FDA is getting ready to clear Pfizer vaccinations for children in the US.

High risk unvaccinated adults are dying in surges in India.

This is not what equity looks like. #covid19
2/ This is the reality of trade offs. No one said there were going to be easy decisions. And with limited vaccine supply, & monopolization of that supply— these are the moral dilemmas that the world must grapple with. Extremely low risk children here v high risk adults elsewhere
3/ Yes, there are high risk kids here & they should be vaccinated. Yes, global vaccine monopolies are not the fault of American parents- no one is saying they are. Nonetheless, vaccine inequity is real. And it’s going to cost us all big time. #covid19
4/ & while supply is limited, this does not necessarily immediately translate into “American children taking away vaccines from high risk adults elsewhere”; but, it certainly shifts attention away from vaccine inequity/ is a new & lucrative market for the Pfizers of the world

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More from @AbraarKaran

2 May
1/ In speaking with multiple NGOs on the ground in India just this morning:

“the government has abandoned us”

The capacity to quickly scale up high grade surgical + N95 masks is there; why isn’t it being utilized?

#IndiaCovidCrisis #covid19
2/ With high-grade mask protection, you can functionally stop transmission both ways. This means that if you’re infected, you can stop spreading to others; and if you’re not yet infected, you can be better protected while doing daily essential activities that can’t be stopped
3/ this is of course with the goal of getting vaccinated; but as is known, immunity post-vaccination is not immediate; during a surge like the one in India, better PPE is the most immediate solution
Read 5 tweets
24 Apr
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
Read 8 tweets
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

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