My latest @PostOpinions column is about the need for urgent attention to an epidemic that is responsible for 300,000 deaths every year: obesity.

As @Dmozaffarian told me, "the slow pandemic of #obesity has intertwined with the fast pandemic of #covid19".🧵washingtonpost.com/opinions/2021/…
Obesity is a major risk factor for diabetes, heart disease, certain cancers & worse outcomes from #covid19. With stress & food insecurity, 42% self-reported gaining weight since the pandemic, with an average addition of 29 pounds. 10% gained 50+ pounds. /2 apa.org/news/press/rel…
The experts I spoke to proposed numerous solutions, including seeing food as medicine so doctors can prescribe healthy produce for patients; changing policies around ultra-processed foods & sugary sodas; and recognizing that systemic racism is built into our food system. /3
“We live in a world where junk food is promoted in every way, in enormous quantities,” @marionnestle.

When 70%+ of Americans are overweight or have obesity, it can’t be seen as an individual problem. It’s a societal issue that requires major change at the policy level. /4
Addressing long-standing structural issues will be hard. Some will disagree that this is the time to do so.

But, as @harvardmed's @jasonpblock said, " it’s largely because of obesity that our children’s generation could have a lower life expectancy than ours." /5
.@Dmozaffarian calls for a “national collective awakening to address obesity and metabolic health.”

It will be a difficult awakening after a difficult year, but it would be tragic to emerge from #covid19 only to have years of life be shortened by another disease. /END

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More from @DrLeanaWen

13 Apr
As a doctor and volunteer in the J&J clinical trial who received the vaccine <2 weeks ago, here's my take on the recommendation for the FDA & CDC pause for the Johnson & Johnson #covid19 #vaccine: 🧵

nytimes.com/2021/04/13/us/…
(1) This is exactly the right move. All possibly concerning safety signals should be immediately & transparently investigated.

This shows that regulatory entities are doing their job. Even something very rare (6 cases out of 7 million) will be immediately looked into.
(2) The events flagged (blood clots with low platelets) are extremely rare. Causation hasn't been established. The reason this really needs to be alerted now is for doctors who may see patients with this rare condition, to know what to look for and how to treat them.
Read 5 tweets
7 Apr
There's lots of discussion on the pros/cons of "vaccine passports".

We need to stop using this term. It's inaccurate, inflammatory & divisive.

Instead, let's describe how proof of #covid19 #vaccination can return us to normalcy @postopinions (thread):

washingtonpost.com/opinions/we-ne…
Asking for vaccination status is a kind of health screen to identify those at low risk for infecting others, not unlike symptom questionnaires or #covid19 tests.

If these aren’t seen as constraints on individual liberties, showing vaccine status shouldn't be, either. /2
In addition, individuals are increasingly asking one another whether they’ve gotten their shots. Vaccination enables activities that otherwise couldn’t occur safely.

I think it’s time for us to extend the newfound normalcy from social settings to business operations. /3
Read 9 tweets
11 Mar
It's been one year since the World Health Organization officially declared #covid19 to be a #pandemic.

What have we learned? Where do we go from here?

A thread. /1
5 key lessons:
1) Importance of a national, coordinated response. Piecemeal approaches to PPE, testing & vaccination do not work.

2) Without data, we are flying blind. A year ago, every detected case was a canary in a coal mine. Same issue with lack of genomic surveillance. /2
3) Hospitals are the last line of defense, not the first. The community, through preventive measures, are the frontlines.

4) Public health depends on public trust. Mixed messaging erodes trust & leads to politicizing of basic measures like masks./3
Read 9 tweets
9 Mar
Today's CDC guidelines on what fully vaccinated people can do are too timid, too limited & fail to tie reopening guidance with vaccination status.

As a result, we are missing a critical opportunity to incentivize Americans to be vaccinated. @PostOpinions washingtonpost.com/opinions/cdc-r…
I know this is a difficult needle to thread. What I want to see is nuance & risk estimates instead of taking an absolutist approach. Healthcare providers must help people exercise good judgment while considering each person’s individual values, or else we lose their trust.
Also, people need to be given incentives to get vaccinated As reopening occurs & people return back to normal, we are losing the opportunity to tie reopening to vaccination. At some point soon, everything will be fully reopened anyway, and there will be no carrot left to offer.
Read 4 tweets
16 Feb
This is the #1 question I get asked: What can newly vaccinated do? Is it safe to see grandkids?

Though there are still unknowns, we need to give a better answer than "follow all precautions".

My dos/don't in this week's @PostOpinions column: washingtonpost.com/opinions/2021/… (1/5)
The #covid19 vaccine is extremely protective against severe disease. There's growing evidence that it may reduce the likelihood of people being carriers.

People should resume essential activities but were being put off--like cancer screenings & dental screenings. (2/5)
It's probably fine to resume some non-essential activities, like going to the gym & out to eat. People should still abide by masking & distancing in case they can infect others. I'd still avoid crowded bars--& be extra cautious if others in your home are unvaccinated. (3/5)
Read 5 tweets
4 Feb
Here’s my best-case scenario: With existing vaccines, we turn #covid19 into an illness akin to the seasonal flu. By the end of 2021, we can resume much of our pre-pandemic lives.

This @PostOpinions column explains how this could happen: washingtonpost.com/opinions/2021/…

(1/4)
I’m optimistic because of a specific result in the vaccine trials that, so far, has received little attention: very few vaccinated people have become severely ill to the point of requiring hospitalization.

(2/4)
This one measure could change everything. Families could safely spend holidays together again if the worst-case scenario shifted from being put on a ventilator or dying to possible fever and body aches. Schools could reopen and much of the economy could return to normal.

(3/4)
Read 4 tweets

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