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Abraar Karan Profile picture
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20 Apr, 7 tweets, 4 min read
Thread: we are celebrating all US adults having open access to vaccines; globally, countries are now being decimated with little to no access even for very high risk citizens who will die.

This matters. This should matter to every single person here. This will affect us all.
2/ Remember- the more the virus rages uncontrolled around the world, the more variants we will ALL see just by virtue of more replication events; if you don’t think this matters here, think about B117 from the UK, B1351 from South Africa, P1 from Brazil. There will be more.
3/ India is getting slammed right now. I have heard from friends there who have posted grim realities on the ground- family members getting sick/dying; them being reinfected despite having had #covid19 within a few months- the situation here is bad.

washingtonpost.com/world/interact…
4/ Both cases (see @juledurg tweet) & deaths rising- see John’s Hopkins graph below, updates as of today. #covid19
5/ I don’t want to diminish the accomplishments of what we have achieved in the US- we have struggled this year and we are finally coming out of it. But- the people now dying in global surges are not just our neighbors; they too must be our family
6/ Vaccine nationalism &/or hoarding definitely isn’t helping.

Unfortunately when you’re surging like this, you won’t be able to 💉 your way out. And lockdowns esp are devastating in places w/ extreme poverty & large informal sectors that can’t WFH

nytimes.com/2021/03/11/us/…
7/ Any lockdowns that are imposed must be done so with serious social supports for people that will suffer.

Lockdowns are circuit breakers- they are not a strategy so much as they are recognition that a place is seriously struggling to control the virus. #covid19

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Abraar Karan Profile picture
21 Apr
This- right here

When we immediately reach for security (close borders, ban travel, hoard vaccines) as our guiding principle, instead of solidarity, we will all suffer the consequences.

India is running into vaccine & supply shortages; lockdowns will also impose harms on poor
2/ “But recent US and European limits on the exportation of critical Covid-19 vaccine production materials have resulted in a severe vaccine shortage throughout the country.”

vox.com/2021/4/18/2239…
3/ “India is also a major manufacturer supplying COVAX, the international #Covid19 manufacturing and distribution agreement. SII had originally committed to manufacture up to 200 million doses for 92 countries. Those plans are on hold for now.”

What happens in India affects all Image
Read 4 tweets
Abraar Karan Profile picture
14 Apr
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

latimes.com/opinion/story/…
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
Read 4 tweets
Abraar Karan Profile picture
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.

gh.bmj.com/content/4/5/e0…
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
Abraar Karan Profile picture
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
Abraar Karan Profile picture
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
Abraar Karan Profile picture
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
blogs.bmj.com/bmj/2021/04/02…
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

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