1/ Sharing a piece I wrote @latimes

As doctors, an act that can potentially do harm dissuades us more than if we do nothing, even if *more harm* happens as a result of the latter

The active v passive cognitively biases us heavily

2/ In one study I reference, doctors would be less likely to give clinically-indicated blood thinners if they caused a bleed in the past on a different patient; but would not be any more likely to give them if they did not do so & their patient had a stroke as a result.
3/ Thankfully w/ the J&J clotting issue right now, we have alternatives like Moderna/Pfizer

We are moving away from the potential of doing harm (even though it is exceptionally rare) to patients

But the lack of vaccinating patients also does harm if they get #covid19
4/ Applying the above, it may seem more acceptable to not actively do harm; and to accept passive harm- begs the question of whether we subconsciously have become accustomed to thousands of people being infected with this virus every day. #covid19

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More from @AbraarKaran

9 Apr
Was invited to speak next week, & I’m looking forward to it—but I cannot imagine giving this talk without referring to @seyeabimbola seminal paper on the foreign pose & foreign gaze in global health. This will frame much of the discussion. Read it.

2/ As I think about this talk- an Indian born, American doctor giving a talk to a number of American researchers about why the way we approach global health can be deeply problematic, can think more about how to classify this talk in terms of foreign/local - pose/gaze
3/ Would then also ask us to consider how different the talk would be if we had a researcher from a non-American context speak to this same audience about these topics; the pose would be very different; it would offer something critically important—would urge @ceid_uga to do this
Read 6 tweets
7 Apr
🧵🧵Australian church choir singer #covid19 outbreak now in CDC EID
•no masks
•no ventilation systems
•transmission >50 feet—> airborne
•confirmed via genome sequencing
•12 secondary cases detected out of 508 (2.4%), although only 434 were tested

Source: CDC EID journal
2/ So the index case was a choir singer who started to feel sick on July 16th; sang at four 1 hour services on the 16th & 17th from a choir loft elevated 11.5 feet above the congregation #covid19
3/ The secondary cases reported no other contact with the singer.

Video recordings were also used to confirm their seating positions relative to the index case as well. #covid19
Read 10 tweets
5 Apr
🧵1/ This is a tragic story in @washingtonpost — we have seen, treated, & continue to treat many cases just like this.

When people share their tragedy, they are sacrificing to remind us all that the epidemic is not just numbers; those numbers are people. They are families. Image
2/ Who do we blame?

Many who got sick *couldn’t avoid it*- they weren’t protected.

Others had the privilege to avoid risk- worked from home, had $ etc.

And some blatantly chose to actively go against advice like wearing a mask, hurting themselves & others.
3/ The piece here specifically implicates the latter groups- where there is some truth to the idea that people’s choices contributed to spread. How much is unclear- partly because many infections are actually in the former group- that couldn’t stay home, that worked frontline etc
Read 5 tweets
4 Apr
🧵1/ In a pandemic, we have two urgent interests: that life saving vaccines/ treatments be created, manufactured, & distributed, and that the disease be quickly contained/eliminated worldwide without a potentially catastrophic resurgence. #covid19
2/ The financial interests of pharmaceutical shareholders accord with our first interest, but not always with the second.

Product allocations go to the highest bidders, rather than to where need is greatest or the pandemic may be contained most effectively. @ThomasPogge
3/ The system as it stands is designed to fail, because public health is a secondary goal behind financial recuperation & explicitly financial profit

In a pandemic, it can’t be that way.

But I don’t need to tell you all this- you have been watching it unfold already. #covid19
Read 10 tweets
1 Apr
“While more than six million of the country’s 18 million people have been vaccinated, a surge in infections has left intensive-care units operating with few beds to spare and the system at a breaking point.” From Chile @nytimes

2/ “Dr. Francisca Crispi, a regional president of Chile’s medical association, said that 20 to 30 percent of medical professionals in the country had gone on leave because they are so exhausted.”
3/ “No one questions that the vaccination campaign is a success story,” she said. “But it conveyed a false sense of security to people, who felt that since we’re all being vaccinated the pandemic is over.”
Read 4 tweets
30 Mar
1/ Sharing new piece: we have learned a lot this year about the deficiencies of the ‘test,trace, isolate’ system, but it is still going to be needed to burn out the epidemic once case numbers are brought down further.

W/ @RanuDhillon
washingtonpost.com/outlook/2021/0… Image
2/ With most of the focus on 💉💉 right now (as it should be)— our other pandemic tools like Test, Trace, Isolate (TTI) have taken a backseat.

Yet, they are still crucial to stopping the #covid19 epidemic- but we need to do each of them better.
3/ Having this infrastructure in place will be essential for future infectious disease outbreaks/pandemics.

I expect TTI will become especially relevant again this summer to stop ongoing transmission chains once we have vaccinated a majority of country

Cc @cshea4 @PostOpinions
Read 4 tweets

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