🧵
1/ Why does it feel like the same crowd that yelled #stayHome is now yelling that unvaccinated low-income workers brought this upon themselves bc they’ve had ‘enough time to get vaccinated’?

As much as I wish it was that uncomplicated, I don’t think it is.
#covid19
2/ I’m not saying there is no aspect of ‘personal responsibility’ but the way this concept is being invoked often feels like people are assuming we are all starting off from the same baseline level of resources & advantages, which obviously is false.
3/ Beyond this, the public is operating in a very confusing environment with regards to divisive politics, poor Sci-Comm from even CDC, and then actual organized efforts from anti-vaxx groups.

That is on top of vulnerable peoples’ baseline level of resource constraints.
4/ That is on top of their possible prior hesitation re the medical establishment.

That is on top of logistical hurdles related to transport, paid time off, navigating systems to sign up/register/figure out where to go etc
5/ People keep pointing out how overcoming one of these barriers is easy; sure—but overcoming all of them is not.

Even vaxx mandates or burden setting (imposing restrictions on flying etc) won’t solve all of these issues although will put pressure on people to ‘figure it out’
6/ Whatever we do to move this needle, we must ensure that it also comes with resources targeted toward the most vulnerable.

Many are losing their patience. I get that. It hasn’t been easy for anyone. It’s not easy for doctors either. And there is real urgency to this
7/ People remaining unvaccinated makes us all less safe— it’s a crisis. In no way am I trying to make excuses for people harming others— but I’m also not going to let simplistic blame narratives frame how I’m viewing a complex public health issue. #covid19
8/ throughout the pandemic, the framing has often been from the perspective of those who are doing everything ‘right’ without a deeper dive into why those not doing so may in fact be unable to for reasons that we must help solve as public health workers

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More from @AbraarKaran

7 Aug
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
Read 4 tweets
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

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