1/ Do you hear that drumbeat? That is the drumbeat of fear. You can hear it all over media (social and otherwise). Fear of delta, fear of breakthroughs, fear of side effects, fear of getting vaccinated, and fear of not getting vaccinated.
2/ Fear has always been the go-to emotion for anyone trying to motivate others. It is powerful, but it can be paralyzing. For fear to be valuable, there must be a path for the person to take to remove themselves from the danger that is fearful.
3/ “The house is on fire, go out this way!”

There are entire psychological disciplines dedicated to analyzing the utility of fear as a motivating force for good, bad, and mundane (like fear to get people to buy products such as antiperspirant; you fear smelling bad).
4/ As we move past this pandemic, we are learning how to deal with a fear that has been omnipresent for 18 months. We must also learn how to deal with fear that develops within the pathway out of danger. “COVID is bad; get vaccinated.
5/ Oh, but wait, there is some perceived fear even in that pathway.”

It is easy to see why we are in the current fearful situation and why the volume of fear is being kept turned up high; it’s about motivation.
6/ Early on, fear served as a positive tool to motivate people to stay home, keep a mask on, and get vaccinated. Unfortunately, it also served as a selfish negative used to keep people engaged in media outlets, clicks, views and thus profits.
7/ It also serves many individuals personally as it keeps their faces on your screen discussing how you should continue to be afraid.

The human mind cannot adequately deal with fear for such a prolonged period of time.
8/ It either tunes out, shuts down, creates mental illness such as anxiety or depression, or starts to rebel openly against the source. I worry we are in that phase. We must create motivation in new ways.
9/ I believe that motivational message must be driven by positive aspects rather than despair.

I bring this up now specifically as it relates to variants and vaccines. This is playing out in the UK at this very moment. Look at the tone of these headlines.
10/ -“Are these the numbers scaring Boris? Study shows 29% of the 42 people who have died after catching the new strain had BOTH vaccinations as cases soar another 40%” (dailymail.co.uk/news/article-9…)
11/ -“Delta variant doubles risk of COVID hospitalisation - Scottish study” (reuters.com/business/healt…)

-“ Two passengers test positive for COVID on Celebrity Millennium 'fully vaccinated' cruise.” (usatoday.com/story/travel/c… )
12/ However, when you click on the actual article (and therefore have successfully fed into the news sites financial algorithms), you realize that the articles stress the small number of cases, the lack of definitive data on the deaths, and the overwhelming success of the…
13/ …vaccines. In other words, the articles are balanced while the headlines are not.
14/ I will ask a question for which I cannot answer due to my ignorance of UK politics, but I wonder how much of the drive of fear of the delta variant is focused on the political divisiveness within the UK?
15/ Again, just trying to understand the agendas at play and realizing that the desire for political gain is a very powerful agenda. As always, the process I go through to fight fear is to examine the actual data. The data says that the variants may be more infectious.
16/ One note, that actually hasn’t been proven though can most definitely be assumed to be true. That said, it remains unclear if the variant causes more severe disease or just a lot more of the same disease in unvaccinated individuals as a dose response curve.
17/ Either way, and here is the most important thing; VACCINES WORK AND WORK WELL against every variant ever tested. Remember what I have written about in the past and be cautious of a few things in this domain: 1. Ignore preprint, non-peer reviewed.
18/ 2. What happens in a lab experiment is not representative of our complex immune system. 3. Remember that the vaccines are there to prevent severe disease, not a positive nasal swab. 4. Pay attention to the exact definition of partial, fully, or non-vaccinated.
19/ These are all incredibly important in interpreting how fearful to be. Here are a series of fantastic references that will help back up what I have just said, specifically with regard to the effectiveness of vaccination.
20/ They all speak to the incredible depth and breath of our immune system in fighting against all variants. We are built for this and the vaccines utilize this incredible power to help protect us.
(nature.com/articles/s4158… )
(nature.com/articles/d4158…)
(thelancet.com/journals/lance…?
21/ Now, let’s specifically deconstruct the headlines.
1. 29% of deaths in the UK are in fully vaccinated individuals with delta. Well, you could easily turn that upside down. In that same report there were 33,206 positive cases of the delta variant.
22/ That means that the mortality of that variant amongst vaccinated individuals is 0.000003%. Also, there were 42 people admitted to the hospital which means that your chance of getting admitted if you are fully vaccinated is 0.00001%.
23/ Furthermore, we have absolutely NO data of co-morbidities, actual cause of death, etc.

And as of today, the UK has re-iterated the overwhelming success of the vaccines.
24/ Now, important for the US population where the AstraZeneca product is not available, look into the actual data behind that report.
25/ What you discover is that the Pfizer (and assumption Moderna) vaccines are 94% effective in preventing hospitalization after 1 dose and 96% effective after 2 doses. That’s incredibly similar AND they don’t even look at mortality.
26/ Look past the announcement headline and go into the actual background data found on the UK government site.
2. Now for the cruise ship data. I will admit my bias that I have never been on a cruise. I get wicked seasick.
27/ Plus, even pre-pandemic I looked at a cruise ship as a massive petri dish. That said, let’s give them some slack. There were over 1250 fully vaccinated people on that ship and they found 2 asymptomatic positive cases.
28/ You could look at it another way and say that if you are vaccinated you have a 0.00001% chance of a positive, asymptomatic test with NO actual illness or hospitalization.

