China, New Zealand, Hong Kong, Taiwan, South Korea, Singapore, Japan, Australia, et al.

How did they do it? Did they have better experts or expertise? Did they implement preventive measures faster? Was the population more receptive. All of the above? More?
Need in depth study. And with humility and attention to detail.

So we learn and don't repeat mistakes. Perhaps nothing is fixable. But it's worth knowing what the reasons are.
Most of them kept deaths low by keeping cases low. Even when cases climbed with omicron it was in a vaccinated population. So they had accomplished what they needed to accomplish.

That means it's not a question of obesity rates or diabetes or age distribution.
It's also not something we can dismiss as "oh, but can we trust their numbers".

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More from @VincentRK

Feb 7
Just out: Mayo Additive Staging System for multiple myeloma: MASS

Uses 5 variables: high risk IgG translocation, 1q gain, del 17, ISS III, & LDH. @BloodCancerJnl
@MayoMyeloma @myelomaMD @MoritzBinderMD @Rfonsi1 @MorieGertz @MayoCancerCare @MayoClinic nature.com/articles/s4140…
The study used data from 1327 patients to develop the risk stratification model. The model was then validated in 502 patients enrolled in the MMRF CoMMpass study.

Stage migration from RISS and ISS shown below.
There are a lot of risk stratification models. We focus the widest applicability worldwide using markers that are clinically available in most places.

The risk stratification and hazard ratios are valuable for counseling.
Read 6 tweets
Jan 26
We need to do something about prescription drug prices. I have written and advocated for lower prescription drug prices for years.

I applaud @mcuban for starting @costplusdrugs to provide prescription drugs at low prices.
costplusdrugs.com
Having spoken to many experts and organizations including experts from Costco and @AARP it was clear that even if the intent is there, providing low cost drugs in our system is extraordinarily difficult.

So I'm glad someone is taking the initiative.
The fact that your copay with insurance can be higher than paying out of pocket at the pharmacy tells you how broken the system is, how much the entire supply chain except the patient benefits from the current system.
Read 8 tweets
Jan 25
One thing that's clear watching the pandemic for the last 2 years is that the only way to truly contain it was early action. A few countries did it the right way. Saved a lot of lives.

If you didn't do the right thing early on, the task became infinitely harder.
Countries which successfully contained covid early on now face a problem of how long they can realistically sustain their approach.

These countries have vaccinated their public and did all the right things. But Omicron makes it very hard.
Countries which acted late find rising cases the moment preventive measures are relaxed. And whenever a new variant arises. It's disheartening.
Read 6 tweets
Jan 21
It took 2 years for first 50 million confirmed cases in the US. Took 1 month for next 20 million. #OmicronSpeed
I think this is absolutely unprecedented. And why so many people who managed to stay safe for 2 years are now reporting that they have Covid.

Why hospitals and workplaces are struggling with worker shortages.
Thankfully due to vaccines deaths have been lower. But sadly we still lost 60,000 lives this past month.
Read 4 tweets
Jan 20
It's a medical miracle how vaccines developed within one year against the wild strain of COVID have maintained 90% efficacy against hospitalizations against an onslaught of variants. coronavirus.health.ny.gov/covid-19-break…
Risk reduction is how most of medicine works. Few things in medicine work 100%.

Few things work 90%.
You see the same effect in other places as well. Here is deaths by vaccination status from Switzerland.
ourworldindata.org/covid-deaths-b…
Read 4 tweets
Jan 18
South Africa and UK is playing out along the east coast, including New York, New Jersey, Massachusetts: Rapid rise and then a rapid fall.

Cautiously hopeful. ImageImageImageImage
More here. It was my hope for the New Year.
As I have indicated the US is so large geographically that the overall time to peak and fall down for the country as a whole will be longer that South Africa or the UK. But each state will likely behave like the east coast states.
Read 4 tweets

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