🧵1/

First, read @ShawnteJamesMD’s whole thread.

It’s informative and moving…
🧵2/

Second, this thread especially grabbed my attention coming on the heels of yesterday’s @NIH_ORWH virtual conference on gaps in research about the health needs most particular to women orwh.od.nih.gov/research/2021-…
🧵3/ One of the most stunning (and maddening?!) slides was a #dataviz that used analysis from this paper: liebertpub.com/doi/full/10.10…
🧵4/ Here’s @LindaGGriffith1’s slide

with the #dataviz
(by @michiganstateu’s Ron Chandler)

showing how much conditions that primarily affect women are grossly underfunded for research by the #NIH

Note: The y-axis is on log-scale. It’s probably worse than it looks Screenshot of virtual confe...
🧵5/ Symptoms of conditions as varied as ovarian cancer, Crohn’s, colon cancer, #fibroids, #endometriosis, etc. can be similar

When these symptoms happen to women, US culture is quick to shove them into the box of menstrual-symptoms-you-just-need-to-deal-with-on-your-own
🧵6/ Even a highly trained MD initially thought of the sudden changes she observed as likely due to menstrual & lifestyle symptoms that could be self-managed

https://t.co/ErUP6HiDvt
🧵7/ A lot of this ambiguity is bc we haven’t invested the research resources in even characterizing the range of what healthy menstruation looks like versus more serious conditions

We can do better and produce more actionable info for providers and everyday people
🧵8/ And I haven’t touched on the healthcare access issues in @ShawnteJamesMD’s story

Another big issue
🧵9/ We also wrote a paper about the specific work that needs to be done to advance the epidemiology of gynecologic health. We need to know more, and we can know more. #gynhealth
jech.bmj.com/content/75/4/3…

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More from @WhitneyEpi

23 Oct
🧵1/ A pre-pandemic story

In 2019, I was on a planning committee for a scientific conference. One of our duties was a “hot topics” session — a hard task when you’re planning a year in advance

We were trying to predict, What will be relevant & topical in epidemiology in 2020?
🧵2/ I suggested vaccine hesitancy as a topic

It was likely top of mind bc I had a new baby in 2019. I was active on Mom Facebook & other US-based social spaces focusing on motherhood
🧵4/ And let me tell you, in these groups, childhood vaccination was a third rail topic

Some groups ended up just banning discussions of vaccination altogether
Read 11 tweets
18 Oct
🧵1/ When we don’t get #SARSCoV2 transmission low, the most vulnerable - the old, the immunocompromised, the just plain unlucky whose bodies can’t mount a robust immune response to vaccines - they pay a high price
🧵2/ I know many people in US see #COVID19 primarily in personal terms. Their risk to others is not a main priority…

Others argue that the unlucky vulnerable should just “shield” themselves indefinitely, as if being old or sick means that you are no longer a social being
🧵3/ And others argue that the shortening of life for the old in particular is not that great a tragedy bc they would have died soon anyway*
Read 7 tweets
8 Oct
🧵 1/ I really like the idea of “test to stay” in US K12 schools

There are actually several different policies called this, but a big one is testing to reduce K12 quarantines when a person/group is a close contact of positive case. I think that’s a great use of “test to stay”
2/ One confusion I see in comments on Dr. Mina’s post is people thinking of very sensitive PCR testing, which can pick up infections in days when people are no longer contagious

“Test-to-stay” typically uses Rapid Antigen Testing: RAT finds those who are actively contagious
3/ One drawback is there will be occasional false positives with widespread use of rapid antigen tests. So a fast, easy protocol for additional testing to confirm (or refute) positives needs to be in place
Read 12 tweets
29 Sep
1/ I’m SO into this new episode of #SERiousEpi!!

I’m literally talking into air, trying to inject myself into the conversation. I decided better to just tweet my thoughts!

pca.st/episode/cefa36…
2/ Re: p-hacking: I was really lucky to learn about dangers of p-hacking/selective reporting/publication bias early when I took Charlie Poole’s meta-analysis class in my MSPH at @UNCSPHResearch

Seeing the funnel plot assymetry in study estimates was powerful!
3/ We even published this study 👇🏾 years later.

If I’d known how much work it was going to be, I may not have done it! But I was young & energetic & totally in love with Epi Methods 😍…

Same story as everyone!

scholar.google.com/scholar?hl=en&…
Read 7 tweets
28 Sep
🧵1/n Game on! Sounds like FDA process for deciding availability of #CovidVaccines for 5 yo - 12 yo has kicked off

A couple thoughts on how I’m thinking about this decision for my 6 yo…
🧵2/n To my knowledge, my kids haven’t been infected with #SARSCoV2 - but I’ve accepted that they probably will at some point because of where we live (US)
🧵3/n So then my decision is whether I’d like that first infection to be in a naive immune system or in one already primed by vaccination for a quicker immune response
Read 11 tweets
22 Sep
1/ This article does a good job presenting several foundational public health tenets that I’ve felt frustration at not communicating earlier and better:
2/ the big one:

A disease that hurts a small % of a huge population can hurt a LOT of people

Small increases in risk for a person can seem relatively inconsequential but still have big, longterm effects on a large group of people Screenshot of a paragraph of The Atlantic article that is li
3/ It’s a mind-bending way of thinking that I see people grappling w in real time re: COVID

That self-learning is cool to watch from a teaching & learning perspective but scary when critical decision-making depends on understanding the implications of this seeming contradiction
Read 12 tweets

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