Craig Spencer MD MPH Profile picture
Dec 27, 2021 10 tweets 2 min read Read on X
I’ve seen a lot of Covid in the ER recently.

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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More from @Craig_A_Spencer

Dec 22
It’s being reported that the Trump administration plans to withdraw from the World Health Organization on day one.

This is not a huge surprise.

But it IS an absolutely stupid and self-defeating move.

And I say this as a longtime critic of the WHO…🧵
The first time the Trump administration tried to withdraw from the WHO back in 2020, I wrote for @USATODAY what we needed to do was build up, not tear down, the WHO.

Despite its faults, the WHO plays a huge role as ‘our eyes and ears around the world.’

usatoday.com/story/opinion/…
There is no other organization with the relationships and buy-in to do the critical work needed to keep us ALL safe—including us here in the U.S.

The WHO also has critical partnerships & programs that we benefit from for vaccines and critical health data

who.int/initiatives/gl…
Read 6 tweets
Dec 19
Hey @elonmusk, that’s not ‘bioweapon labs’

I’m (unfortunately) very uniquely qualified to tell you why this is important. And why you’re very wrong here.

I assure you, with 100% certainty, that cutting this is pure stupidity

(Also, did you read a few more lines to Sec 2315c?)
For anyone paying attention (is anyone still actually even here??)…

THIS 👆👆👆 is exactly how overconfidence mixed with a stunning lack of expertise and stubborn unwillingness to listen to people who actually know what they’re talking about will directly put you at risk.
I could happily speak on the congressional floor for hours about why we need BSL-2, BSL-3 (and BSL-4) labs. So could a lot of really qualified folks, many way smarter than me.

We could also talk about what happens if we don’t have them, and how that puts us all at risk.
Read 6 tweets
Dec 6
"What's happening with this mystery illness in the Congo"

I've gotten this text dozens of times in the past few days.

Here's what we know. What we don't.

And what really matters 🧵 Image
Since the end of October, there have been just under 400 cases of an 'unidentified' illness in the Kwango Province of Southwest DR Congo.

And 79 reported deaths.

Symptoms include "fever, headache, coughing, breathing difficulty, and anemia".

Kids under 5 appear most affected. Image
Breathing difficulties and other signs suggest a respiratory disease and likely respiratory transmission.

Epidemiologists have been sent to the area.

Testing is in process, with results expected in the next few days.

BUT we don't know anything for certain...
Read 11 tweets
Nov 12
10 years ago today I walked out of the hospital after surviving Ebola.

Back then I begged the world to strengthen our response to that crisis and prepare for others.

I’ve been reflecting on what we’ve learned over the last decade.

And the role of the U.S. in global health🧵 Image
The international response to Ebola in 2014 was way too slow and weak.

Too many people died because we didn’t have the experience, coordination or willpower to address the crisis quickly and head on.

In the aftermath, we focused on lessons learned. We made changes.
We created new ways to fund outbreak response at the global level.

The Africa CDC was created to help the continent better prepare for and respond to disease threats.

And changes were made in U.S. government to allow better coordination among agencies.

africacdc.org/about-us/our-h…
Read 15 tweets
Sep 30
As news of the Marburg cases in Rwanda spreads, I want to share some thoughts on where the outbreak stands, what will likely come next, and why this outbreak may (hopefully) end up being unlike other viral hemorrhagic fever outbreaks in the past 🧵
For those just tuning in, Marburg is a viral hemorrhagic fever, very similar to Ebola.

This is the 18th Marburg outbreak since 1967.

Most outbreaks fizzle out fast. This one, despite being just announced days ago, is already among the largest.

Although the incubation period, symptoms, and spread are very similar to Ebola, there are some really important differences.

Most importantly, we have FDA/WHO approved vaccines and treatments for Ebola.

But we only have experimental therapeutics and vaccines for Marburg.

fda.gov/emergency-prep…
Read 15 tweets
May 22
I teach a class on the history of humanitarian response.

We talk about how a field full of dead soldiers in 1859 in Solferino led to the ICRC, Geneva Conventions, & international humanitarian law.

Every year, my students always ask “the ICC seems useless, why do we need it?” 🧵
In the aftermath of World War II, the Nuremberg Trials was the first international war crimes tribunal.

I think we can all agree that prosecuting those responsible for the atrocities of the Holocaust was an important endeavor.

There were calls for a more permanent tribunal…

cfr.org/backgrounder/r…
But the ICC wasn’t established until 2002.

In the last 22 years, it has indicted 40 people and convicted only 10.

Given that it seems like bad guys get away with doing bad things with impunity all the time, many will question the ICC’s role and impact.

icc-cpi.int/about/the-court
Read 13 tweets

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