🧵/ I really appreciate @caitlinnowens’s summary of the federal COVID response under Pres. Biden. There are a few observations I’d like to highlight in a short thread, here.
2/ Several long-time health policy advisers to the Biden team are distancing themselves from the COVID-19 response. This is a continuation of a trend that began with a series of opinion essays published last week.
3/ Some of the advisers who are distancing themselves from CDC policies are simultaneously defending the CDC Director— this is an untenable position. It will be interesting to see how long these advisers are able to walk that tightrope, and which side they ultimately favor.
4/ Among Walensky defenders are conflicted in their blame-shifting, and they don’t appear to offer a consensus answer to a very simple question: “If you’re rejecting CDC policies but support the CDC Director, then what *precisely* is the root cause of the problem?”
5/ One Walensky defender blames the former Administration. This tack is politically savvy but self-undermining— it betrays the premise of the 3 policy perspectives they co-authored and published just last week.
6/ Another Walensky defender tries to shift the blame to other agencies. This tack is also politically savvy but ignores the fact that the CDC Director is appointed. Sure, there’s a dotted-line to the HHS Secretary, but that neither obviates nor overrides the solid-line to POTUS
7/ The most revealing quote came from a Biden Admin official: "The question is, do I think anybody could do it better? I think it would be a difficult position to put anybody in"

I don’t know what to make of it, but I know it’s *not* a glowing endorsement of the CDC Director
8/ Another interesting line: “Health and Human Services Secretary Xavier Becerra is notably absent from the COVID response, critics say, and the FDA still doesn't have a Senate-confirmed commissioner.”

These strike me as haphazard whataboutism by Walensky defenders.
9/ The HHS Secretary role is an executive position, not a scientific one. I’d be curious to hear what critics expect from Sec. Becerra in this particular context— and how they square their expectations with the fact that the CDC Director serves at the pleasure of the POTUS.
10/ TL; DR: there’s a lot of finger-pointing going on, and some private rifts spilling into public view. It seems that the pro-Walensky and pro-CDC factions are one-and-the-same. Something’s got to give, and I doubt that it will be a Senate-confirmed Cabinet position.


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More from @DataDrivenMD

10 Jan
🧵/ I just spoke with two journalists about data that shows how the U.S. healthcare system is collapsing before our eyes. The million dollar question during both interviews was, “What else could we be doing right now?” The answer: flatten the *hospitalization* curve. Now.
2/ Hospital staffing never fully recovered from the Delta variant surge. We can’t keep cutting bed capacity because we’re now in the Omicron surge. ImageImage
3/ The CDC’s ill-advised abbreviation of #COVID19 isolation for healthcare workers has done more harm than good

#MedTwitter Image
Read 11 tweets
10 Jan
I couldn’t help myself. I figured out the #Wordle algorithm.

Wordle 204 2/6

Meaning: I know how to generate all past and future answers
Pro tip: If you want to get tomorrow’s #Wordle early, just advance your computer’s date and refresh your browser window
Read 4 tweets
8 Jan
⚠️ FDA says: don't swab your throat for rapid antigen tests that are designed to be used with nasal samples
Closed replies to this ^^ b/c misinformation was being shared, and b/c several replies ignored the text in the FDA's tweet— a sign of troll- and bot-like activity.

I answered some of the questions. For the rest, I urge you to read the FDA's thread (👀⤵️)
Several noted that other countries, like the UK and South Africa, recommend swabbing the back of the throat. Please note that the studies other countries use to support their guidance is based on tests available in *their* country— tests differ in the US, hence the FDA's notice
Read 11 tweets
7 Jan
🧵/Remember when I said that New York would end up with a higher total number of patients in the hospital because most hospitals already reported numbers that excluded *with* #COVID19? Well…
2/ ⚠️ As I said, the data reported to HHS already excludes hospitalizations *with* #COVID19. Here’s an apples-to-apples comparison of pediatric hospitalizations using HHS data vs. New York state data:
🔸Dec 19-Dec 24: +3 HHS overcount
🔸 Dec 25-Jan 1: -87 HHS undercount
3/ The difference stems from the fact that hospitalizations are the result of a simple equation:
# patients admitted - # of patients discharged

I wrote a short thread about this yesterday 👀⤵️
Read 7 tweets
7 Jan
PSA: hospitalizations and admissions are fundamentally different metrics— they're not comparable. Example:

A hospital reports 100 COVID-19 hospitalizations on consecutive days. That could mean:
🔸0 admissions - 0 discharged
🔸100 admissions - 100 discharged
🔸any combo netting 0
^^That's just scratching the surface. There are #COVID19 admissions that may not count toward daily hospitalizations— like short stays lasting <24 hrs

From a patient's POV: they were hospitalized

From a reporting standpoint: daily hospitalization totals may not reflect the stay
^^Yet another nuance: the patient's condition upon hospital discharged. Are they deceased? Were they transferred to another hospital? Were they transferred to a subacute or rehabilitation hospital? Or are they able to go back to their daily routine?
Read 5 tweets
6 Jan
🧵/NEW: Preliminary study findings suggest that “in addition to reducing the risk of acute illness, COVID-19 vaccination may have a protective effect against [#LongCovid]”
2/ “Of the 951 participants, 337 (35%) reported not fully recovering from the initial COVID-19 symptoms at follow-up. The most commonly reported symptoms at the time of follow-up were fatigue (22%), headache (20%), and weakness in arms or legs (13%)”

3/ “After adjusting for duration of follow-up and presence of symptoms at baseline, a 54-82% reduction in reporting symptoms among those fully vaccinated for seven of the ten most commonly reported symptoms was detected (Table 3).”

Read 4 tweets

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