Thread by @Vidyut

So this #Covid19India second wave thing. Some thoughts.

Disclaimer: Not a doctor.

Many things are different about the second wave. The sudden surge for one. One day we had things under control, suddenly we were flooded.

We have vaccines this time around, but it doesn't reassure as much as we'd imagined when we wished there were vaccines we could take but there weren't.

Apart from inadequate vaccines, we first realized we could still be infected. Then discovered people could also die anyway.

Many people are drawing parallels between vaccines and the second wave. I don't understand enough about viruses to say if this is "linked" to vaccine, but at least in several cases we have seen inadequate crowd control at vaccination centers. This is definitely a problem.

We have imported a lot of knowledge. Including that people have vaccine hesitancy, even though it isn't a *thing* in India to any major extent.

This is resulting in unnecessary "encouragement" to vaccinate that is counterproductive because .... vaccines are not available.

So those who want to vaccinate not getting appointments is a new source of anxiety with daily stressors on how it is necessary, etc

BUT news reports of vaccines are also .... evolving.

India's AEFI is not very clear. We are urged to trust the statistics from other places in the world. Then told not to worry about things that got vaccines stopped anywhere else in the world also.

Then, side effects post vaccine *seem* more than anticipated, protection less.

Vaccine is safe, people who died after getting it died for other reasons, we are told. Apparently side effects can be because of vaccine, death cannot.

This now enters the territory of blind faith.

Then we hear of people dying of covid after vaccinations.

We are urged to see how many fewer people have died compared with before. But before we had PPE shortages and little knowledge of effective treatments!

So how many fewer died because of vaccines? Honest answer? Can't say. No one keeping track to say with certainty.

Vaxxers want you to trust that the vaccines are effective. Meanwhile vaccine claims of protection have gone from 90%+ to only 33% or so unless second dose taken, then 80%

Reports of people dying of covid inspite of both doses of vaccination (including doctors) continue.

Lay vaxxers (non-doctors) argue some protection is better than none. Hard to dispute this when life is at stake. Masks + social distancing + vaccine + whatever other protection will all add up into a fortress of prevention+immunity.

Vaxxers (doctors) speak of variants.

Vaccines were created against variants that existed at that time, effectiveness against new variants unknown/80%/etc

Are we keeping rigorous track of variants? Nope.

Who is supposed to so that general public can pressure? Not known.

Vaxxers tell you to not worry about variants. Some immunity is there against all to varying degrees. Some immunity is there by default in human body itself too - given that 80% cases resolve on their own. So how much because of vaccine? Unclear. ¯\_(ツ)_/¯

But vaxxers assure you variants all somewhat similar. Vaccines will be effective to some degree. See world data. Lots of data. Ignore news. Anecdotal that is.

But covid is acting different in India in other ways too - black fungus reports are from doctors in India.

We don't see this black fungus being an issue in other places. Could be hot climate? Variants? Steroids? High blood sugar?

But seen in patients not treated with steroids and who got only mild symptoms too.

But clear that both disease and vaccines not behaving as seen in other countries and not enough research to say authoritatively what the heck is going on or what to expect from disease or vaccine.

IMA not even keeping track of dead doctors or their vaccinations properly?

Not a vaxxer or anti-vaxxer. Information junke who feels suspicious when conclusions are pushed without evidence.

I wish more doctors said "I don't know" "I can't explain discrepancy" rather than "trust the data" when news reports clearly contradict it.

If we can begin with admitting we don't know, we can get around to finding out. Lay people may not understand big data like epidemiologists or medicine like doctors, we understand how to make enough noise on SM to make sure YOU get the info you need for SCIENCE. Not blind faith.

About the black fungus, I forgot:

1. At least one report of black fungus in intestine in patient with mild symptoms who did not get steroids.

2. If corelation with high blood glucose is conclusive, why not ask people to buy glucometers to ensure control like they got oximeters?