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Dr. Taison Bell Profile picture
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28 Jul, 7 tweets, 4 min read
I’m getting more worried about the elderly & immunocompromised patients as the #DeltaVariant spreads. Some concerning stats:
- 75% of patients hospitalized with breakthrough infections are 65 & older
- 44% are immunocompromised despite making up only 2.7% of the population.
🧵
The data is even more concerning for severely immunocompromised patients (like organ transplant recipients). They have an 82x higher risk of breakthrough infections. See below from @costisifri.
Studies looking at giving a 3rd dose of #mRNA vaccine to immunocompromised patients who fail to mount an antibody response are promising. This one showed that 33-50% of these participants developed an antibody response after the additional dose.
So what’s happening now? The Advisory Committee on Immunization Practices (ACIP) is considering advising a third dose for immunocompromised patients. In order to do it the EUA needs to be amended or the vaccines need full FDA approval. We don’t have time for the latter, IMO.
I would like to see the EUA amended so ACIP can make the rec. I’d like to see more data for 3rd dose in those 65 or older but I’m leaning yes to this as well. Interested in some colleagues thoughts: @BhadeliaMD @costisifri @PEHJackson @roby_bhatt @KrutikaKuppalli @ARLetourneau
Link to ACIP presentation: cdc.gov/vaccines/acip/…
Looky here 👀

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More from @TaisonBell

Dr. Taison Bell Profile picture
23 Jul
Cases from the #DeltaVariant are increasing in every state. So should you start wearing a mask indoors again if you're fully vaccinated? I have, and for most people I think the answer is yes. But this is especially true for folks who live in areas with low vaccination rates. 🧵
Delta is no joke. Compared to the original strain, 1000x more of it sits in your nose/throat and it peaks earlier. It's hard to believe. It is one of the most infectious respiratory viruses we have ever seen. Period.
virological.org/t/viral-infect…
With something so infectious your risk of infection goes up with any higher risk activity you do. But at each level of risk, your chances of getting infected are higher if you are unvaccinated. If you are in a community with low vaccination rates, this risk is even more amplified
Read 6 tweets
Dr. Taison Bell Profile picture
22 Jul
I’ve debated all day whether to post this, but the world deserves to know that 9 years ago to this day my first child, Julian, was stillborn. While @k_scottbell and I knew him through his kicks and tumbles, he was born at full term and never took a breath. We don’t know why.
🧵
There are no words to describe losing a child, so I won’t try. The emotional shock and depression was profound and it’s hard to even access that emotional space this far out. But it taught me how to set my priorities, and I’m a better parent, husband, and physician because of it.
I’m forever grateful for the staff at @MtAuburnHosp, where Julian was born. They advised us to create an identity for him. We swaddled him, kissed him and took pictures. We held him in our arms until the warmth passed on from his mother began to fade. These are precious memories.
Read 7 tweets
Dr. Taison Bell Profile picture
18 Oct 20
After a MICU stretch I finally saw #TotallyUnderControl. One line that stuck with me is there are times when politicians need to get out of the way. @alexgibneyfilm shows that a key failure of the WH was the inability to cede control and let the experts manage the pandemic.
The film does a very good job of taking the frustrations voiced by so many people and bringing them into a laser focus on the root causes. It should serve as a record of how our response went wrong and how to avoid the same mistakes for the next pandemic.
The film highlights the importance of public servants. People like @RickABright & @DrNancyM_CDC should be commended for the stand they took. At their personal/professional expense, they put the needs of the country first to tell the truth & speak out. They are heroes in my book.
Read 4 tweets
Dr. Taison Bell Profile picture
8 May 20
Yes. #RunningwhileBlack should not be a death sentence. Maybe it’s a good moment to share some insight into being black and male. I haven’t run alone for years out of this concern; but there are other things black men do to decrease their chances of being killed 1/
One night I was on call in the ICU and had to come in for a dire emergency. I hopped in my car and started to floor it. But then realized I was a black man, alone in a speeding car, late at night. It’s a setup for badness. I slowed down for my safety. 2/
Also speaking of cars, this is a “don’t shoot me” sticker. Every car I’ve ever owned has had some sort of sticker like this. It’s not a desire to advertise my cred, but an effort to assign me #human value when it may not be assumed if I’m pulled over. 3/
Read 11 tweets
Dr. Taison Bell Profile picture
24 Apr 20
I put a photo thread together to describe the themes that emerged during a 34 hours-long stent in the hospital I just completed. 1/
Loneliness.
During my residency at @MGHMedicine I started a habit of taking a break by walking the halls late at night when on call. My hospital is noticeably more empty at night in the non-patient care areas. I enjoy the casual encounters that take place here. It was lonely. 2/
“I don’t know.”
The loneliness in the hallways reflects the isolation you feel as an attending managing #COVID19 pts. Past medschool, I’ve never spent so much time saying, “I don’t know.” We’re still learning about this disease. It feels like you’re in a black box at times. 3/
Read 10 tweets

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