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Tatiana Prowell, MD

@tmprowell

28 Dec

Being blunt: No one is coming to save you. To save any of us. Timely tests are all but impossible to get.I’m personally driving home rapid tests I bought online wks ago to people. The effective therapeutics we now have are in VERY short supply. #Omicron

What we do have, abundantly, thank God, is #COVID19 #vaccines, #boosters, & #masks. That is the major difference between now & March 2020 for most of you at risk of #Omicron. If you do not go #GetVaccinated & #GetBoosted the minute you’re eligible, & #WearAMask…

You’re are gambling with your life WHEN (not if) #Omicron finds you, or you have any other need to access medical care. In the absence of #leadership, we are it. You are it. Do the right things. #StayHome if you can. This is like a 🚀. Many people are going to get sick QUICKLY.

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Tatiana Prowell, MD

@tmprowell

27 Dec

From direct comms to #Maryland physicians:

🆘 State just set record for new daily cases
🆘 Hospitalizations ⬆️ >180% in month since #Omicron identified by WHO as a #covidvariant of concern
🆘 8.8% of unvaccinated #Maryland adults account for >75% of #COVID19 hospitalizations

2/4 Quit scrolling & listen to me. This is a big f-ing deal. If you are indoors in public without a high-quality mask, #Omicron will find you. If you are not #vaccinated, you are at high-risk to land in an overcrowded, understaffed hospital. Most Americans have no experience…

3/4 With what it means to be in a hospital where conditions are frankly unsafe, which is where we now are. I have worked in countries where there aren’t enough hospital beds & pts are on floors, where 1 dr is overseeing care of WAY too many patients. I have been that dr.

Read 5 tweets

Tatiana Prowell, MD

@tmprowell

25 Dec

Well, I got 2 messages before 9am from friends telling me they have #COVID19 in their households. And in the 12 mins since, I’ve just heard about 4 more. So Merry Exponential Growth #Omicron #Christmas. 🌲 😫

A quick 🧵 on what to do if that’s you since I’m typing it anyway.

1/ The first thing to say is that if someone has #COVID19 symptoms (#Omicron most common: nasal congestion/runny nose, scratchy sore throat, fever, & aches), you have to assume they have it. You may not have a test (urgent cares are still open & do) or they may still be neg.

2/ You, as the person exposed to the one with symptoms, have to assume that you both do & don’t have #Omicron too. Wait, what? 🤔

I mean: assume you could infect others now & take care to avoid exposing them, BUT don’t assume it’s too late for you to avoid getting it.

Read 24 tweets

Tatiana Prowell, MD

@tmprowell

23 Dec

🧵 Your risk of dying if you get #Omicron in the next few wks as opposed to a few months from now will be dramatically different. We are facing huge surges in Jan that will make it hard to get seen in an ER in a timely fashion & even harder to get admitted to a hospital.

2/ Should you be fortunate enough to find a bed, you will have drs & nurses overwhelmed with patient volume, who will have very limited time to spend w/ you. Dr to patient (& nurse to patient) ratios will be unsafe, like unthinkable in pre-#pandemic times. #Omicron #MedTwitter

3/ This alone will dramatically increase your odds of death. That’s been seen in the prior surges. With #Omicron, the # falling ill at once is 🚀 off the charts. I’m seeing attack rates of 75-100% even in fully #vaccinated (& some #boosted) gatherings & households. #MedTwitter

Read 13 tweets

Tatiana Prowell, MD

@tmprowell

23 Dec

📣#Preprint #COVID19 #ConvalescentPlasma
📌RCT (N=1.2K)
📌Outpatients age 18+
📌High-titer CCP (>1:320) vs placebo plasma w/in 9d of symptoms
📌Primary endpt: Hosp/death by d28
📌CCP 🏆: 54% ⬇️, driven by non-ICU hospitalizations (NNT=29); HR 0.46, p<.01
medrxiv.org/content/10.110…

2/ A few important points about this #COVID19 #convalescentplasma trial
📌High-titer CCP was much higher than that used in some other studies (median titer of >1:14,580 & 95% had >1:4820)
📌Median days to plasma: 6d
📌53 of 54 hospitalizations were in unvaxxed (#GetVaccinated!)

3/ 📌 Only 3 deaths in post-hosp period, all in controls
📌 Few #COVID19nCancer or #immunocompromised
📌 Study used #convalescent plasma mostly from Apr-Dec 2020 (ie pre-#vaccine availability)
📌Would *predict* CCP from #vaccinated to perform well vs #Omicron & #covidvariants

Read 9 tweets

Tatiana Prowell, MD

@tmprowell

21 Dec

Got the contact tracing call yesterday for 2 of my kids:
-My middle schooler: friend in same lunch bunch has #COVID19. This is 2nd person in that group this yr. My kid has insisted they do lunch outside EVERY day, 🥵 🌧 🥶. NO secondary cases have occurred so far in the group 👍

-My high schooler: person few ft away tested positive for #COVID19. Often wore mask below her nose. My kid has worn a high quality mask consistency & correctly all yr. So far so good. I just texted her. Spontaneous response.

Kids are always watching. Teach them well!

This is not impossible. Will we end up with one or more of the kids getting #COVID19 at some point? Probably. But they’re all #vaccinated. Those elig are #Boosted. We wear quality masks indoors. We stay outdoors as much as we can. We open windows. We use EVERY tool & then live.

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