The whole time I was reading this piece, this was the thought that was on my mind — & then @zeynep literally had it written out right here:

nytimes.com/2021/05/07/opi…
#covid19
2/ @zeynep - one of the best pieces you’ve written on this IMO. & some of the best in infection prevention- the team I am researching & writing w/ now from Brigham & Women’s similarly have shifted toward short range aerosols likely being dominant mode of transmission. Big shift
3/ From perspective of @RanuDhillon @sri_srikrishna and myself- we focused on the worst case scenario as it related to precautionary principle & PPE which is where #bettermasks came from

& we were criticized first by academics who held on to dogma of droplets as rationale
4/ What frustrated me the most was academic arguments being used to say public did not need better PPE despite hospitals having better infection prevention protocols than public spaces, & despite many #covid19 patients actually being less infectious by the time they were admitted
5/ despite insane inequities in who the virus infected; there were experts arguing against getting these high risk non medical workers better protection than the cloth masks they were wearing all year bc privileged academics were that committed to a dogma that favored droplets
6/ I guarantee you none of them would go work in a poorly ventilated kitchen or factory during covid surges w/ a cloth mask on; but this is the fundamental problem: who gets to talk about #covid19 as “experts” etc & who actually gets infected on the job- very diff groups here
7/ & lastly- I’ll say that I have no professional commitment to aerosol scientists, to @zeynep (although we are friends), or to anyone else on this issue; my commitment was and is to the patients I took care of who would have been protected by, among many things, #bettermasks

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More from @AbraarKaran

8 May
1/ Three Cs from Japan- avoid crowds, prolonged close contact, & closed spaces (poor ventilation)

These fundamental principles must be the core of reducing transmission during #covid19 surges in large unvaccinated populations

Adhering to these requires serious social supports
2/ There will still be a number of essential activities that must be done for survival.

The safest way to do these is with the best personal protective equipment available: namely, high filtration masks, whether N95 or reusable eN95 respirators, or equivalents KF94, KN95, FFP2
3/ Beyond these, rapid at-home POC diagnostics (cc @RanuDhillon @sri_srikrishna) at scale could be key; ideally, these should be available universally before surges happen--> these can quickly remove highly-infectious people from the pool daily before they become superspreaders
Read 11 tweets
4 May
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
Read 4 tweets
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.”

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
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.

washingtonpost.com/world/interact…
Read 7 tweets

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