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Vincent Rajkumar Profile picture
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14 May, 10 tweets, 7 min read
A year ago today, >100 prominent scientists wrote an open letter calling on leaders to require masks for all to control COVID.

Our letter had an impact. @jeremyphoward @zeynep @erikbryn @EricTopol @trishgreenhalgh @DrSidMukherjee masks4all.co/letter-over-10…
The letter was announced in @USATODAY

@jeremyphoward @zeynep @JillDLawrence google.com/amp/s/amp.usat…
The WHO updated its guidance on June 5, 2020, agreeing that masks are recommended for all people in areas with high transmission— not just people with respiratory symptoms.
The evidence review for masks has been published in PNAS. @PNASNews

Prior to this, it was one of the most downloaded preprints ever. @jeremyphoward @trishgreenhalgh pnas.org/content/118/4/…
Even though we released the letter on May 14, 2020, many of the authors of the open letter were advocating for masks for all on news media and social media since mid to late March, well before the CDC guidance was eventually revised on April 3, 2020. npr.org/sections/coron…
It was incredible to be a part of an effort to change public policy along with a who's who of leaders in medicine and science, including 2 Nobel Laureates, and editors of several major academic Journals. @Bob_Wachter @PSampathkumarMD @SagarLonialMD @chadinabhan @NoopurRajeMD
As someone who advocated for masks for all before the CDC or WHO recommended them, and as someone who advocated for mask mandates, I know all too well the importance of masks.

I also understand the implications of the revised CDC guidance, issued a year after our letter.
A lot has happened in the last year. Most states did implement mask mandates. Looking at what is happening in India I know how the pandemic would have looked like without masks.
We also have 3 highly effective vaccines. The vaccines are not perfect. Nothing in medicine is. But they do afford almost 100% protection from severe disease and deaths. They make COVID go from being COVID to the common cold or the flu.

Cases and deaths have decreased.
It is in this situation: decreasing cases, low test positivity, 83% elderly vaccinated with at least one dose, and almost 50% of all adults vaccinated with one dose, that someone like me who pushed not only for masks but mask mandates can support the new CDC guidance with caveats

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More from @VincentRK

Vincent Rajkumar Profile picture
14 May
A lot of COVID deaths in India in young people who should be doing well & recovering.

I am making a plea to doctors in India to cut down the use of STEROIDS. Please.

Steroids are only useful after the patient is hypoxic. Harmful if given early, or given for too long
In the first week of the illness when the virus is dividing, the use of steroids can suppress the immune response and make the virus divide even more. Steroids are not antivirals. There was a trend to more deaths in RECOVERY trial in patients who were not hypoxic.
In patients who have hypoxia, it signals that there is lung involvement. By now the virus is likely controlled by the body and the damage is from the immune system. Only at this stage are steroids useful: at small dose (Dex 6 mg) and short duration (5 days).
Read 10 tweets
Vincent Rajkumar Profile picture
14 May
Pan Corona Virus vaccine thread

What you missed from the WH briefing yesterday: Dr. Fauci's comments. @ASlavitt

1/ We are going to keep having mutants/variants and one of the solutions would be to have a pan corona virus vaccine that stops the virus no matter what it does.
2/ Dr. Fauci referred to an important paper published in @nature on an exciting new nanoparticle cross neutralizing antibody technology targeting both pandemic and pre-emergent coronaviruses. nature.com/articles/s4158…
3/ The idea is to make a vaccine that elicits antibodies that can neutralize multiple different coronaviruses: A pan-coronavirus vaccine. And that it might be possible! Coming from Dr. Fauci who led the NIH team that developed the Moderna vaccine, I am taking notice.
Read 9 tweets
Vincent Rajkumar Profile picture
13 May
CDC revised guidance on masks. Good news. We have been saying for a while that our messaging on vaccines has to emphasize that masks will go away and restrictions will cease as vaccination rates increase.
Revised guidance: People who are fully vaccinated may skip masks and distancing in most indoor & outdoor settings. Exceptions noted below. @nytimes
google.com/amp/s/www.nyti…
This is possible because:

1) >70% of people age 65 and older in the US are FULLY vaccinated
2) 83% people age 65 and older have had at least one dose.
3) Almost 50% of adults in the US have had at least one dose.
4) Of the rest 1/3 have had COVID and recovered.
@ASlavitt
Read 10 tweets
Vincent Rajkumar Profile picture
13 May
This tweet sent on the same day the CDC director was worried about "impending doom" was based on my confidence in COVID vaccines. Americans did heed the director's advise and followed precautions. I'm glad it was a ripple, not a wave. We are making steady progress. #GetVaccinated
Most countries in the world would love to be in our position: more than enough COVID vaccines for every resident. Vaccines approved even for children 12-18.

But we have a problem. To prevent cases and deaths in the fall, we must overcome vaccine hesitancy and reach herd immunity
Vaccines work only if people take them.
Read 4 tweets
Vincent Rajkumar Profile picture
13 May
Only 2.5% of the population in India is fully vaccinated. (Which is part of the problem)

Fully vaccinated healthcare workers appear to be protected from severe COVID. Important story from @soutikBBC @BBCWorld bbc.com/news/world-asi…
I have been speaking to doctors and hospitals and I get the same sense.
Nothing in medicine is perfect. So you will hear about patients who have been fully vaccinated succumb. But this is likely the exception. 👇
Read 5 tweets
Vincent Rajkumar Profile picture
12 May
FAQ: Will current vaccines protect against the B.1.617 variant that is felt to be playing a role in the COVID crisis in India.

Answer: Yes they will. The summary of all the information out there is that current vaccines are highly protective, especially against severe disease.
It doesn't mean vaccinated people in India can relax on precautions. Or that we stop worrying about the mutant entering other countries & causing problems. Coz:

-Vaccinated people may still spread to others
-We need more data on protection
-There may be other mutants that arise
It does mean:

-Vaccines work & people should get vaccinated as soon as possible.
-Countries with extra doses of COVID vaccine, any COVID vaccine, should send surplus to help India. You will save a huge number of lives. You will also protect yourself from rise of new mutants
Read 6 tweets

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