazil and all of Latin America and Africa and Asia.

(Ht @fibke)

pandem-ic.com/vaccine-equity… Image
28) ...I’m hearing some signals US might help Brazil hospitals in some potential ways soon. Unclear what yet. But there are some in WH that are exploring. Fingers crossed of what’s to come.
29) this was Brazil 3 days ago... and those spikes have now surged even more.
30) Now Brazil’s #P1 crisis has spilled over into neighboring countries...
31) And now #P1 has invaded North America - British Columbia 🇨🇦 has a recent sudden surge of #P1.
32) The Brazilian 🇧🇷 #P1 epidemic has now definitively spilled into other countries and caused outbreaks—the largest being in British Columbia, Canada.
33) P.s. small update on Brazil 🇧🇷 situation - I have receive word that Brazil is now engaging with the US directly. Hopeful 🙏
34) Brazil needs to act fast.... now more young people are dying than in first wave.

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More from @DrEricDing

Eric Feigl-Ding Profile picture
Jun 16
📍 THE 17 FIRED MEMBERS OF CDC’s VACCINE ADVISORY COMMITTEE (ACIP) speak out…

📍“As former ACIP members, we are deeply concerned that these destabilizing decisions, made without clear rationale, may roll back the achievements of US immunization policy, impact people’s access to lifesaving vaccines, and ultimately put US families at risk of dangerous and preventable illnesses.” 🔥

Full text:

Vaccines are one of the greatest global public health achievements. Vaccine recommendations have been critical to the global eradication of smallpox and the elimination of polio, measles, rubella, and congenital rubella syndrome in the US. They have also dramatically decreased cases of hepatitis, meningitis, mumps, pertussis (whooping cough), pneumonia, tetanus, and varicella (chickenpox), and prevented cancers caused by hepatitis B virus and human papillomaviruses.1 Recent scientific advancements enabled the accelerated development, production, and evaluation of COVID-19 vaccines, leveraging novel technologies that are estimated to have prevented approximately 1.6 million hospitalizations and 235 000 deaths in the US alone.2
For more than 60 years, the Advisory Committee on Immunization Practices (ACIP)—codified in the federal regulations (42 USC 217a: advisory councils or committees)—has served as a panel of experts that reviews the most up-to-date evidence on vaccines and monoclonal antibodies (eg, against respiratory syncytial virus [RSV]), providing sound recommendations to the US Centers for Disease Control and Prevention (CDC) regarding how vaccines should be used. ACIP recommendations are the cornerstone of the immunization program in this country. First, they serve as guidance and are the national standard for the use of Food and Drug Administration (FDA) authorized and licensed vaccines, providing a unified and trusted approach to vaccinations for the diverse array of immunization providers across the US. Second, they ensure science-based and tested immunization schedules that are optimized for well-timed protection against serious diseases. Third, the recommendations affect insurance coverage and safeguard broad access for vaccines. Fourth, ACIP’s continued monitoring of disease epidemiology and scrutiny of vaccine safety inform timely updates to recommendations that have maintained the trust and protection of the population. This transparent and ongoing surveillance of vaccines is one of the most stringent around the world, historically making the deliberations and decisions of this committee a beacon for immunization programs globally, while also serving as the foundation for recommendations harmonized with leading medical organizations in the US.3,4
ACIP committee members have always been selected through a rigorous process based on their expertise in immunology, epidemiology, pediatrics, obstetrics, internal and family medicine, geriatrics, infectious diseases, and public health. Historically, committee members were chosen because they worked at hospitals, clinics, health departments, universities, and other organizations where they dedicated themselves to caring for patients, conducting research, and helping to prevent and treat infectious diseases. Members’ deep understanding of immunization issues ensured that vaccine policies were grounded in scientific evidence, aligned with the needs of economically, socially, and medically diverse US communities, and always considered the public value, trust, and acceptability of vaccines.
Despite recent suggestions to the contrary, health care providers and the US public trust ACIP. For the past 18 years, the National Immunization Survey has shown that 99 of every 100 children in the US have received at least some recommended vaccines by 2 years of age, consistent with acceptance of ACIP recommendations implemented by trusted clinicians (National Immunization Survey - Childof Healthy People 2030).…Image
2) Full text part 2:

This does not suggest the population is so distrustful that it warrants dismantling the process by which vaccines have been recommended. ACIP standard procedures have minimized the risk of alleged conflicts of interest and biases. For decades, members of ACIP have undergone a thorough application and review process to participate. Proposed members submitted letters of support from other known experts and peers, completed an interview process, underwent a background check, and disclosed financial interests that might be considered a conflict, including any professional or financial relationships of immediate family members. Historically, it has taken up to 2 years for nominees to be approved to join ACIP.
Once part of the committee, ACIP members spent significant time preparing for meetings, reviewing the scientific evidence, and chairing work groups that, along with many CDC public health officials, led to the final recommendations that were determined during public meetings, which also included opportunities for public comment. Recordings of these meetings, agendas, and presentations were publicly available. Additionally, members agreed to ongoing monitoring and disclosure throughout their tenure. For example, potential conflicts of interest were reviewed throughout their time on the committee. Statements about potential conflicts were required during each meeting and before each vote, and members recused themselves from voting if any conflicts were identified. These disclosures have also recently been posted on the CDC website for public scrutiny. ACIP was among the most stringent and transparent of the federal committees, and we hope those criteria will apply to any new members joining the committee.
The abrupt dismissal of the entire membership of the ACIP, along with its executive secretary, on June 9, 2025, the appointment of 8 new ACIP members just 2 days later, and the recent reduction of CDC staff dedicated to immunizations have left the US vaccine program critically weakened.5,6 These actions have stripped the program of the institutional knowledge and continuity that have been essential to its success over decades. Notably, the ACIP charter specifies that committee members serve overlapping terms to ensure continuity and avoid precisely the disruption that will now ensue. The termination of all members and its leadership in a single action undermines the committee’s capacity to operate effectively and efficiently, aside from raising questions about competence.
Compounding these concerns, recent changes to COVID-19 vaccine policy, made directly by the HHS secretary and released on social media, appear to have bypassed the standard, transparent, and evidence-based review process.7 Such actions reflect a troubling disregard for the scientific integrity that has historically guided US immunization strategy. The newly stated strategy to replace ACIP members with individuals who will “exercise independent judgment, refuse to serve as a rubber stamp, and foster a culture of critical inquiry” is already leading to warnings by academic and scientific institutions, professional organizations, and the public who for decades have known well that these sought-after qualities precisely characterized the now-dismissed members of the ACIP.5
3) Part 3:

