1/ One of the biggest reasons why we had been pushing for #BetterMasks was because when you have a catastrophic surge like we are seeing in India-- you need the best personal protection you can get, *immediately* #covid19
2/ This was *always* about staying prepared.

Yes, we will have government leadership to blame. Yes, we need support from the state. Yes, epidemics are complex social, man-made disasters.

But at the end of it, if you can't breathe and you can't access a hospital bed- that's it.
3/ I'm a physician. Even now, in Boston, I have sent #covid19 patients to the ICU.

Every physician remembers the surges here. Every doctor and nurse knows what it is like to be at the bedside during times like this.

Watching videos out of India are frankly triggering for many
4/ We need to take preparedness seriously. If the data is suggesting that #covid19 is primarily driven by short-range aerosols; if we are seeing catastrophic surges around the world w/ new variants etc; we must be better prepared before we are due for our #covid19 boosters.
5/ Every American should have immediate, affordable, and durable access to high-filtration masks at any time. I'm done hearing about production issues and shortages-- it's been over a year FFS.

As @sri_srikrishna says, this is like having a fire extinguisher in your home.
6/ Right now, with vaccinations severely lagging in India- with supply shortages, export bans on critical vaccine components, overwhelmed healthcare systems w/ patients literally dying before even making it to a hospital bed--we should be furious, both at Modi gov & intl response
7/ But our fury and frustration don't change what is happening to patients in India right now. This is serious tragedy, & it should be a stark reminder to the world that we must take pandemic *preparedness* seriously - that means esp when we have low numbers of cases(!) #covid19

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More from @AbraarKaran

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.”

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
Read 4 tweets
20 Apr
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.

Read 7 tweets
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

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
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

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