With so many people getting infected recently, some folks may wonder what’s the point of getting vaccinated at all?
And is there really any value to a booster dose if I’ve had two Pfizer/Moderna or a shot of J&J?
My observations: 🧵
Every patient I’ve seen with Covid that’s had a 3rd ‘booster’ dose has had mild symptoms.
By mild I mean mostly sore throat. Lots of sore throat. Also some fatigue, maybe some muscle pain.
No difficulty breathing. No shortness of breath.
All a little uncomfortable, but fine.
Most patients I’ve seen that had 2 doses of Pfizer/Moderna still had ‘mild’ symptoms, but more than those who had received a third dose.
More fatigued. More fever. More coughing. A little more miserable overall.
But no shortness of breath. No difficulty breathing.
Mostly fine.
Most patients I’ve seen that had one dose of J&J and had Covid were worse overall. Felt horrible. Fever for a few days (or more).
Weak, tired. Some shortness of breath and cough.
But not one needing hospitalization. Not one needing oxygen.
Not great. But not life-threatening.
And almost every single patient that I’ve taken care of that needed to be admitted for Covid has been unvaccinated.
Every one with profound shortness of breath. Every one whose oxygen dropped when they walked. Every one needing oxygen to breath regularly.
The point is you’re gonna hear about a LOT of people getting Covid in the coming days and weeks.
Those that have been vaccinated and got a booster dose will mostly fare well with minimal symptoms.
Those getting two doses might have a few more symptoms, but should still do well.
Those who got a single J&J similarly may have more symptoms, but have more protection than the unvaccinated (if you got a single dose of J&J, please get another vaccine dose—preferably Pfizer or Moderna—ASAP!)
But as I’ve witnessed in the ER, the greatest burden still falls on…
The unvaccinated. Those who haven’t gotten a single dose of vaccine.
They’re the most likely to need oxygen. They’re the most likely to have complications. They’re the most likely to get admitted. And the most likely to stay in the hospital for days or longer with severe Covid.
These are all just observations from my recent shifts in the ER.
But the same has been borne out by local and national data showing that the unvaccinated make up a very disproportionate share of those with severe disease, needing hospitalization, and dying from Covid.
So no matter your political affiliation, or thoughts on masks, or where you live in this country, as an ER doctor you’d trust with your life if you rolled into my emergency room at 3am, I promise you that you’d rather face the oncoming Omicron wave vaccinated.
Please be safe. ❤️
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I taught a class on the history of eugenics and public health today. Here's what we covered: 🧵
Eugenics is Greek for 'well-born'. But it wasn't coined by the Greeks. It's a late 19th century term made up by Francis Galton. He LOVED data. We will come back to that.
Eugenics had the biggest impact on the approach to mental illness, immigration, and reproductive justice.
We will dig into each.
But first, you gotta know the background and key players.
For background, eugenics arose in an environment obsessed with progress, but also frustrated with economic and social realities.
Having worked in conflict zones, I want to share a bit on humanitarian response in Gaza, as aid starts to trickle in.
This isn’t a thread on how to end the war, or hostages, or any of the other very important things. Those are critical too. But they’re not at all my expertise 🧵
Over the past week, shortages in food, water, and electricity have exacerbated the humanitarian and health challenges.
This creates new problems, as well as worsening chronic issues.
Without gas, generators can’t run. Newborns on life support in intensive care can’t survive.
Without electricity, patients can’t receive dialysis. Insulin for diabetes can’t be kept refrigerated, as it should be. These chronic health issues worsen, quickly.
Without water, infectious diseases like cholera (and others) become increasingly likely.
Today I spoke in a colleague’s class about the COVID-19 pandemic.
He asked me to talk about what it was like in NYC’s emergency rooms in March and April 2020. Seemed easy enough.
But revisiting the trauma was really hard and painful.
I’m still not sure we’ve fully processed.
It really hit me when I described how we strung oxygen tubing from the wall outlets up through the ceiling so it reached patients in the middle of the ER who were suffocating when the canisters under their bed ran out…
We all normalized something that just wasn’t normal, at all
It had been years since I thought about how my colleague avoided my gaze as I examined her.
Struggling to breathe, she was looking over my shoulder as her mother was intubated across the emergency room.
You know why we intubated people for Covid in March 2020?
Because otherwise they were going to die. Full. Stop.
I remember a patient rolling in with an oxygen saturation of 42%, breathing twice as fast as normal,struggling on a face mask with oxygen all the way up.
What to do?
I’m sick of seeing people trying to relitigate 2020 through the eyes of 2023.
If you miraculously know everything now, why didn’t you tell us so then?
So over a million Americans didn’t have to die of Covid.
So we didn’t have to put ourselves at risk every time we went to work
I don’t care about the narrative you want to create, from the safety of where you stand now.
Do not try to reimagine the environment and the challenges so many of my colleagues felt on the frontlines, 3 years ago, when we knew almost nothing.