As former ACIP members, we are deeply concerned that these destabilizing decisions, made without clear rationale, may roll back the achievements of US immunization policy, impact people’s access to lifesaving vaccines, and ultimately put US families at risk of dangerous and preventable illnesses. Vaccines and the anti-RSV monoclonal antibodies are lifesaving, and people in the US deserve to have recommendations and broad access to use them to prevent serious diseases. In this age of government efficiency, the US public needs to know that the routine vaccination of approximately 117 million children from 1994-2023 likely prevented around 508 million lifetime cases of illness, 32 million hospitalizations, and 1 129 000 deaths, at a net savings of $540 billion in direct costs and $2.7 trillion in societal costs.8Finally, as individuals, we remain committed to evidence-based vaccine policy, both through our ongoing work in immunization science, public health, and medical education, and by supporting future efforts to keep America healthy that uphold scientific rigor and the public’s trust.
Read 4 tweets
Eric Feigl-Ding Profile picture
May 8
⚠️Tariffs On Medications Will Make America Sick

We might soon see the Trump WH impose tariffs on pharmaceuticals—patients will suffer and die.

During the past few weeks, President Trump’s on-again, off-again tariff wars have rattled the stock market, decimated many Americans’ retirement funds, and promised to send grocery prices soaring—and his administration hasn’t even gotten to critical pharmaceutical tariffs yet. But that will likely be the next shoe to drop.
Trump exempted pharmaceuticals from his first round of tariffs in early April, but recently declared that he intends to impose “a major tariff” on imported medicines “very shortly.” These tariffs, he claims, will prompt pharmaceutical companies to leave countries including China and India and begin “opening up their plants all over the place.”
Commerce Secretary Howard Lutnick said in a television interview in mid-April that these tariffs are coming in the “next month or two.”

What will this mean? 

Read on:
progressive.org/op-eds/tariffs…Image
2) The majority of brand name drugs used in the United States are imported. Even generic drugs often rely on ingredients and direct imports from China, including pain relievers and cardiovascular drugs used by millions.
3) The United States was already facing a drug shortage crisis before Trump’s tariff announcement. Now, his policies will drive upnot only the cost of medicines, but also other health care items such as X-ray machines and medical instruments.
Read 8 tweets
Eric Feigl-Ding Profile picture
Apr 10
It’s a trap: CATCH 22—if you register, ICE will deport you. If you don’t register, you’ve now committed a crime for the first time, and ICE will deport you. Trump doesn’t care if you’ve paid all taxes and followed all laws—ICE will deport you.

apnews.com/article/illega…Image
2) The Department of Homeland Security announced that it was mandating that all people in the United States illegally register with the federal government, and said those who didn’t self-report could face fines or prosecution. ***Failure to register is considered a crime***
3) Registration will be mandatory for everyone 14 and older without legal status. People registering have to provide their fingerprints and address, and parents and guardians of anyone under age 14 must ensure they registered. The registration process also applies to Canadians who are in the U.S. for more than 30 days, such as so-called snowbirds who spend winter months in places like Florida.
Read 4 tweets
Eric Feigl-Ding Profile picture
Apr 3
Now economists know how scientists felt back when he pushed “hydroxychloroquine”
2) HCQ preventing COVID deaths has been debunked— and it’s now been linked with deaths.

@JoshuaPCohen1
forbes.com/sites/joshuaco…Image
@JoshuaPCohen1 3) JPMorgan on Trump Tariffs: “The largest tax increase since 1968” Image
Read 6 tweets
Eric Feigl-Ding Profile picture
Mar 28
My god—Earthquake (a Richter ~7.7) causes a skyscraper to collapse in Bangkok. Hope all the construction workers made it out.
2) this skyscraper collapse was captured from a distant car’s dashcam while on a highway

3) another view of the collapse. For those who lived through 9/11, this collapse is a bit triggering.
Read 5 tweets
Eric Feigl-Ding Profile picture
Mar 27
Welp—kiss public health & medical research infrastructure in America goodbye for the next 4 years. RFK Jr plans to cut 10,000 jobs from Trump HHS. Image
2) this will not make America healthy again… not by a long shot. So dangerous and irresponsible.
3) “Kennedy is set to announce Thursday the planned changes, which include axing 10,000 full-time employees spread across departments tasked with responding to disease outbreaks, approving new drugs, providing insurance for the poorest Americans and more”.
Read 5 tweets

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