1/ COVID Deaths are lower than horrible peaks, but seem to have plateau'd- as cases rise in several states are we due for another surge in deaths?

I don't think so.

(vaccines work)
2/ It's important to remember just how much deaths lag infections. Many of the deaths being reported today will have first become infected a month ago, or even longer

The death data does not yet reflect the big surge in vaccine administration that happened in the past few weeks
3/ The recent surge in vaccinations has been impressive, and the group with the highest vaccination rates (appropriately) are the 65+

As @aslavitt46 reported, 73% of elderly vaccinated now (and 36% of adults) 👏👏👏
4/ But what has happened to the age distribution of deaths?

what do you see?

The group with the biggest drop in relative share are the 85+ which used to account for a third of cases, and are disproportionately represented in the early nursing home/ long-term care vaccinations
5/ With over 95% protection, vaccination of three-quarters of the elderly population will result in another big drop in deaths that we have yet to see the full impact of 🙏

To get the other 25% of elderly vaccinated may require outreach from primary care vs mass vacc sites

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More from @Farzad_MD

3 Mar
1/ this is the most detailed description of the lab-leak hypothesis I have seen (and I don't buy it)

It posits a "chopped-and-channeled version of RaTG13 or the miners’ virus that included elements that would make it thrive and even rampage in people?"
nymag.com/intelligencer/…
2/ to be clear, I've seen first-hand-in a 7 month-old baby-the scourge of a lab-produced bioweapon that was exfilitrated (anthrax 2001).

I agree w @mlipsitch position that the risks of creating Gain of Function pathogens w increased infectivity/deadliness outweigh the benefits ImageImage
3/ beyond artful prose and connect-the-dots suggestions, here's the idea:

That a bat virus sample (RaTG13) was manipulated in Wuhan lab to be more infectious through the lego-block addition of key genetic mediators of human infection

But that's not what the sequence looks like Image
Read 7 tweets
1 Mar
1/ It took us over 6 months to have the epi studies that answered these questions.

That's one of the less recognized failures of an institution I revere, the CDC

They should have sharpened the questions, designed the studies and put dedicated epi resources behind them, quickly
2/ It took forever to do a proper serosurvey, to answer the IFR/CFR question

Understanding the primary role of asymptomatic spread was a game changer, took 6 months?

We are *still* debating kids as vectors.

Do we really know if vomiting indicates COVID?
3/ a few months later, we had other questions that needed answering-

Are we improving on timeliness of testing? 

Are we protecting the elderly? Where? (how?)

Is IFR declining within age groups?

Where were the focused surveillance activities to answer these key questions?
Read 5 tweets
22 Feb
1/ COVID has been a public health catastrophe

500,000 extra deaths, taking an average of 13 years each- 6.5 million years of life lost

That dropped US life expectancy by a full year

Did we erase a decade of progress? Will a child born today live a year less than last year?
2/ At first blush, it can seem confusing.

If life expectancy dropped by a year for 320 million Americans, shouldn't that translate to 320 million years of life lost, not 6.5 million?

OTOH, I trust the CDC. Here's the paper cdc.gov/nchs/data/vsrr…

seems legit. so what gives?
3/ Here's some more data- why did life expectancy plummet in 1917-1918 (by 10 years!) then rebound completely?

Life expectancy is the average number of years a group of infants would live if they were to experience prevailing age-specific death rates throughout their life
Read 8 tweets
29 Jan
1/ Please send all your #HealthIT eAsy fiXeS to @mickytripathi1

He'll love receiving & responding to them

The more the merrier! Make sure to include "just"

I'll start! ("likes" will demand a thorough response from @ONC_HealthIT)

>You should just get everyone on the same EHR<
2/

>You just need to create a universal patient identifier<
3/

>You just need to stop messing with the free market, industry will figure it out<

And introducing my guest speakers @DavidBlumenthal @HealthIT_Policy @HealthPrivacy @Fridsma @amalec @claudiawilliams
Read 5 tweets
23 Jan
1/ The Denmark variant story was pointed out by several people as being quite concerning- this line struck me - "Cases involving the variant are increasing 70 percent a week in Denmark, despite a strict lockdown"

But the actual data was hard to pin down- so I dug it up
2/ "The U.K. variant was 2 percent of sequenced coronavirus cases the last full week of 2020. By the second week of January, it had risen to 7 percent."

But in the context of declining cases what does that mean?

No link to data in article but it's here: covid19genomics.dk/statistics
3/ But those aren't actually the true cases, cause despite the headline "Denmark is sequencing all coronavirus samples..." while they are *trying* to sequence all, the number of cases with a genome of sufficient quality relative to the total number of cases ranges w-w from 10-36%
Read 7 tweets
11 Jan
1/ read this @adamcancryn @tylerpager piece, and let's discuss some of the points raised

‘There is a palpable concern’: Biden presses advisers over 100 million Covid shot goal politi.co/2XHhk1f
2/ first, I am so glad @JoeBiden *is* putting a hard to reach goal out there

When @matkendall and I set our first public targets
@ONC_HealthIT a longtime fed told us "never give them a date AND a number"

It's risky, it's gutsy, and it's the right thing to do for the country.
3/ It will be very hard to hit 100M in 100 days

But the very fact that this article was written EVEN BEFORE THEY START points to the intense focus it brings.

The new admin may miss their first big test, but vaccinate tens of millions more than if they shunned responsibility

🇺🇸
Read 12 tweets

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