1/🧵 #COVID “Swiss Cheese” Model of Protection

Important in #Delta surge❗️
 
The protection you seek from #COVID19 is NOT “all or none.” It exists on a continuum. Each decision ⬆️ or ⬇️ your vulnerability to an evolving #virus 🦠.
 
bit.ly/3gltN42
2/ On a bus this week, the man next to me was huddle up, scared & covered. He said, “I’m petrified because I don’t have any antibodies yet, but I don’t want to be in an experiment.” I thought, “well, you’re consenting to an experiment by getting on a bus without #Vaccination.”
3/ He took a chance, and we all do. I’m not perfect at my protection plan either. At a public meeting this week, I took my mask off to speak & the person next to me promptly coughed. I though, “Unvaccinated?”

@Sketchplanator designed this original model for COVID risk reduction.
4/ So how protected are you? Again, it’s NOT all or none. The virus wants you on its list. For every asymptomatic infected person you come into contact with, your level of protection will tell the tale. This Swiss Cheese model by @mackayIM outlines MANY steps we can take…
5/ In an unprotected population, a #DeltaVariant-infected person infects ~350 people after just 3 rounds of spread. Basically all #COVID now is #Delta & 30-40% are totally asymptomatic w an incubation period of 5-10 days. Gambling has led to a 10X ⬆️ in ICU admissions in <60 dys.
6/fin
At 10 miles an hour, the average seat belt will do. When we are driving fast, things are riskier & we need a better seat belt. With #Delta, we are all on a #COVID19 super-highway.
 
How good is your seat belt?
 
#Vaccinate #Mask #SocialDistance

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More from @WesElyMD

13 Sep
1/🧵🎥 REFLECTION on Fear & Love – what connects 9/11 & #COVID19?
 
On #Sept11, 2,996 died. 412 were 1st responders running INTO danger.

WIKI: bit.ly/3AiqZN2

WHY did they do this? Listen to my patient Col. Correa👇

HINT: it was NOT religion, politics, or patriotism.
2/ When someone around us needs help, the only universally unifying response is #LOVE.

Wells of love (see pics 👇) must be what we drawn on to achieve success in serving others, whether on 9/11 or in this #Pandemic.
 
Pics by Robert Mecea & @marklennihan
3/🎥 I cared for 9/11 hero Colonel Victor Correa as he died in our @VA hospital years later. His story is told in #EveryDeepDrawnBreath. He carried men out of the Pentagon saving lives. Watch more of his testimonial…
Read 9 tweets
10 Sep
1/🧵🎥 Tennessee has highest #COVID19 case rate IN THE WORLD 🌎‼️

1/3rd are KIDS, & we haven’t even peaked!

Dr. Jeff Balser, @VUMChealth President & CEO, explains our dire situation. Despite 375M doses of #Vaccine is US alone, we have ~50% overall #Vaxxed & need YOUR help.
2/ This surge is different. The children are disproportionately affected – 1 in 3 new cases. Overall, and this is hard to believe, but we are at our ALL TIME HIGH in admissions. Image
3/ 🎥 Except for immunocompromised patients, almost all in hospital are #unvaxxed. We are re-deploying OR personnel to the ICU and having to curb care for non-COVID pts. It’s just not fair to them. Not getting vaxxed means more suffering for everyone.
Read 5 tweets
1 Sep
1/🧵💥 NEW COVID THERAPY SAVES LIVES

Adding baricitinib to steroids will save 1,000s of hospitalized #COVID pts. Our @LancetRespirMed COV-Barrier study is FREE.

I explain👇why it’s such a great #Pandemic discovery story: a new way to ⬇️ COVID19 deaths.

bit.ly/3DE8Co8
2/ Early in COVID, computers predicted “Berry” (for Bari-citinib), an FDA-approved medication for rheumatoid arthritis, could be repurposed to stop SARS-CoV-2 from killing us. Now we proved it! Why did the computers think it would work?

bit.ly/3t244CR
3/ Bari has antiviral mechanism but mainly we thought it would work by interfering with the intense inflammation the virus 🦠 causes, which is what leads to so much lung, heart, blood vessel, & brain damage (#delirium).

bit.ly/3jsgCjN
Read 15 tweets
1 Sep
1/🧵 EVIL & the #AntiVaxx Movement:
 
By no means do I think the #Unvaxxed patients filling our ICUs to capacity are evil. NO. But I do think there is evil involved in the misinformation leading many good, caring people to that decision. And I listen to each. Please hear me out.
2/ Philosophers define evil as “a deprivation of the rationality that proper human action requires individually and as a member of society.” In that sense, we can discuss choosing not to be vaccinated and “cooperation with evil.”
3/ Thus far, “cooperation with evil” has been used as an argument by some in the #antivaxx culture as a reason NOT to get #Vaccinated. The main argument is that Pfizer and Moderna were safety texted w the HEK-293 fetal cell line.
Read 6 tweets
31 Aug
1/🧵 “Live every day like you have a terminal illness.”

The most important thing I learned @ISICEM, after 3 ✈️ & 4,400 miles to Belgium for this huge meeting of #COVID ICU doctors, had nothing to do w science.

The iconic @JRandallCurtis1 taught me…(pic & story shared w perm) Image
2/ My friend of 25 years opened his lecture on End-of-Life with, “I have a disclosure of sorts. I’ve been diagnosed with ALS (Amyotrophic Lateral Sclerosis, aka Lou Gehrig’s disease), so this will probably be the last time I lecture at this meeting.”

Then he asked us to PAUSE. Image
3/ Talk about a Frame Shift.

I already knew, but it all hit me like a thunderbolt⚡️. The Father of ICU EOL #PalliativeCare research & former president of @atscommunity had just told us all that he has a fatal illness, and we could hear it in his speech pattern.
Read 12 tweets
31 Aug
1/🧵 The main question I wake up wanting to answer every day as a physician in the #COVID “I see you!” is this:

“How can I help people recover fully so that their dignity is upheld…so that the unique pricelessness…(read on)

Podcast: bit.ly/3gLnCa0

#ListenDNA
2/ of every human being who comes into my care is such that they feel fully human, fully respected, and that they don’t think they lost part of themselves in the process of critical illness.”

Yet #LongCovid pts are telling me they’ve lost themselves.
3/ my colleague #delirium neuro @doctorShawniqua is haunted by this too. She’s trying to find out what exactly happens to the neurons & synapses in the brain of critical illness survivors so that we can manage people more safely during and after illness.
Read 4 tweets

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