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WesElyMD

Feb 1 • 8 tweets • 4 min read

@NEJM

1/🧵 Covid-19 #vaccination in American Indian & Alaska Native (AI/AN): @NEJM

The AI/AN population has the highest 1st dose & full #vaxx rates of any US racial or ethnic group.

This photo of Black Elk should remind us of true #HEROES

link: bit.ly/3KY77og

2/ This successful trend is especially important given AI/AN communities have been disproportionately affected by Covid-19 and by ongoing discrimination throughout the health care system.

AI/AN communities have worked to protect the health and well-being of their members by…

3/ …adapting community mitigation & vaccination strategies to their diverse cultures.

There are 574 federally recognized tribes located in 35 states. AI/AN lands, which are sovereign territories, extend over 100 million acres, including 44 million acres in Alaska.

4/ Indian Health Service (IHS) serves 2.56 million people in AI/AN communities. The agency received Covid-19 vaccine doses soon after emergency use authorizations were granted and shipped allotments swiftly by means of its national distribution system.

5/ They provided vaccine access through either the IHS or state partnerships therefore appears to have been an effective strategy. Let this be an example to rest of the country. Let’s band together and improve our systems to achieve herd immunity.

#NotThereYet

6/ A poll of nearly 2000 AI/ANs identified a messaging tactic with strong support: portraying vaccination as the best way to prevent further suffering caused by a pandemic that has brought incommensurate harm to tribal communities.

7/ The survey also found that emphasizing the preservation of culture and language, including by protecting elders by means of priority vaccination, increased support for vaccines. Such findings could inform future pandemic-related public health strategies in AI/AN communities.

8/fin
I am proud that one of my daughters has chosen to devote herself professionally to working with the #Lakota nation as a social worker for children in need.

Such beautiful people and a wonderful example of community & love from whom the rest of our country can learn!

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More from @WesElyMD

WesElyMD

@WesElyMD

Feb 2

1/🧵 What is #LongCOVID⁉️

A disabling malady from ongoing inflammation, autoimmunity, & potential viral reservoirs (GI, brain?)

NEW DATA: The Lungs “light up” on special MRI Scans 3 to 9 months later in patients never hospitalized for COVID.

bit.ly/344Oajp

2/ These #LongCOVID pts had NORMAL CT scans but when asked to inhale Xenon, an inert gas, the MRI showed their lungs transferred gases (think oxygen) into the bloodstream abnormally. This is alarming evidence of another weird form of organ damage from COVID not visible on CXR/CT.

3/ Oxford Prof Dr. Gleeson says these patients, who were never in hospital & didn’t have acute severe illness w their COVID19, have been experiencing symptoms for a year after contracting the infection.

Read 14 tweets

WesElyMD

@WesElyMD

Jan 31

@JAMA_current

1/🧵 How do #COVID patients suffer after the ICU?

This new @JAMA_current study of 246 Dutch pts shows that 3 out of 4 people had physical problems 1 YEAR LATER plus 1 in 4 have #brainfog, depression & anxiety.

What do we call this?

#LongCOVID #PICS

bit.ly/3o4djkT

@Medscape

2/ The paper is also discussed in @Medscape👇: “Our study shows what an impact ICU admission has on former #COVID19 pts. Even after 1 year, half are tired or experience lack of the energy to fully resume their work," says author Marieke Zegers, PhD

wb.md/33U9DeF

3/ I searched this paper for well-known terms like post-intensive care syndrome #PICS, #LongCOVID & even “post-acute sequelae of COVID”#PASC

NADA. Zip. Zilch.

Why weren’t these names mentioned? At the very least, these pts’ disabilities are DEFINITELY PICS & underestimated btw

Read 9 tweets

WesElyMD

@WesElyMD

Jan 25

1/🧵 Beauty in simplicity

For too long in life, I thought success was about climbing in the 🌎’s eyes…higher, better, farther. My physician wife & I are “new parents” to my 58 y/o brother w #DownSyndrome & he’s giving me all kinds of new understanding of what matters.

#COVID

2/ When I come home, Greg is usually hiding from me, like you see here. He thinks so beautifully, “How can I make someone else #happy in the small things in life?”

Here he is hiding in plane sight next to our dog Butter. Look at that grin!

#Recovery

3/ Hide and Seek: He taught me that if he can’t see me, I can’t see him!

At first that seems nutty, but in truth, for me to enter “into #relationship” w you, we do need to SEE EACH OTHER, right?

So who’s teaching who here?!

Read 6 tweets

WesElyMD

@WesElyMD

Jan 21

1/🧵 WHY are Booster Rates so low⁉️

Only 1 in 4 Americans is Boosted. People get vaxxed & then bag the best protective approach.

I honestly don’t get it??

Let’s review some studies:

750k people boosted (Pfizer) showed 90% ⬇️ in death vs non-boosted.

bit.ly/33WQ2tK

2/ Another study of ~750k people showed vaccine (Pfizer) effectiveness at 7 days after 3rd dose w 93% effectiveness. WOW

BLUE (3 doses) on this graph shows WAY better protection than RED (2 doses) =
⬇️ hospitalization
⬇️ severe dz
⬇️ death

It’s clear!

bit.ly/3KuHDic

@DrEricDing

3/ And that explains clear results posted by @DrEricDing 👇 that show impressive reductions in hospital admissions…

You want to stay safe at home right??

You don’t want me as your doctor because that comes w an ICU & ventilator. Get #boosted.

Read on…

https://twitter.com/DrEricDing/status/1479521179694256133

Read 6 tweets

WesElyMD

@WesElyMD

Jan 20

@NEJM

1/🧵 @NEJM “Covid19 has rendered U.S. racial, ethnic & social health inequities too stark to ignore.”

In the face of staggering inequities in Covid morbidity & mortality, the scientific workforce must confront #StructuralRacism

TY @DrCHWilkins & authors
bit.ly/3fGHycT

2/ The 2020 U.S. Census estimated that 33% of people in the United States identify as members of racial or ethnic groups that are underrepresented in medicine but less than 6% of research faculty are members of such groups.

@FDA

3/ Only 4 to 5% of participants in trials of drugs submitted for approval by the @FDA between 1997 & 2014 were from groups historically underrepresented in medicine.

Read 5 tweets

WesElyMD

@WesElyMD

Jan 19

@Nature

1/🧵 BEWARE: Mild” COVID can cause #LongCOVID‼️

@Nature study of N=147 (31 w LongCOVID) found Covid infection exerts unique & prolonged effects on our innate & adaptive immune system over 8 months later.

This may drive Long Covid.

go.nature.com/3ntDOQk

2/ Obviously, Acute COVID-19, caused by infection w SARS-CoV-2 is characterized by wide ranging severity from asymptomatic to fatal. Our immune response (big or little) to the virus drives the pathology that can kill us.

3/ We know that the acute infection causes pronounced immune system problems w lowering lymph cells and rising inflammatory mediators that can cause organ damage.

This is why I have to put so many people on ventilators & dialysis.