Long thread - The Nov 29th post & the information is all here below in the link posted and after that will be the updates for today ie 30th November@emilygraymd_mph ,@rubyslippahs,@GANyborg ,please add information that may have been missed @itosettiMD_MBA
Ctd1) A summary of what we know new about the current #Omicron, #OmicronVariant is apparently causing more admissions in children?we need to take precautions & vaccinate kids @PMOIndia ,@MoHFW_INDIA , @OfficeOf_MM ,@PrinSciAdvGoI , @shekhar_mande,@NITIAayog,@nvcmenon
@PMOIndia @MoHFW_INDIA @OfficeOf_MM @PrinSciAdvGoI @shekhar_mande @NITIAayog @nvcmenon Ctd2) vaccines seem to be working to some degree against the #Omicron in preventing deaths and hospitalizations at least to the information that we know now .#GetVaccinated, #OmicronIsAirborne, #Vaccinessavelives,@rubyslippahs
Ctd3) The number of cases which are severe is rising ( see orange Curve on Rt) and the proportion is at 30% , expected to rise further as time passes, so the discussion that#Omicron is milder is not true as per updated information
Ctd4) If you look at % of admissions who turn into severe disease there is not much difference (between 30% -45% ) across age groups, at the end of it the gross numbers will be important & as the elderly are vaxxed kids will dominate the total @emilygraymd_mph,@itosettiMD_MBA
Ctd5)Another of the mistakes many make is that only kids with comorbidities will need to go to hospitals , looking at ctd4 and here it is easy to understand that healthy kids will be needing hospitalizations much more that comorbid ones.@TigressEllie
Ctd6) From the graphs below it is absolutely clear that it is kids who are needing hospitalizations more than adults and elderly and from ctd 5 it is clear that these kids are absolutely healthy kids otherwise @MoHFW_INDIA , @PMOIndia , @narendramodi ,@PrinSciAdvGoI ,@iapindia
Ctd7) For those who say that #Omicron is less dangerous look at what it can cause the 133% increase in deaths has to be read with the negative ie -50% to -75% in other areas essentially a 200% increase in deaths& that is only 2 weeks,going to increase further @emilygraymd_mph
Ctd8)The hiatus between the sudden jump in cases and the last wave is at the max 12 weeks ie 3 months and this short duration confirms the fear about ability to evade #NaturalImmunity by #OmicronVariant #RPSMTrust
Ctd8) That is a huge acceptance of the problem that the #Omicron as we all have been saying repeatedly, there are too many spike protein changes , seemingly it will NOT protect against clinical disease BUT will prevent deaths and hospitalizations, though that may take a hit .
Ctd10) Countries need time to stockpile Molnupiravir, that can happen if we slow down spread
Ctd10) the time between 2 doses of AZ should be reduced from 16 weeks to 8-12 weeks duration.
Ctd11) The Netherlands confirm that they had the #Omicron in samples from 19th .The official SA reports came on 24th .rivm.nl/en/news/omicro…

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More from @Rpshahmemorial1

Nov 26, 2022
Short🧵How #Covid is killing Health Care Workers ?? Today I met Mrs Tandon.Her husband a 52/M physician had #Covid during #Delta wave which had injured his lungs BUT he came back home & started his private practice.He remained fine till 10 days ago when he made a short trip ctd)
2/n He felt weak on returning & wanted rest .Next day he was feeling body ache , joint pain & slight fever.He tested & found his platelets ⬇️to 23,000 .Further testing showed Dengue-ve.He started feeling dyspnea & was shifted to hospital where his oxygen suddenly plunged.ctd)
3/n Testing Covid+ve,he was already in ICU when the results came & must have infected many.CT very bad.Was shifted on ventilation support but couldn't survive next 24 hrs.3rd case I have heard in last 48 hrs of ⬇️platelets,bodyache & sudden decompensation mimicking Dengue.ctd)
Read 5 tweets
Oct 17, 2022
🧵 on why the past experiences aren't good enough #monkeypox disease was first confirmed in humans in 1970.When the outbreak happened most thought it will be a few cases based on earlier outbreaks BUT some of us believed otherwise. See the old tweet ctd)
2/n We were plain lucky to have the West African clade of #monkeypox spread and not the #Congo clade spread , had that happened those who are lecturing is would have been scurrying for cover. Whether it is #Nigeria or it is Globally #monkeypox has broken a lot of barriers.ctd) Image
3/n with massive undercounting globally we are at 70,000+ cases in 102 new countries.All with availability of #Vaccine & #Tecovirimat in many countries. It would have been thousands more - so even if anyone has experienced the past- it doesn't help - the field has changed ctd) Image
Read 5 tweets
Oct 15, 2022
Short🧵 on the story of the swollen toe - A known of mine phoned 2 days ago, their 19 yr old daughter had suddenly developed a swelling in toe - 2 hrs earlier along with sore throat & slight fever. On my urging they did a rapid test-ve, the RT-PCR ordered for next day -ve ctd) Image
2/n The fever subsided with naproxen but thereafter neded paracetamol to keep it under check. The mother did not want further testing currently BUT the kid would be in isolation because they have a 90 yr old grandmother living with them .They will watch carefully &masked ctd)
3/n while I was reassuring the mother that it is okay to watch carefully and even though it is most probably #Covid toe , we just need to be very careful she said something and I quote " Dr I am fed up ,this girl is getting fever every 5 weeks ,nothing seems to help" ctd)
Read 5 tweets
Oct 10, 2022
Short 🧵 On Persistence of #Ebola - Patient infective over 500 days & spreads infection by Sex- So with the risk of spill over we may see repeated outbreaks. In 2016, Guinea had recorded 3 probable, 7 confirmed cases, of which 6 were admitted at an Ebola treatment unit ctd)
2/n 4 patients died in the community ,4 patients in the ETU.Fatality ratio among probable & confirmed cases in this cluster in Guinea was 80% (8/10).They were closely related to viruses from the 2014–2016 outbreak, ruling out a new introduction from an animal reservoir ctd)
3/n Epi investigation revealed that case 1 had sexual intercourse with a male #Ebola survivor who reported sexual abstinence after discharge from Nov 2014 -August 2015 as recommended. From Sep 2015, he had occasional intercourse with various partners, including case 1 ctd)
Read 8 tweets
Oct 9, 2022
Short 🧵 on why some people are showing resistance to acceptance of risk of #Covid. This is a thread not on those who have fallen to misinformation BUT on those who initially took good care, till the vaccines came through - Suddenly become extremely careless & don't mask ctd)
2/n When the pandemic started a physician with army background told me - You know when do maximum casualties take place usually and went to explain & I quote" the maximum casualties dont happen during the 1st 2-3 days when the armies face each other - both sides dig into - ctd
3/n their own bunkers or hide from shelling - The moment they find they are being targeted they jump from one place to another or scurry for cover.After 10 days weariness comes in & with it comes false sense of security or overconfidence in your gear - Ctd)
Read 6 tweets
Oct 2, 2022
Short🧵Why I think #Covid can cause existential consequences for Human Race ?? For any species to continue it has to procreate,that depends on fertility of both men & women.We started getting edgy couple of months ago.Here's the original ctd
Ctd2) Then we found more correlation, the infection was really causing changes in hormone levels ctd)
Ctd3) We know that the number of ova in a woman is fixed at birth.The body doesn't produce more ova.Only a fixed number mature rest die off , maturation needs hormones & lots of other factors. If either hormones or reservoir is reduced #risk ctd)
my.clevelandclinic.org/health/article….
Read 7 tweets

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