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Darren Markland

@drdagly

27 Nov

So a couple of very early thoughts on #OmicronVariant. All of this is very preliminary so take it with a grain of salt. I realize that this is going to make people very jumpy. I will not tell you to relax. That just makes things worse.

🔹Where it came from isn’t as important as why. It likely has been living in an immunocompromized host for a while. That time in the host was well spent, refining its molecular machinery over months under just enough immunological pressure to not get taken out but to improve.

It contains a lot of mutations that have been seen in other variants. These mutations are beneficial or harmless. They occur naturally because the virus is pretty sloppy at replicating. Bad mutations aren’t passed along efficiently because they hamper viral replication.

Read 12 tweets

Darren Markland

@drdagly

20 Nov

@coffee_outside

Today I took a different route to a gathering I helped create 7 years ago. @coffee_outside started as a simple way to connect with people who we saw on the street and who chatted on @Twitter, but over time has grown into a community of open hearted individuals.

It’s a testament to making connections and bringing people together from different walks of life. It’s an open challenge to the sterility of online interactions and now more than ever a way of bringing humans together in humane conversation.

There are many paths that take us to Ezio Fararone Park, where we meet every Friday morning. The journey, at least for me, is half of the fun.

Read 5 tweets

Darren Markland

@drdagly

9 Nov

This, among several evolutionary achievements has not only made #SARSCoV2 Delta a remarkable viral predator, but has also shaken our resolve about vaccination.

What you are looking at is a molecular catapult that smashes this virus into your cells. It’s the equivalent of a cellular trebuchet and it accelerates the rate of infection significantly. It’s this virological blitzkrieg that is the heart of our concern about vaccination.

There has been a lot of discussion about the utility of vaccination if people can still get infected and spread the virus. I think people have heard this enough to now doubt the effectiveness of these vaccines. Let me reassure you. They work.

Read 28 tweets

Darren Markland

@drdagly

8 Nov

Please file this under things I would never have thought needed to be said. Alcohol enemas are dangerous. #sigh.

Now, I feel I should temper my statement about boofing a bit. You see anything done without the proper instructions can be risky. So if you are going to but chug remember a few important points.

First. It’s going to take a lot less alcohol to get you intoxicated. That’s because you bypass the liver which does the lion’s share of metabolizing alcohol. You get hammered on a spritzer? Reduce the dose by about half.

Read 6 tweets

Darren Markland

@drdagly

26 Oct

Coming home today I had a lot to think about. I say this not to seek sympathy, but it’s been a month since I last had a day off. For me and many of my colleagues it’s become a new normal. Watching young people die has become all too familiar as well. Not normal, but …

I spend my commute home telling myself that this is horrible. These deaths are preventable. That vaccines save lives. That those who fight them are the minority. I need to reinforce these walls, because it seems that the outrage is fading. That the news is stale. We’ve adapted.

I write these things down, as to mark the sand, for I worry that I too will adapt and begin to accept this. Be it fatigue or bombardment, eventually one must drop their head and tuck in their shoulders as if to bear the weight of loss. This wave has been especially brutal.

Read 5 tweets

Darren Markland

@drdagly

15 Oct

One of the most challenging aspects of the 4th wave has been the alienation and estrangement of families. Once our allies for shared decision making, many are skeptical of the medical management of COVID if not in complete denial it exists. Trust is essential in building rapport.

It is further amplified by isolation from our restrictive visiting policies. I miss the day where I could sit in the room with a family and explain what was going on. More importantly I could see the interactions and understand the dynamics of its members.

Daily updates, conversations about the weather, their participation in medical rounds all gave them grounding and trust in what we were telling them. That is gone now, and though we update family by phone or zoom it is a veil between us.

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