To those who are unvaccinated because of worries about “unproven mRNA technology” you know you can get:
- the J&J vaccine (🇺🇸)
- the Oxford-AZ vaccine (🇬🇧&🇪🇺)

Both can prevent hospitalization or death from COVID. Neither are mRNA vaccines. So why not get vaxxed today?
To those worried about blood clots after J&J, as of April 2021:
-there were 15 cases of TTS
-out of 8 million J&J doses

That’s a risk of less than 1 in 500,000. cdc.gov/mmwr/volumes/7…

The risk of getting struck by lightning is higher than that! cdc.gov/disasters/ligh…
The vaccine efficacy (VE) of the J&J vaccine *is* slightly less than the mRNA alternatives: 68-71% VE to prevent hospitalization (compared to ~90% for mRNA vaccines). That’s still much much better than being Unvaxxed.

(N.B. this is pre-omicron data)
cdc.gov/mmwr/volumes/7…
In terms of efficacy against omicron, a study from South Africa found that boosted J&J was 85% effective at preventing hospitalization! Not too shabby!

medrxiv.org/content/10.110…
To put this another way:
You are about as likely to catch COVID, get hospitalized, and die *precisely at the stroke of midnight* than you are to develop TTS after vaccination

1/6 risk of COVID infxn * 1.5% CFR * 1/24 hrs *1/60min =
0.0000017
vs
15 cases / 8m =
0.0000018

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More from @nickmmark

Jan 16,
Updated WHO severe COVID treatment guidelines bit.ly/3rhGgKW

Recommended
🟢Steroid (#Dexamethasone)
🟢IL6 blocker (#Toci) or 🟢JAKi (#Baricitinib)
🟠±mAb in seronegative people

NOT recommended
🔴#Hydroxychloroquine
🔴#ivermectin
🔴#remdesivir

Lots to discuss, a🧵
1/
Remdesivir (RDV) is in the “We suggest no remdesivir” category.
At some level, this isn’t too surprising & is old news.
Despite initial hype, RDV never moved the needle much on patient centered outcomes (risk of mortality or requiring IMV) & many of us had stopped using it.
2/
In #ACTT1 RDV did improve outcomes on an ordinal scale, but the effect was modest. It shortened time to clinical improvement but not hospital LOS (patients stayed in the hospital longer to receive it).
RDV did NOT improve mortality or risk of IMV.
ncbi.nlm.nih.gov/pubmed/32445440
3/
Read 19 tweets
Jan 15,
I was alone on an elevator today when I began hearing a voice.

It asked me if I “still support President Donald Trump’s ambitious agenda?”

I look around. No one here.

Hmm that’s weird
1/
Then the voice asked me if I’d like to “make a donation to support President Trump and the America first agenda he enacted?”

Pause

Umm no. This is an elevator.

Pause

The voice said “Aha.”

Then it continued “I’m sorry. Thank you bye bye.”

2/
So either:
A. I’m having a pro-Trump command auditory verbal hallucination or
B. His campaign robocalled the elevator’s emergency phone

3/
Read 7 tweets
Jan 7,
As someone who has dedicated a lot of time to studying and making #dataviz, let me explain why I dislike this NYT COVID graphic so much.

1/
It’s not that it’s a spiral - one of my favorite types of graphs is the Condegram spiral. (Named after Mark Conde)

It’s used in astronomy/meteorology to show changes the Earths magnetic fields (Kp index) & is used to visualize space weather.

2/
Another awesome spiral graph - and one of the best examples of #dataviz ever IMO - is the Rose plots by Florence Nightingale.

These 1858 plots show the causes of mortality in Crimean war & make a compelling case that for improving conditions (particularly shelter in winter).
3/
Read 11 tweets
Jan 5,
The risk of myocarditis in kids after mRNA vaccines is MUCH lower than was initially feared.

12-15 yo: 265 cases/18.7m doses = 1.4 cases/100k kids vaxxed
5-11 yo: 12 cases/8m doses = 0.12 cases/100k kids vaxxed

For context, the risk of getting struck by⚡️ is ~0.2/100k per year.
People asking about 16-17 yo males:

Yes we know that group has slightly higher (but still objectively low 7/100k) rates of myocarditis

The point is that rates of myocarditis are *even* lower in younger kids (5-15 yo) Hence ACIP’s recommendation that kids *should* get boosted.
As for the VSD data. In this dataset, among people aged 12-17yo, they reported 39 cases out of 1.1m vaccinations. Most were mild.

This is higher but still objectively very rare: 3.2/100k

Again, this safety data was used by ACIP to justify a stronger “SHOULD” recommendation
Read 5 tweets
Jan 4,
The US hits a million COVID cases in one day. Shit.
Hospitalizations also rising rapidly.

The key is that “milder” ≠ “mild”

A variant that is 2x infectious but 30% less virulent is still very bad & has potential to overload our hospitals.
Also important: most people in the hospital don’t have COVID but everyone’s care is harmed when we don’t have enough staff.

Some hospitals have >30% of acute care staff out sick.

Today is a bad day to need the cath lab or OR.
Read 4 tweets
Dec 27, 2021
Finally read the new @American_Heart AHA guidelines & they are absolute garbage.

Providers shouldn’t delay compressions or defib to put on PPE? Seriously?!? It takes like 10 seconds to put on an N95!

1/
Also were they afraid to actually *recommend* vaccination?

How about saying “vaccines substantially reduce the risk of DYING or getting SERIOUSLY ILL from COVID. All healthcare workers *should* be vaccinated”

Instead they went with a toothless “may reduce their risk” blah
2/
Others have pointed out the utter hypocrisy of people who are NEVER the first responders to a code writing this guideline. This is true.

Also, logistically, who do they think will respond to a code when a dozen RNs are home sick after being exposed at the last one?
3/
Read 5 tweets

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