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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
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
Eric Feigl-Ding Profile picture
Mar 15
SICKENING—Trump’s DHS just deported a surgeon from Brown University Medical School—who is here legally on an H1B visa that doesn’t expire until 2027, and has committed no crimes. Trained in the U.S. at Ohio State, University of Washington, and Yale as a **transplant surgeon** (one of the most difficult surgical fields in all of medicine!!!), she is a highly trained doctor on kidney transplants, which cannot be easily replaced. Her phone was seized at the border. A federal judge handed down an injunction against her deportation—but she was already deported on a plane en route to Paris. Brown’s kidney transplant clinic is now strained by her deportation.Image
Image
2) Full text:

PROVIDENCE — A Rhode Island doctor who had traveled to Lebanon to see her parents was prevented from re-entering the United States at Boston’s Logan International Airport on Thursday evening, her lawyer and a colleague said.

Dr. Rasha Alawieh, 34, who lives in Providence, has been working at Brown Medicine’s Division of Kidney Disease & Hypertension since last July, and she [has] been part of the transplant service at Rhode Island Hospital, according to Dr. George Bayliss, the organ transplant division’s medical director. She has been studying and working in the United States for about six years, he said Friday.

The US consulate in Lebanon had issued her an H-1B visa, which is given to people in specialty occupations requiring expertise. The visa was valid through mid-2027, said Thomas S. Brown, an attorney representing her and Brown Medicine.

Alawieh was detained when she returned to Logan airport, and family members are afraid that she is about to be deported to Lebanon, he said.

“We are at a loss as to why this happened,” Brown said. “I don’t know if it’s a byproduct of the Trump crackdown on immigration. I don’t know if it’s a travel ban or some other issue.”

He said her phone has been seized and he has not been able to contact Alawieh.

Bayliss said a lawyer filed a petition with the US District Court in Massachusetts, and Judge Leo T. Sorokin issued an order saying Alawieh should not be moved outside of Massachusetts without 48 hours notice. But he said that message apparently did not reach immigration officials in time, and a plane carrying Alawieh left for Paris.

“This is outrageous,” Bayliss said in an interview. “This is a person who is legally entitled to be in the U.S., who is stopped from re-entering the country for reasons no one knows. It’s depriving her patients of a good physician.”

A US Customs and Border Patrol spokesperson, Ryan Brissette, was not able to immediately answer questions about Alawieh on Friday evening.

Bayliss said Alawieh graduated from the American University of Beirut medical school and came to the United States for a nephrology fellowship at Ohio State University. She then landed a transplant fellowship at University of Washington and had a residency in the Yale hospital system before starting at Brown Medicine last July, he said.

“She’s really a very humble and able person,” Bayliss said. “She takes care of her patients. She is talented and thoughtful and a great addition to our division.”

Bayliss said Alawieh went to Lebanon to visit parents and planned to be gone for two weeks. He said she texted a colleague at 6:30 p.m. Thursday saying she was back in Boston, but then her family heard from immigration officials.

Dr. Paul Morrissey, surgical director of the organ transplant division at Brown University Health, said Alawieh works on getting people in Rhode Island on the list for a kidney transplants, and that’s a crucial job at a time when there has been a lot of focus on the need for kidneys and their equitable distribution.

He said Alawieh should not have had any problem traveling out of the country with an H-1B visa.

“It’s an unfortunate set of circumstances,” Morrissey said. “It’s putting a strain on our office. Her work has been exceptional.”

bostonglobe.com/2025/03/14/met…Image
3) There is a new Trump ban against many countries, including tourist visa bans against all countries in the red and orange lists. This list is still tentative. And it shouldn’t have affected people with existing visas, such and the Brown kidney transplant surgeon Image
Read 8 tweets
Eric Feigl-Ding Profile picture
Mar 14
I’ve said it before, and I’ll say it again… once upon a time, liberals did have our own “Leftist Joe Rogan”… his name was Joe Rogan…

Here he is advocating for socialized medicine, healthcare for all, and supporting labor unions to protect workers.
2) Recall, Rogan was once pro Obama and pro Bernie Sanders, and pro Yang Gang, and anti Trump. It’s sad he has since failed to the dark side. But like Vader… maybe he can be redeemed someday and come back to the light.
3) *Fallen, not failed (above).

Joe Rogan was also pro gay rights and pro DACA and pro helping inner city communities that suffer economic and social injustices. It’s sad what he has become. I feel we should try to pull & welcome him back someday. Everyone can be redeemed.
Read 4 tweets
Eric Feigl-Ding Profile picture
Feb 26
BREAKING—FDA suddenly cancels meeting to update next season’s flu vaccines, with zero explanations. Any delays will jeopardize next year’s vaccine supply chain. Image
2) Folks who follow me know that I’m no bullshitter. I criticized past pandemic response right and left, and have called balls and strikes without bias. And I often say things that doctors & epidemiologists are whispering among themselves but don’t say publicly. (Cough cough) ⬇️
3) While I don’t recommend hoarding… I think stocking up on flu antivirals, which you can obtain prophylactically (preventively) from doctors if you ask nicely why you’re high risk, can be a good idea. I know many doctors, epidemiologists and virologists who do for their family.
Read 6 tweets
Eric Feigl-Ding Profile picture
Feb 26
Doctors are debunking RFK Jr’s claim that 20 hospitalized measles cases in Texas are there for mainly quarantine. Doctors on the ground say the 20 kids hospitalized are having trouble breathing. Oh and they are all unvaccinated against measles, which RFK Jr neglects to mention. Image
2) RFK Jr told Trump today there’s now 2 measles deaths.
3) RFK Jr is a tear with his FDA today. A dark Darwinian future lies ahead for America.
Read 4 tweets

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