For States and regions in the US that have low vaccination rates because people don’t want it, wouldn’t the federal gov’t be better off waiting until they ask for help rather than trying to push/force vaccinations on them, which just seems to increase resistance.
In this construct, the federal gov’t would say, we are ready and eager to help with vaccines, funding, people - let us know when you are ready. This, in place of being characterized as forcing people. De-politicize it… feds just wait to be invited to help.
The key is to make vaccines accessible and free to everyone; make trustworthy information about the vaccines abundant and clear. And let people make their choices. Be the sun and not the wind, and people will eventually take off their coats.
And having 65K doses of vaccine go to waste in Alabama because people do not want to be vaccinated is worse than a shame. Send doses to match their demand. Do not over-supply. There are plenty of people in the world who want to be vaccinated. @nytimes
@nytimes Our federal goal, every person who wants to get vaccinated should be able to do so rapidly, easily, and without cost. The federal recommendation is to be vaccinated. But do not force it on those who resist; just invite them to re-consider… and say, when you do, we will help you.
@nytimes And for people living in regions with low vaccination rates, feds should make it easy for them to be vaccinated… and they need to convince their neighbors and politicians to help them if they want to turn their region into a highly vaccinated, lower risk area. Grassroots.

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More from @hmkyale

17 Jun
“...first longitudinal imaging study in #COVID19 where patients initially scanned before contracted the disease.” An incredibly important @uk_biobank study… 'Brain imaging before and after COVID-19 in UK Biobank’ by an esteemed group. medrxiv.org/content/10.110… @medrxivpreprint
@uk_biobank @medrxivpreprint "significant, deleterious impact of COVID-19 on olfactory & gustatory cortical systems, w/more pronounced reduction of grey matter thickness & volume in L parahippocampal gyrus, L superior (dorsal) insula andL lateral orbitofrontal cortex in COVID patients.” #LongCovid
@uk_biobank @medrxivpreprint Here is the kicker… of the people w/COVID for whom there are records, very few had been hospitalized. These brain effects occurred largely in largely in people not sick enough to be hospitalized. Time to re-think how benign this is in people w/o severe symptoms. Time will tell.
Read 12 tweets
16 Jun
Another remarkable trial from the RECOVERY team. This time 'Casirivimab and imdevimab in patients admitted to hospital with COVID-19’ - and with an impressive finding. Kudos @PeterHorby @MartinLandray and all contributors. Now on @medrxivpreprint medrxiv.org/content/10.110… #COVID19 Image
@PeterHorby @MartinLandray @medrxivpreprint They studied @Regeneron monoclonal antibodies (casirivimab and imdevimab). They report: 'In patients hospitalised with COVID-19, the monoclonal antibody combination ... reduced 28-day mortality among patients who were seronegative at baseline.' Image
@PeterHorby @MartinLandray @medrxivpreprint @Regeneron An important finding in this trial is that the effect of the monoclonal antibodies was present in hospitalized patients with COVID-19 who were seronegative, but not those who were seropositive. A key insight into who benefits. Image
Read 5 tweets
15 Jun
What a pleasure to hear @NHLBI_Translate from @nih_nhlbi talk @YaleCardiology about the persistent gaps in quality of healthcare and the opportunities with implementation science. He is challenging us to do more with what we already know works. @YaleMed @NIHDirector Image
@NHLBI_Translate @nih_nhlbi @YaleCardiology @YaleMed @NIHDirector For context…implementation science is the study of methods to promote the integration of reserach findings and evidence into healthcare policy and practice. [and we must involve patients in all of these efforts]. Image
@NHLBI_Translate @nih_nhlbi @YaleCardiology @YaleMed @NIHDirector We hear from @NHLBI_Translate talk about the importance of thinking about equity in the implementation of evidence… we can inadvertently worsen disparities if we do not apply an equity lens. @YaleCardiology @YaleMed Image
Read 4 tweets
24 Mar
A blockbuster #preprint of #LongCovid from UK; 1077 patients discharged in 2020; at median 5 mos only 29% fully recovered, 20% had new disability. medrxiv.org/content/10.110… @medrxivpreprint @REvans_Breathe @uol3i @HamishMcAuley @LouiseVwain @Survivor_Corps @patientled @dianaberrent Image
@medrxivpreprint @REvans_Breathe @uol3i @HamishMcAuley @LouiseVwain @Survivor_Corps @patientled @dianaberrent And another indicator of the impact of #COVID19… at a median of 5 months after hospital discharge, 19% experienced a health-related change in occupation. @medrxivpreprint Image
@medrxivpreprint @REvans_Breathe @uol3i @HamishMcAuley @LouiseVwain @Survivor_Corps @patientled @dianaberrent "Factors associated with failure to recover were female, middle-age, white ethnicity, two or more co-morbidities, and more severe acute illness.” Image
Read 7 tweets
23 Mar
And here is another important #longCOVID #preprint by the amazing @NatalieJLambert and team. "most common symptoms were fatigue, headache, shortness breath, difficulty concentrating, cough, changed sense taste, diarrhea, & muscle aches." medrxiv.org/content/10.110… @medrxivpreprint
@NatalieJLambert @medrxivpreprint "Symptoms causing greatest distress (scale 1 “none” to 5 “great deal”) were extreme pressure at base of head (4.4), syncope (4.3), sharp or sudden chest pain (4.2), brain pressure (4.2), headache (4.2), persistent chest pain or pressure (4.1), and bone pain in extremities (4.1)."
@NatalieJLambert @medrxivpreprint Again, we see a remarkable range of downstream symptoms from COVID; this illness has devastating consequences for so many that extends far beyond the acute illness. Much to learn. Need to move quickly. @Survivor_Corps @dianaberrent
Read 5 tweets
23 Mar
Striking #preprint on #LongCovid: 'high rates of long-term symptoms and poor long-term outcomes, present several months after hospitalisation for #Covid19’ Over 50% with symptoms months later. A quarter w/new or worse disability. medrxiv.org/content/10.110… @medrxivpreprint
@medrxivpreprint So useful: ‘>half of patients reported not being fully recovered 7 mos after onset Covid-19 symptoms.’ 'Younger women &those w/more severe acute disease in-hospital had worst long-term outcomes.’ @dianaberrent @ahandvanish @louise_sigfrid @JTSglobalhealth @Tom_Drake1 @tweediechap
@medrxivpreprint @dianaberrent @ahandvanish @louise_sigfrid @JTSglobalhealth @Tom_Drake1 @tweediechap They conclude: 'Policymakers need ensure there is long-term support for people experiencing #LongCovid & plan for lasting long-term population morbidity. Funding to understand mechanisms and identify potential interventions for testing in randomised trials is urgently required.'
Read 6 tweets

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