Amy Cho, MD MBA Profile picture
Jan 31 4 tweets 1 min read
“Centering equity often means one size does not fit all.”

Different communities have different resources and face different underlying risk (that varies with surges) as does their need/ability to employ effective public health tools.

There is no simple, binary choice.
Different families and individuals have different resources and face different underlying risk (that varies with surges) as does their need/ability to employ effective mitigations.

There is no simple, binary choice.
The pandemic will “end” for different communities, families and individuals at different times.

Be wary of any “expert” who tells you there is a simple end date and their policy applies to every community at the same time.
Be wary of any expert who curates data to distort evidence in support of a personal policy preference.

Be wary of any scientists or doctors who employ #ManufactureOfDoubt tactics to public health interventions.

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More from @amychomd

Feb 3
I really can’t believe this drivel.

I am not an academic. I’m a real doctor who cares for patients and I’m a real parent so I’m just going to spend a few minutes commenting on how this is not a serious nor trustworthy article.
💩1: “Shielding kids from exposure only increases their risk.”

This is NOT true for a vaccine-preventable disease. Image
And UK is considering changing their strategy based on actual data.

“However, studies in the US & other countries, where vaccine programmes have been running for years, have not seen the large ⬆️ in shingles that were predicted.”

amp.theguardian.com/society/2021/m…
Read 22 tweets
Jan 26
Just great.

I am certain that the jeering anti-everything COVID deniers will show up at the next school board meeting demanding that masking end "no later than February 15" with this toolkit in hand as evidence to support their demands.

This is so exhausting.
#NotNormal
I am certain there will be no nuanced discussion of the reality of outbreaks or healthcare capacity. Or of our ethical duties to those most vulnerable among us.

There will be no real world data on whether “focused protection” is feasible or effective.

I am certain that the title of these doctors will be used to justify and normalize leaving our most vulnerable behind. Unnecessarily.

I want to get back to normal too. I agree it is urgent and I’m working hard to get us “there.” But we aren’t there yet. Things are #NotNormal
Read 13 tweets
Feb 1, 2021
We need split flow for vaccination.

In the ER, we run to those with greatest need and triage by acuity. We also “split” off patients with low resource needs into a “fast track.”

It speeds things up for everyone.
We should invest more to vaccinate those at greatest risk due to medical vulnerability + social vulnerability.

Those with social vulnerability that puts them at ⬆️ risk for infection often have barriers to vaccination.
We should identify the barriers and invest in overcoming these barriers quickly. Some include:
👩‍💻MyChart account & tech savvy
⏱Time to search for appointment
🚨Timely alerts about open spots
⏲Time off during business hours to get vaccinated
🚙Transportation
❓Questions answered
Read 6 tweets
Dec 13, 2020
Congress has been working for years to solve “surprise billing.”

I’ve been trying to explain this issue - and EMTALA for years now.

Congress hasn’t been able build consensus or pass a bill for years.

On Friday a deal was announced. At 5:45p, a 300 page bill released.
It will be attached to a must-pass omnibus or COVId relief bill.
The 300 page bill was released on a Friday at 5:45p. The word from staffers is no changes will be entertained. Others say that and changes need to be done by EOD Monday. (So it can be included in a must-pass omnibus bill.)

No hearings. No public comment. No stakeholder review.
Read 30 tweets
Dec 12, 2020
Physicians are among the most resilient people I know.

We don’t need more resiliency training.

This is a system problem.

We need to fix the system.
The system is set up to maximize “efficiency” (ie profit), even as returns are diminishing. But cost (ie outcomes, complaints, burnout) is borne by individuals.

This is a system problem. This is why I’m thankful I work for an independent group with AGENCY to balance trade offs.
When you don’t work on the front line or pay the cost of your mandate, regulation, prior auth requirement or other directive, it’s easy and free to ask physicians to do just one more thing or make another compromise.

nytimes.com/2019/06/08/opi…
Read 4 tweets
Nov 15, 2020
A finish line is in sight. We can do this. Time to hunker down.

What I’m doing:
-keeping littles home from preschool
-pulled all kids from indoor sports
-no gyms
-continue online church
-takeout only
-no indoor gatherings without masks, even with our bubble
Our family is planning for #ChristmasInJuly. It’s not easy but I’ve worked Thanksgiving/New Years or Christmas holiday every single year since I’ve been an emergency physician (long time now 😬.)

Holiday traditions are important but they don’t make families. People do. Image
It’s really hard to tell my kids they can’t do sports or get together with anyone. But we can get through this. There is a finish line and the prize is worth the sacrifice.

But it *really* helps knowing that it’s not forever and the payoff is worth it.
Read 4 tweets

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