🧵I have to say it: Christmas break is going to be bad. I'm watching confirmed #COVID19 cases⬆️ exponentially at our highly-#vaccinated school w/ a #MaskMandate & HEPA filters in every class. Make a plan now for how you'll handle Xmas & #quarantine when someone gets #Omicron.
2/ Think about how you can create a separate space for the person(s) infected. Remember #OmicronIsAirborne. Pick a rm w/ windows to open & its own door if your home allows. Today put a fan there that can be used to improve air exchange. Put a 🌡️, an O2 sat monitor, good masks.
3/ Go get a MERV13 filter for your HVAC at Home Depot or Lowe's or online. While here, get the stuff to build a simple, inexpensive, highly-effective Corsi-Rosenthal box. You can see what this is here. Build it now so it's ready.
4/ If you have a little microwave or a mini fridge or cooler or something, put those in there too, along w/ food/snacks/rehydrating drinks. The goal is to create a space where the ill person can be as self-sufficient as possible to minimize their need to enter the main space.
5/ Pretend you're going away for a long wknd. Make sure the room has stuff you'd need--basic toiletries, a phone charger, etc. I assure you I am not a prepper (ask @gleeson_md--he'll tell you I pack 45 mins before my flight leaves from a 15 min drive away). You need to prep.
6/ It seems like overkill now, but I promise you when someone tests positive & they will (come back & say hi to me), you'll be delighted to have the #quarantine suite ready to go. Decide who will stay w/ the ill person if it's a kid (or anyone dependent on you) if only 1 is ill.
7/ Get a few rapid tests online (Walmart.com has them now) so you can rapidly determine if anyone else is positive. That may make the above decision simple. Make sure you have good masks for the ill person & others. Get them today.
8/ You don't want to faced with needing to go out to stores when you should be at home in #quarantine due to a close contact exposure. Though #vaccineswork to reduce risk, esp of severe/fatal #COVID19, #Omicron is still far more likely to infect you than any prior #CovidVariant.
9/ This is NOT a case against #GetVaccinated or #GetBoosted. You should do those IMMEDIATELY if you have not. But we can't rely on #vaccines to be iron-clad here as we kind of could w/ other #CovidVariants. We should expect #Omicron to tear through households if we're not ready.
10/ I deeply miss my family. I want to see them. I had hoped we could do it safely enough for my cancer survivor parent, my high-risk kid. I'm not sure we can anymore, even with them #vaccinated. If you WILL travel during #Omicron, think through logistics even more. It's...hard.
11/ What will you do if someone gets sick on your trip? Or has a positive #COVID19 test the day before you're due to fly home from overseas. Will you have space to stay apart in a hotel? Will you rent a car to drive home? Will family split up or stay together? Map it out now.
12/ This probably seems like a waste of time, but just like a fire drill, it's a total waste of time until it's not. The scenarios here, with #Omicron, will be the rule, not the exception. I won't be surprised to see 1/4-1/2 million+ cases per day by year's end. Be ready.
13/ Finally, pay attention to the #COVID19 cases where you are (or where you are headed if you may travel). If cases are high, if hospitals are full, just be aware that you may find yourself starring in a bad scene in an unfamiliar place. Decide if the trip is worth it for you.
14/ Every situation is different. Some may decide gathering is worth it. You or your loved one may have a short life expectancy. You may decide it's now or never, & you can't wait any longer to see each other because it truly may be your last chance. Ok. Just decide w/ 👀open.
15/ Take every precaution you can. #MaskUp. Rapid test to gather. Order takeout/cook together & eat outdoors. Only outdoor bars. The game has changed this month. #Omicron plays to win. Just plan it all out, so whatever happens, you've planned for it. Stay safe, y'all. /End

