New piece in my @bmj_latest column: we must stop blaming & start protecting 'the unvaccinated'

If I blamed my patients for their illnesses, I'd hardly be a physician

As public health experts, we must figure out how to protect, not blame.
blogs.bmj.com/bmj/2021/08/06…
2/ The natural responses to this will be 'but are people deserving of blame'?

That's not the question I'm trying to answer

I'm trying to re-focus this conversation on how we close the vaccination gap

Blaming 'anti-vaxxers' might make others feel better; not sure it helps.
3/ And beyond this, the 'unvaccinated' aren't a homogenous group of people; nor are 'unvaccinated' the same as 'anti-vaxxers'

Many of my patients who fell into the former group were confused by the aggressive pushes from the latter group #covid19
4/ Instead, we must craft policies that focus on protecting the most vulnerable; in many places, this will be in the form of vaccine mandates

But mandates MUST be accompanied by means for people to get the vaccines

Transportation, paid time off, access to medical experts etc

• • •

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More from @AbraarKaran

5 Aug
A short thread...
1/ Many people have been saying "but I did everything right"

Sadly, this is part of the issue- individuals did what we needed entire communities to do

Now, we are left w/ some feeling like they were screwed by others...
2/ And others feeling like the government is trying to 'control' them or take their 'freedom'

We are failing as a community, bc perhaps this country has been so focused on individualism, we lost sight of what we lost in the process
3/ We were fractured well before #COVID19

And even now, the rhetoric quickly turns to blame

"I masked, why didn't they?"

"I got vaccinated, why didn't they?"

The deeper question to me is why our reflexes as Americans are so self-preserving, not community-preserving?
Read 4 tweets
1 Aug
Once again, we are the country with all the resources yet such a dysfunctional social fabric that we can literally hoard vaccines & still remain unvaccinated

American exceptionalism at work
#covid19
2/ This says a lot more about us than many are perhaps considering

This isn’t just about people disagreeing about stuff

It’s about a lack of leadership AND the lack of equity as an American societal principle
3/ I suspect that among many who are untrusting of our government now trying to get them vaccinated — we have many who are surprised that the government or politicians care about them or their communities at all.

That problem didn’t start yesterday. It won’t be solved overnight
Read 4 tweets
25 Jul
#COVID19 outbreak from #Gamma variant in Gold Miners in French Guiana

24/44 infected (54.6%), and 21 symptomatic

25/44 were fully vaccinated (Pfizer)--> and 15 of those 25 were infected (60%)

but

NO clinically severe #COVID19 requiring hospitalization

wwwnc.cdc.gov/eid/article/27…
2/ Gamma variant (P1) has been shown to escape from neutralizing antibodies, but the immune system is made up of more than just humoral immunity

Studies from other variants have shown retained activity of T cell immune response

sciencedirect.com/science/articl…
3/ While the attack rate here is high among even fully vaccinated w/ mRNA vaccines, our number one goal is to prevent severe disease, hospitalizations, deaths.

With that said, as variants continue to emerge, we must monitor very closely.

Also, no mask use was reported here.
Read 4 tweets
24 Jul
🧵🧵
1/ The moment we begin to reframe unvaccinated people as people vulnerable to malicious misinformation, & still deserving of protection from a deadly virus, the sooner we will figure out ways to bridge this gap.

Shaming them isn’t going to work. It will further the divide.
2/ People seem to argue that because they could understand how to see through misinformation (& get vaxx’d), that there is no excuse for others to also not have come to the level of understanding that they have

This thinking quickly turns into blame/anger, but it doesn’t help
3/ When we tried to use blame/shame this year, we lost access to those who were on the fence.

In some cases, this meant losing access to contact tracing when people were hesitant to reveal they had tested positive.

bostonglobe.com/2020/11/30/opi…
Read 6 tweets
22 Jul
Very concerning. Especially with millions still unvaccinated, and rates of vaccinations slowing.

And do not say this is 'their fault'; people are literally being fed anti-vaxx BS daily in this country.

These are patients, these are people; they don't deserve to be sick.
2/ Our oath as doctors is to protect our patients; our oath as public health leaders is to protect the health of our communities-- it is NOT good enough to say that it's the public's fault for not being vaccinated at this point.

That's not how public health works.
3/ This is a constant battle between information and misinformation. People have a right to be hesitant to new medical interventions. Our job is to dispel myths and lessen fears; to bring public health to communities, not wait for them to come to us. Esp not during a crisis.
Read 6 tweets
17 Jul
Our op-ed summarizing the findings of our recent study in CID @IDSAInfo from @BrighamWomens looking at risk of #SARSCoV2 transmission from index cases to their hospital roommates. ~40% secondary attack rate; and beds are 7 feet apart w/ curtain in between

medpagetoday.com/opinion/second…
2/ We felt that short-range aerosol transmission most likely explains our key finding. Better ventilation & #betterMasks are essential in addition to vaccine rollout.

Cc @kprather88 @j_g_allen @linseymarr @DFisman @carlzimmer @jljcolorado @RanuDhillon @sri_srikrishna @zeynep
3/ Important to note that over several months, the incidence of roommate transmission was exceptionally low- 0.1%; the key takeaway is that IF you end up roomed w/ someone that has a #covid19 infection w/ a low CT value (high viral load, infectious)- very high risk of spread.
Read 4 tweets

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