3. Finally, let’s look at some good data on the immune system again.
29/ As I said, the complexity and robustness of our protection is incredible. This is further found even in cancer patients. (sciencedirect.com/science/articl…) Even if we use the surrogate of antibody response, cancer patients still have a good response.
30/ Now, add in all we know about Tcell, etc. and there is no reason to be pessimistic about a vaccinated, at risk patient population.

Back to my original thoughts about fear. I think these sorts of positive messages are far more impactful than fear.
31/ The motivation around how well you can do with a safe vaccine vs. how much you better be terrified if you don’t get one is a far better path to take.
32/ We must be honest and realize that have a growing problem with people being either paralyzed into inaction or rebelling against the current motivational tools.
33/ We should embrace the margins and encourage flexibility of positive response since there is growing evidence that one dose of the mRNA vaccines are protective if you have had previous infection and that they are also protective against hospitalization even if you haven’t…
34/ …had previous infection (see above). (immunology.sciencemag.org/content/6/58/e…) Yes, I would love to have everyone fully vaccinated with both doses. Yes, that is the best and it is safe. However, I continue to be a realist and I want to move the needle further.
35/ France is even taking that stand as an entire country. (rfi.fr/en/france/2021… ) Two is best, but one is better than none.

I don’t think that fear is the way to accomplish moving the needle.
36/ Fear of the need for a booster (though NO evidence to suggest that we really will need it) does nothing to get an unvaccinated person to agree to getting the first dose. Fear of variant upon variant no longer motivates those on the margin.
37/ Fear of partial vs fully only confuses the picture and causes rebellion against getting even one dose; or worse the resignation of “why bother”. These are all based in the same motivational scheme of fear. How about we try to be positive, respectful, and open-minded?

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More from @ChecchiaPaul

6 Jun
1/ Dealing with adolescence is challenging, for both the parent and the teen. You know they are going to be ok; and at some level, they know as well. However, the journey through those years is never a straight line.
2/ There seems to be an ever present feeling of anxiety about life. It is completely normal, and it applies everywhere. This is happening on a global level right now.
3/ However, just as we all learn coming through our own adolescence or raising our child through theirs, it’s not as bad as perceived. I want to try to combat the anxiety and angst with an examination of the data.
Read 44 tweets
4 Jun
1/27 When we were traveling recently (thank you vaccines), the biggest question I got from parents dealt with the concern about the vaccines causing infertility in their daughters.
This is NOT TRUE! How’s that for clarity?
2/27 Now let me explain as best I can with data and then dive into the manipulation of this discussion by those with a nefarious agenda.
The root of this myth comes from a blog posting. Remember, blogs are free speech and therefore never fact checked.
3/27 The title was "Head of Pfizer Research: Covid vaccine is female sterilization.” (I’m not linking to any of it to avoid driving more money into their pockets.
Read 27 tweets
2 Jun
27/ Bottom line, I want parents to be comfortable and accepting of these vaccines. I would love to see “perfection” of following the original trial designs. I continue to advocate that these vaccines are our way out of this mess. However, I am a realist.
28/ I adjust the bar when necessary. There is an age-old question about making improvements: would you rather improve one thing 100% or 100 things by 1%.
29/ At this moment in the history of this pandemic, I have to admit I would rather see 100% of 12-25 year old people vaccinated with 1 dose than see 50% of them fully vaccinated with 2 doses.
Read 4 tweets
2 Jun
1/ Today, I was going to examine the myth of fertility effects of the vaccine; but then Israel reported a “probable” link of vaccination to myocarditis so change of plans.
2/ Let’s revisit the entire entity of cardiac findings post vaccination as well as what COVID does to the heart.

I had written about how the inflammatory response following vaccination may be the culprit in the rare cardiac findings being observed.
3/ I still stand by that hypothesis. I don’t see any new data or evidence that would persuade me from thinking that the heart is a bystander to the cytokines and inflammatory mediators generated by the robust immune response of these fantastic vaccines.
Read 25 tweets
27 Apr
1/ A few weeks ago, I wrote about what I called Pandemic Stockholm Syndrome. Many of us have become enamored with our captor and have become comfortable with our fear. This is not wrong but rather an outcome of the extreme disruption we have all faced for the past 14 months.
2/ I truly believe this is a very real issue and one that will continue to cause significant distress for all of us in the coming weeks. It appears that the media is also picking up on the anxiety we are all feeling. (nbcnews.com/news/us-news/e… )
3/ To me, the easing of mask restrictions is part of the “release” from captivity and thus another opportunity to deal with our Stockholm Syndrome.
Read 34 tweets
2 Feb
1/ Are you afraid right now? I’m pretty certain all of us have some level of constant, smoldering fear. For some, it’s fear of the present virus. For others, it’s fear of the future “variants”. For many, it’s fear of not being able to provide for their families.
2/ Unfortunately, for some, they fear losing their personal “benefits” associated with this news frenzy; whether it be viewership, fame, or clicks.
Fear can be motivating. Remember that quote from Wall Street about greed?
3/ “Greed clarifies, cuts through, and captures the essence of the evolutionary spirit.” Well, fear can clarify, focus, and ultimately motivate people to do something.
But only to a point…
Fear worked in March. It kinda worked in July. Maybe it worked a little in November.
Read 30 tweets

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