Incredible investigative journalism on why Africa was seemingly *spared* the worst of COVID.

The answer is not younger pop, more Ivermectin, nor climate.

Answer: Lack of testing and massive cover-up.

Great reporting by @JoeWSJ .

Short thread of his findings:
"At the Kondo graveyard in Dar es Salaam, Tanzania...We used to bury one a week [before the pandemic], but over the past year we have reached 17 a day.”
"Last year, President John Magufuli declared the virus a “satanic myth” propagated by imperialist powers.... ...and labeled those who wore masks unpatriotic.

By this spring, the president was dead, along with 6 other senior politicians..."
"In Uganda’s capital, Kampala, workers at the main Bukasa cemetery said the average number of daily burials has jumped from six to 30 since last year. "
"In the central morgue of Zambia’s capital, Lusaka, Covid-19 was present in 87% of all bodies in June, Boston University scientists found in a recent study."
"Underlining the problem is a lack of testing: African nations have tested just 70 million people ...or around 5% of the population, according to WHO. In the U.S., for comparison, total tests number about 618 million, close to twice the population, according to the CDC."
"In Tanzania, where the official Covid-19 death toll is 724, the Economist study estimated an excess mortality of up to 69,000 since the pandemic began."
"But with vaccine skepticism widespread after a year of official Covid denial, the shots have so far reached just 1.6% of the population, one of the lowest rates in the world." (Tanzania)
"On a single day—May 15—every one of the 43 people who tested positive in the country were Tanzanian truckers crossing the border, forcing the government to close it. Four Tanzanians died at the wheel of their trucks waiting for a test."
"Health Minister... called a press conference that looked a lot like a cooking show..."The government has no plans to receive...vaccines...being distributed in other countries,’’ Dr. Gwajima said, before covering herself with a blanket to inhale steam from a saucepan of herbs."

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More from @thehowie

5 Nov
"Fewer than 1% of patients taking the drug needed to be hospitalized and no one died. In the comparison group, 7% were hospitalized and there were seven deaths."

THIS is a game changer, with caveats:

bostonglobe.com/2021/11/05/bus… via @BostonGlobe
"Treatment began within three to five days of initial symptoms, and lasted for five days."

This means people need to have ACCESS to testing, clinical evaluation and a prescription. (True for Monoclonal antibodies, as well).

In the real world, people often present TOO late.
This is already approved in the UK. This will be reviewed by FDA on November 30 for EUA. fda.gov/news-events/pr…
Read 4 tweets
30 Oct
CDC quietly released this VERY consummate REVIEW (not new study) of existing evidence about vaccine-acquired & infection acquired immunity.

It is a VERY good summary and everyone should read it.

Key points in this thread. 1/7

cdc.gov/coronavirus/20…
Love that they start with humility. Everyone should feel this way. Most don't.

"New data continue to emerge, and recommendations (the science brief, this webpage, etc.) will be updated periodically, as needed."
2/7
"...fully vaccinated individuals and those previously infected with SARS-CoV-2 each have a low risk of subsequent infection for at least 6 months."

More people need to acknowledge this. 3/7
Read 7 tweets
18 Oct
Yale Update (short thread)
0.15% pos.rate for students (0.17% undergrads⬆️; 0.1% grad students⬇️)
0.25% for faculty staff⬇️

Vaccination rates creep higher.

We are at VERY similar case levels to last year: why should be celebrate? Because we are MUCH closer to normal.
Last year, there were few classes held in-person and those that were held, were near empty. This year, full census in classrooms.
Last year, staff (including most/many faculty) & researchers were primarily WFH. This year, they are back to working on-site, albeit with some accommodations/modifications.
Read 7 tweets
18 Oct
Brief thread:

We have a "rheostat". It works by dialing up and down *some* de-densification, masking, TESTING, & OBVIOUSLY vaccinations, but also boosters at some point.

We can AND SHOULD dial these up when outbreaks present.
It does not mean that we can't have social events, but we need to offset this in other ways.

Wear a mask if you are speaking face to face with someone.
DO NOT hold events in poorly ventilated spaces.

Use AND advocate testing in schools and other settings where spread WILL occur.
Read 6 tweets
12 Oct
Key findings from KFF:

"...91% of Democrats, 85% of independents, and 76% of Republicans, as well as majorities of seniors (84%), who would be most affected by such a provision [favor drug price negotiations by Medicare prior to learning more]"
"...most (84%) of the public, including 3/4 (78%) of Republicans, say the argument in favor – “this is needed because Americans pay higher prices than people in other countries, many can’t afford their prescriptions, & drug company profits are too high” – is convincing."
"...a third (33%) say the argument against – “this would have the government too involved and will lead to fewer new drugs being available in the future” – is convincing. This includes nearly half (45%) of Republicans."
Read 5 tweets
20 Sep
Thread:
I've been paying more attention to the histories on emergency department (ED) patients coming in w/ covid.

They are younger. They are almost exclusively unvaccinated (the ones that are vaccinated are generally much older and/or have immune suppression).
They convey fear, frustration, & anguish. Many have already been to the ED 1 or more times. Their symptoms are often constitutional (headaches, extreme fatigue, muscle aches).
In all my time in medicine, I have not seen lingering symptoms to this degree after a viral infection (caveat, AIDS). We see the occasional post-viral/post-flu pneumonia cases; & PCPs have seen many weakened or exhausted by bad flu; but numbers that present to the ED are large.
Read 6 tweets

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