Lessons for professional & personal life. 🧵

For life during the COVID-19 2nd wave & beyond.
1. In medical education, teach an extra course called PPD (personal & professional development) which includes medical ethics, difficult conversations about end of life, breaking bad news to family, inequality in health, conflicts & global crisis,etc...
... in my medical school in Sydney, PPD was taught interactively for two hours, about 4 times a semester. They learn about conflicts as an issue of public health. (Looking at IMA’s response to Lancet). My class discussed Rohingya. In ‘end of life’ session, nearly everyone cried
2. Have a reliable & independent scientific committee in addition to health ministry that reviews all decisions by the state & inform where evidence is against or for their policy. All departments of science should be represented & junior researchers encouraged to participate
3. Media orgs should recruit more journalists outside the arts & humanities skill set. Journalism institutes should have them undergo all types of academic projects to teach diligence & evidence collection beyond qualitative analysis
3. This is a no brainer. But only so much public funding can be allowed to test already negated results. Include all scientific research in mainstream & use the same rules for evidence review. No evidence, cut it lose. Importantly, publish the negative results.
4. Ask Qs about conflict of interest in every sphere. For any product, whether medical or otherwise. If the data is not produced & reviewed by an independent platform, other than the manufacturer, head or the investor of the company- Don’t blindly trust the research- its CoI
5. Don’t empower religious scholars & cult leaders in matters unrelated to their expertise. Religion is a way to learn patience, get hope & help each other in the community in the times of crisis. It doesn’t understand the modern advances. Limit it for what it’s meant to do.
6. Put your faith in the scientific process, if not in scientists with expertise. This “know is all” & “know it better than the expert” attitude is the reason we are in such crisis. No amount of denial will change the fact that cases are peaking despite mass consumption of altmed
7. Elect educated representatives to make decisions for you. And educated doesn’t mean just journalists, film actors or lawyers. The house seems to be full of them, and worse, the uneducated & unlearned.
8. Use subtlety for actions & to convey information. I mean please use it in every way. Turn down the loud, the hyper & the exaggerated version of your personality. Don’t consume information with that tone. Make that behaviour a social crime. Protect your eyes, ears & tongue.
9. Reconcile the knowledge from books/ education with your personal life. Don’t live with double speak. When we know that the Big Bang was a chance event in empty space, where the universe continues to expand. Don’t live thinking you are a special species on a special planet...
...you (humans) are also not the perfect “creation”. Nature is imperfect because it is based on chances to perfect a system/ Not planned to create special creatures in 1go in 7 days. Your wisdom tooth, appendix, structure of tailbone, goosebumps are vestigial for a reason.
10. Lastly, treat mythology as mythology (spoken story of the people). Stories change from one mouth to another & these scriptures are from pre-civilisation. Use it to learn history in context & its reason for success- instead of its revivalism. Most of it has lost relevance. //

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More from @Neurophysik

12 Apr
Sputnik V has 91.6% efficacy against COVID-19 & 100% against severe covid. 5 countries producing domestically incl. India & China. Aka GAM-COVID-Vac, it’s made of recombinant (S protein expressing gene of SARS-CoV2) adenovirus of 2 different serotypes (26 & 5)
Approved in India✅
PS it’s not Sputnik 5, it’s Sputnik V (the alphabet) probably a short to suggest it’s a viral vector vaccine. Sputnik 1 was also the first human-made satellite to orbit the earth.
Sputnik V is a double dose, 21 days apart vaccine. Both doses contain different serotypes of adenovirus. Single dose is not so effective (~85%). 2 way storage: 1. As a ready made water solution stored at -18•C OR 2. the freeze dried powder stored at 2-8•C & later mixed in water
Read 4 tweets
3 Mar
PSA for those who have registered/about to get COVID-19 vaccine via the Co-WIN app.
It is absolutely essential that those who have had immune suppressants like chemotherapy or during organ transplants, etc should make it known during the inoculation and avoid the #Covaxin jab.
Covaxin and other live attenuated vaccines should be avoided by:

1. HIV,
2. Cancer & chemotherapy,
3. Organ transplants
4. Taking steroids
5. Congenital immune deficiencies including complement deficiencies
6. phagocyte dysfunctions

Contd..
Read 5 tweets
24 Jan
COVAXIN Efficacy: A thread...

n0
Q1: Is there a method to hypothesise the efficacy of COVAXIN when no data has been released?
Q2: How is this efficacy enhanced & measured?
Q3: Why can’t COVAXIN be compared with other mRNA vaccines like COVISHIELD (AstraZeneca), ModeRNA and Pfizer?
n1
We know that COVAXIN, also known as BBV152, is based on a tested technology which inactivates or weakens the whole virus, in this case, SARS-CoV-2. NIV isolated the virus strain (NIV-2020-770) of the coronavirus from a COVID-19 patient and sequenced its genome.
n2 Schematic drawing of the 1D structure of coronavirus spike.
Read 26 tweets
23 Jan
The Lancet has NOT endorsed Covaxin. It has just published the phase I data -the preprint (non peer reviewed version) of which was available since last year. Good that @BharatBiotech published this data, but it does not mean it has a been cleared from the safety perspective.
Safety clearance requires testing in many many people of various groups. In this paper, 3 types different vaccines were tested in 100 people each and compared with 75 people of placebo.
In comparison, @pfizer released the data of its vaccine in the briefings with the @US_FDA as below
Read 5 tweets
3 Jan
My analysis of the paper released by #BharatBiotech researchers & the Press Statement by the Drugs Controller General of India (DCGI) on Restricted Emergency approval of 1out of 3 COVID-19 virus vaccine from Bharat Biotech: A thread...
1. PIB "The Phase III efficacy trial was initiated in India in 25,800 volunteers & till date, ~22,500 participants have been vaccinated across the country"

Fact check "A total of 25,800 subjects will be enrolled & randomized in a 1:1 ratio to receive BBV152B vaccine and control"
1. Fact check contd...

A 1:1 ratio means half of 25800 will be enrolled, of which only (almost) 12900 will be given BBV152B vaccine and the other 12900 will be given a placebo, i.e. Phosphate buffered saline PBS with Alum gel (without antigen)

Source: CTRI
Read 24 tweets
8 Jul 20
TW & thread: COVID-19, menstruation & depression

Gynaecologists, Obstetrics & women that have recovered from COVID-19:

(Or keen beaners of Covid-19)

Women, How were your menstrual cycles post COVID-19 recovery? Want to know what may have happened?

Read on... 1/n
So we know that SARS-COV2 affects a lot of organs in the body apart from the respiratory system. They infection is systemic after a point and the virus is found in many areas of the body including the brain, liver, gut, & the reproductive organs. But once the recovery is over..2n
What do we know about the after effects? A lot of people have reported generalised fatigue several weeks (6-7 or more) post recovery. Not just physical but mental fatigue. And that conversation about depression I had with @dhruv_rathee was never so timely. Everything hurts...3n
Read 20 tweets

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