1/🧵 Why have #COVID19 hospital admissions skyrocketed? 🗣
 
The virus’s spike protein acts like VELCRO in our airway. #DeltaVariant has modified the #SpikeProtein to make it SUPER-VELCRO. When exposed, you’re way more apt to get infected.
 
#Yale Press: bit.ly/3lKvJqs
2/ “In a completely unmitigated environment—where no one is vaccinated or wearing masks—the average person infected with original coronavirus will infect 2.5 others. In the same environment, #Delta infects >4 other people & grows more quickly.”
3/ Additionally, once the infection takes root in you (most often a person NOT #vaccinated), it has modified itself to increase viral shedding 1000X (ie, 1,000 virions for every 1 that was shed with original SARS-CoV-2.

go.nature.com/3CpHadb
4/💥This is the July 23, 2021 #DeltaVariant reference about super spreading of #COVID19

“viral loads of Delta infections, when first PCR+, were on average ∼1000 times greater compared to A/B lineage infections”
 
bit.ly/3lK1gJ0
5/ Note this dire warning: “Disease control activities should be adjusted in order to account for the increasing prevalence of the Delta variant worldwide.” 🌍
 
Are we responding adequately? NO!
6/🎥 Do you want to hear an elegant explanation of how solid the science is for the #Vaccine? Please watch @ScientistSwanda teach (and pass it on):
 
7/
Realize that w #Delta you are in a situation in which you walk past a person who coughs in the Mall or Kroger, and you have 1,000 times more virions with SUPER Velcro blasting over your cells to reproduce and spread #COVID into all blood vessels & organs of your body!
8/fin
1. Delta is 2-3X more contagious
It has shorter incubation (4 vs 5 days)

2. Infected people shed >1,000X more virus

3. Unvaccinated people are at greatest risk including young

4. Delta leads to outbreaks where vaccine uptake is low

H/T @DMAronoff

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More from @WesElyMD

11 Aug
1/🧵🎥 The #COVID19 ICU: an Insider’s look behind the curtain of our conversations with patients.
 
From my vantage point, there are TWO ROADS. Whether we meet depends on which one is chosen…see this video and read a real patient conversation👇

2/ Two Roads:

1. Get a #vaccine & >99% you won’t have me as your doctor.

2. Don’t get a vaccine & #DeltaVariant’s SUPER-VELCRO Spike Protein gets to decide your fate.
3/ If you don’t get a vaccine and then go to #DisneyWorld or the mall, & get #Delta infection (as multiple people in my life did recently)…

THIS is the conversation we may have…
Read 12 tweets
6 Aug
1/🧵🎥 Leading #COVID19 ICU Doctor @DavidJanz5 in New Orleans, the epicenter of U.S. #DeltaVariant surge, testified before US Senate Committee on Health, Education & Labor. Here is what he said: “Studies of #FrontLine workers caring for COVID-19 patients have shown…👇
2/ that the risk for the development of #mentalhealth problems (#PTSD #Depression) are like 9/11 Terrorist Attacks & Hurricane Katrina. Recent research shows that over 1 in 3 healthcare workers are experiencing anxiety, depression & post-traumatic stress disorder.
3/ Symptoms of #burnout are experienced by over half of critical care physicians. This is the state of the workforce asked to return to the #COVID19 #frontlines for a second, third, and now fourth wave.
Read 9 tweets
5 Aug
1/🧵Fluids in sepsis: When a patient’s blood pressure is too low and they are in shock, as happens all the time with #COVID19 viral #sepsis, we give fluids. This @bmj_latest figure👇makes a bit of sense of where the fluid goes. Let me unpack a bit more…

bit.ly/3lvrL50
2/ 👇 @bmj_latest
We talk about 2 categories of fluids: Crystalloids & Colloids. For crystalloids think “thin fluid like salt water with sugar.” For colloid think “thick fluid with lots of protein like albumin.” The figure shows that crystalloids leak out of the blood vessels…
3/ while colloid stays in the blood vessels. But there are several other important teaching points beyond what the figure shows.
✅ If a person has a lot of edema, as we see in heart, kidney & liver failure, colloids pull fluid into our vessels & ⬆️ blood volume to end shock…
Read 8 tweets
5 Aug
1/🧵Disaster in my childhood home of Louisiana ➕Update on Mandatory #Vaccination:
 
Louisiana is leading U.S. in exploding new #COVID19. Hospitals overflowing & admitting young people. But the crisis is also driving some to get #vaccinated.

nyti.ms/2WZzHRP
2/ ICU Dr. Justin Fowlkes: “I feel LESS SAFE in public than I do in the hospital.”
 
Patti Hilbun, 65, was reluctant to get #Vaccinated. No more, as she's spent 2 weeks w #COVID. “I will be blatantly honest,” she said. “This is as real as smallpox & polio.”
3/ Mandatory #Vaccination is becoming a REAL:
 
✅ >400 colleges = on board!
✅ Tons of hospitals = on board!
✅ Federal employers = on board!
Read 5 tweets
5 Aug
1/🧵 You are a BAD #GOLFER & have a big day with buddies & are in the tall grass a LOT. Later, you take off a #tick👇and in 7 days develop a fever & headache. You have no rash. The emergency room gives you acetaminophen. Is that OK?
 
#medtwitter #Nurse
2/ Tick bites are a big deal in Summer months. Rocky Mountain Spotted Fever is a concern, and the absence of rash also brings up #Ehrlichiosis. This @NEJM paper showed that worse golfers retrieved balls from the rough & got the dz more often!
 
bit.ly/3e6vQrF
3/ Of those with #Ehrlichiosis, 20% get bad nervous system dz & 20% of those die. If you live in Southern US and find a Lone Star tick (pic above), and then develop fever & headache, get evaluated and probably start the antibiotic doxycycline quickly!
 
bit.ly/3e5ndxF
Read 5 tweets
3 Aug
1/🧵🎥 Former ICU Nurse with #LongCOVID👇 describes disabling #POTS (Postural Orthostatic Tachycardia Syndrome)
 
“I'm an Ivy League grad & former ICU nurse who got COVID a year ago (before #vaccination). I had no medical problems & now suffering Long COVID so badly…”
2/ …”that I can’t work in the ICU and basically have a desk job. POTS & Long COVID gave me a racing heart, dizzy head & inability to function adequately in life. It’s horrible. My brain fog makes it impossible to execute tasks to care for patients. Life as I knew it seems over.”
3/ …she said, “It irks me to hear people downplay this disease when I'm suffering this badly a year later. I’ve been vaccinated myself now. We are surging again. People are scared. Let’s talk this out & find a way out of the €%£! pandemic.”
Read 9 tweets

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