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More from @tmprowell

20 Dec
I’ve been contacted 2x just this wk—1 IRL acquaintance & 1 person I know only via Twitter—after they got imaging results in portal before their dr. They DM’d w/ screenshots, panicked, asking for help. I’m 💯 for pt access to #EHR, but #CuresAct implementation needs a MAJOR reboot
Whenever I have expressed concern about #CuresAct, #advocacy often tells me it’s still better. But it def was not better for these folks, nor for me dropping everything to help ppl who aren’t my pts, whose records I lack, & whose drs I don’t even know, i.e., it’s bad care. 😔
And I’m always happy to help patients, genuinely. I actually started using Twitter to be able to report out from #SABCS17 (I think) for #advocacy. But I don’t like providing bad medical care, & this is a set-up for doing so. We need a systems fix so pts aren’t left hanging…
Read 4 tweets
19 Dec
🧵It is now clear that we are going to have to get people to #MaskUp to get thru winter without US health care system collapse. #Omicron is way too contagious. #VaccinesWork & #GetBoosted, but they will not be enough on their own. So this thread is for people who hate masks:
2/X: If you hate masks because the ear loops make your ears sore, google "ear savers." That's the term I've seen used for various products that spare your ears w/ masks. Examples in pics, but if you can sew on a button, make some. What else are you gonna do in #quarantine?
3/X: You can get a beanie, headband, baseball cap, head scarf, whatever & attach button or hooks of any kind that you can get from any sewing store or online, & attach your mask loops to that. Ear pain solved! It's important to have a snug fit so try diff distances.
Read 17 tweets
19 Dec
I know personally 3 people receiving monoclonal antibodies this evening. All have had 3 doses of #COVID19 #vaccine or prior infection + 2 doses of vaccine. All are careful. They all have risk factors, but all are pretty symptomatic. Jan is gonna be…rough. #MaskUp. #Omicron
Tweet 2: A lot of people seem to be panicking based on this anecdote. Panic is NOT productive. Instead you need to calmly plan & act to reduce your risk. These are some effective things you can do right now:
👉Upgrade your masks. No more cloth alone. Best is N95/KN95/KF94...
Tweet 3: As an alternative to N95/KN95/KF94, if you can't tolerate those or don't have them, I rec a surgical mask (ASTM level 3, 3-ply is great) w/ cloth mask over it. Read this: scientificamerican.com/article/why-we…. The non-profit @projectn95 has vetted, affordable PPE including masks.
Read 13 tweets
18 Dec
📢#HCWvsHunger Team #Feedalizumab! We know it takes a village in #MedTwitter, & it's time to make a move on the leaderboard. Announcing #MultiDFoodBoard merging #Feedalizumab, #BadBlood, #HopeAtTheScope, #RadsForFood, #HeartAttacksHunger, & #AmoxiChilin! 😎hcwvshunger.org/how-to-donate/
Your move, #KidVengers & #BladesNBougies. I told you not to count out #Feedalizumab. No one knows better than #OncTwitter how much it takes a village to care for complex patients. Heme/Onc/Path/Rads/ID/Cards--we need them all. Boom! GO merged team #MultiDFoodBoard😎♟️#HCWvsHunger
My only question is how far away people will be able to hear @kari_jerge, @MSharifpourMD, & @DrJenChen4kids when they see this tweet announcing the merger?🤔Go #MultiDFoodBoard. #HCWvsHunger
Read 5 tweets
16 Dec
📣#HCWvsHunger, the AMAZING Exec Chef at the Lord #Baltimore (& prev Ritz-Carlton), @chefdini, will be making homemade 🍩 at your Balt/DC worksite for 50 ppl (outdoors & brings minifryers) if you’re the next donor to give $1K+ to food bank for #Feedalizumab! Holiday party ✅! Image
Tweet 2/2: We’ll use the earliest official Google form time stamp on any $1000 or more donation following my tweet to determine the winner. Donate to any food bank first then log it here in 30sec for #HCWvsHunger #Feedalizumab. Must be Balt/DC area to win! hcwvshunger.org/how-to-donate/
Wondering what this is all about? Read more about Health Care Workers Vs. Hunger here. We’re taking care of you all during this #pandemic & we’ve raised > $550K since Dec 2020 to make sure people don’t go to bed hungry on our watch. #HCWvsHunger

Read 4 tweets
15 Dec
If you're confused about why #omicron is suddenly a crisis, it's exponential growth. Even if fewer people get seriously ill w/ this #covidvariant than priors (not clear, but hopeful data from #SouthAfrica), so many people abruptly ill with anything can grind the world to a halt.
With so many sick at once, you may lack school bus drivers, teachers, truck drivers to move supplies, grocery store shelf stockers, doctors & nurses, & so on. The world isn't set up for everyone to be sick simultaneously w/ #omicron. There's not enough redundancy in the system.
So even if NO ONE got seriously ill, but a large # of ppl were sick enough to be unable to work for a few days, it would be tough. Now add in that some % will get hospitalized, or die, of #Omicron. Even a small % of a very large # of cases is a big #. That's why we are worried.
Read 6 tweets

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