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Abraar Karan

@AbraarKaran

31 Oct

One thing I guarantee you will notice if you pay attention

Doctors who have cared for #covid19 patients will never underestimate what this virus is capable of

The antivax, antimask pundits who have been tweeting from the safety of their home for the past two years often will

2/ I have yet to meet a fellow physician who has spent the majority of their time caring for these cases who would claim to know exactly what to expect from #SARSCoV2 — bc we continue to be surprised. Surprised by people who die that shouldn’t. People who suffer for longer than

3/ …we would expect. People who seem to get better & then suddenly turn for the worse. People who are doing poorly & who end up surviving.

Medicine humbles us as clinicians; this virus has too.

Hearing non-clinicians downplay it…

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Abraar Karan

@AbraarKaran

30 Oct

Something on my mind— at least weekly, one of the consults I see on the infectious disease service suffered not only #covid19 but thereafter so many other med complications from clotting, long term ventilator, indwelling lines etc; not to mention the psychological aspect of this

2/ This is more broadly to say— anyone who has been critically ill knows that there is so much more to this than whether you survive or not

People who are against masks and vaccines etc often try to cite general mortality statistics

I fear they don’t understand the other side

3/ They don’t understand the suffering that patients & families have gone through

They don’t understand the long term consequences socially, psychologically, & otherwise that can scar people for a long time afterwards

We see it every day in the hospital

Read 5 tweets

Abraar Karan

@AbraarKaran

21 Oct

@StanfordCIGH

1/ Really a privilege to hear from Dr. Steve Luby @StanfordCIGH discuss the now well-known Bangladesh masks randomized trial for #covid19

One of the most important take-aways for me is that masking actually increased physical distancing, not the opposite.

Why does this matter?

2/ As you may remember from earlier last year, one of the reasons that the US public health agencies said that community masking would be harmful is that it could decrease physical distancing & increase transmission.

This hypothesis was used to support early policy against masks

3/ Many of us pushed back saying that this “risk compensation” logic wasn’t necessarily true— that masking could instead serve as a reminder that we were in a pandemic.

And that it could increase distancing + provide personal protection + source control

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Abraar Karan

@AbraarKaran

21 Oct

1/ I’m a young, healthy physician; at first, I wasn’t convinced of the rationale for getting a booster shot.

I’m in the group that CDC’s advisory committee voted against in a split vote on Pfizer.

I later did, & here’s why:

washingtonpost.com/outlook/2021/1…

2/ Fundamentally, there are two parts to the equation—
Am I protected?

And am I at high risk of transmitting to those who are not?

As vaccine effectiveness wanes against infections in all age groups, those of us who have a lot of exposure to the virus & to vulnerable folks…

3/ are going to increasingly be at higher risk of transmitting onwards.

As a doctor taking care of immunocompromised patients in whom vaccines don’t work as well— reducing the chance of getting infected becomes more important. This holds true for those with…

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Abraar Karan

@AbraarKaran

19 Oct

🧵🧵
1/ While two-dose vaccine series have been shown to remain exceptionally protective against #covid19 disease, especially in younger age cohorts — we know that vaccine effectiveness against #SARSCoV2 infection has decreased.

Booster doses can help reduce onward transmission.

2/ As I think about this more, this is especially important for the many immunocompromised patients that we are treating as healthcare providers.

These are patients in whom vaccines don’t work quite as well to induce an immune response.

3/ Similarly, reducing transmission to children is an important goal, even if it deserves examination of many trade-offs.

The best way as of now to protect kids is to minimize risk of transmission from adults. Vaccines are one part of that equation.

Read 10 tweets

Abraar Karan

@AbraarKaran

15 Oct

1/ It's difficult to study #SARSCoV2 transmission in the real world bc of many confounders

In our study of hospital roommates, we studied this in a relatively controlled setting

We found that the virus transmits efficiently beyond 6 feet & despite a curtain in between roommates

2/ We were examining a number of cases that turned positive but whose initial tests were negative (so early incubation period) so they were roomed with other patients in shared rooms

This allowed us to explore a window into exposure when index cases are most infectious

3/ We found that for those with cycle threshold values <=21 (meaning high viral load), 11/18 transmitted to their roommate (61%)

Roommates are 7 feet apart (head to head in bed) with a solid curtain in between

If transmission was primarily droplets, we wouldn't expect this

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