Thread by @drjudymelinek

As a pathologist who certifies deaths I understand why: Excess deaths capture deaths from Covid + all the deaths that are Covid-related. e.g. If you get myocarditis from Covid but die of heart failure months or years earlier than you should, we wouldn’t know it was from Covid.

https://twitter.com/MicahPollak/status/1477727474003894274

I would just do an autopsy and sign it out as “probable cardiac arrhythmia due to myocardial intertstitial fibrosis” or maybe blame your concomitant atherosclerosis. The way Covid19 attacks endothelial cells, it causes long term damage in the heart and brain.

These two organs don’t do well long term with vascular damage. Brains develop strokes, aneurysms & hearts develop arrhythmias. I would not be surprised if Covid survivors have shortened lifespans from diseases like strokes, aneurysms or heart disease.

These organs also kill you suddenly & unexpectedly which means this will put more burden on our already understaffed sudden death investigation systems. You think we don’t have enough nurses & ICU docs, wait till you find out how few forensic pathologists there are.

But most of these deaths won’t even get autopsies. They will be written off as “natural” deaths due to heart disease and we won’t figure out that they were the long term effects of Covid19 until years later… when we look at the excess deaths in an entire generation.

Which is why I have, from the start of this pandemic, advocated for caution in approaching any pathogen we don’t know that much about. All the voices advocating for “reopening” because of economic or social collapse were not considering the long term effects.

Even now, @CDCgov guidelines of shortened isolation, PPE use & home testing appear influenced by social/economic demands for staffing and not on best public health practices.

Home testing, for instance, is not public health. It’s private health. In the US the testing burden shifts to you, the consumer, and this we lose important data in our public health system on actual numbers of new cases. Poor people can’t afford these tests.

Nearly two years into this pandemic and the U.S. still has no mask mandates, no way to get everyone free N95s, which is what we know works. Masks are cheaper & easier than lockdowns, than anti viral drugs. Contact tracing has been abandoned. Again, burden put on the individual.

If you get sick the burden is on you to figure out and tell who you may have exposed. This isn’t public health. This is a complete abrogation of responsibility & a public health system that has given up.

The U.S. will continue to fuel the fires of Covid19. The next challenge may be a variant that evades rapid tests & vaccines. I ask again, how many people need to die before they figure out that the open secret to handling this pandemic better is already being implemented?

Look to China, Taiwan, S Korea, New Zealand. Learn from what they already know: 😷 works , vaccines work, public health campaigns with good science communicators work, managed isolation & limits on freedom of travel/movement work. They don’t have to be draconian.

You can find a formula that works for your political system, but by all means *use them.* People trust government when it shows results. Public health is the cornerstone of good government and long term economic prosperity. /End rant.