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Céline Gounder, MD, ScM, FIDSA

Feb 14 • 6 tweets • 3 min read

@TheAtlantic

1/ The elderly are in a league of their own when it comes to COVID risk:
theatlantic.com/health/archive…
by @TheAtlantic's @sarahzhang

@BellevueHosp

2/ If someone you love is over 50 isn't yet vaccinated & boosted, please help them get 💉💉💉.

While on service at @BellevueHosp last month, almost 3/4 of my patients were not vaccinated.
They weren't anti-vaxxers.
They just needed help getting vaccinated (homebound elderly).

3/ It's hard for some older people who have chronic medical conditions, disabilities, limited resources, limited social networks, etc to get vaccinated.

We need to be REACHING OUT, not waiting until people ask for help... or... all too often... it's too late.

4/ Elder Americans 65 & older are covered by Medicare.

Is Medicare a way of REACHING OUT?
- Direct incentives to patients to get COVID vaccine
- Make COVID vaccination a "quality measure" & incentivize health care providers (similar to what we do for pneumonia vaccines?)

5/ Improve working conditions at nursing homes ➡️
- More trust
- Less turnover
- More institutional memory
- Better organization

6/ COVID vaccination coverage among nursing home residents AND staff should be quality measures, too.

Nursing homes that don't meet targets
shouldn't get 5🌟.
Those that do should be rewarded.

(more on the paradox of how Medicare awards 🌟: khn.org/news/article/h…)

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Céline Gounder, MD, ScM, FIDSA

@celinegounder

Feb 1

@MSNBC

1/ Good news today for many parents!

Pfizer is applying for FDA authorization of 2 doses of its COVID vaccine in kids aged 6 months to 5 years.

The COVID vaccine is SAFE in all kids 6 months to 5 years.

Kids 2-5 years may need a 3rd dose.

with @MSNBC's @KatyTurNBC

2/ We need to wait & see whether a THIRD dose is needed to provide enough protection in kids 2-5 years of age.

But in the meantime, there's no real downside to getting kids under 5 started on their first two COVID shots. They're safe.

@KFF

3/ Parents' worries about safety seem to be driving low vaccination rates in kids 5-11, who've been eligible for COVID vaccination since November.

Here are findings from @KFF's latest Vaccine Monitor poll:
kff.org/coronavirus-co…

Read 7 tweets

Céline Gounder, MD, ScM, FIDSA

@celinegounder

Jan 24

@MSNBC

1/ Are we on the other side of this Omicron peak?

Think of peaking as taking a ski lift to the top of the mountain, and then starting to ski down the mountain.

We've just started skiing down the Omicron mountain.

with @MSNBC's @craigmelvin

2/ SARS-CoV-2 is spreading in epidemic waves.

It burns through social networks with each surge.

Then it takes time before there's a shift in social networks to again be enriched for people with no/partial immunity.

And then you get another surge of infection.

3/ The Omicron surge will NOT be our last surge.

There will be MORE variants. Omicron won't be the last.

Not enough people in the US are fully vaccinated.

We remain vulnerable to future variants & surges.

We should better prepare & insulate ourselves from future variants.

Read 4 tweets

Céline Gounder, MD, ScM, FIDSA

@celinegounder

Jan 13

1/ Big day at the Supreme Court today:
- UPHELD: vaccination requirement for staff working in facilities that accept Medicare & Medicaid funding
- BLOCKED: OSHA rule requiring vaccination or weekly testing for employers with 100+ workers
nytimes.com/2022/01/13/us/…

2/ It is now highly unlikely that the U.S. will hit the ~85-90% of Americans vaccinated to get to the other side of the pandemic.

@NYCMayor

3/ States & cities can impose their own vaccination requirements, as did @NYCMayor:

www1.nyc.gov/office-of-the-…

Read 5 tweets

Céline Gounder, MD, ScM, FIDSA

@celinegounder

Jan 13

@latimes

1/ ‘They underestimated this virus.’ Omicron cuts through U.S. defenses despite Biden’s efforts by @latimes' @anumitakaur @ChrisMegerian

latimes.com/politics/story…

with my friends & colleagues @meganranney @RickABright @Bob_Wachter @DrJayVarma

https://twitter.com/celinegounder/status/1480189355113295872?s=20

2/ latimes.com/politics/story…

More on "the articles" in this thread🧵:

https://twitter.com/celinegounder/status/1480189355113295872?s=20

3/ latimes.com/politics/story…

Here's where to buy N95, KN95, & KF94 masks:
projectn95.org
The real thing, not knock-offs.

Read 4 tweets

Céline Gounder, MD, ScM, FIDSA

@celinegounder

Jan 11

@RobertDPutnam

1/ America, we've got a lot of work to do.

But we CAN do it.

Here's how.

with @RobertDPutnam & @shaylynromney
many thanks to our editor @lucas_wittmann

Read 15 tweets

Céline Gounder, MD, ScM, FIDSA

@celinegounder

Jan 11

1/ What happens when hospitals are overwhelmed & understaffed?

People die.

gothamist.com/news/nycs-hosp…

3/ "Premium prices" to the point that traveling nurses are paid several times as much per hour as doctors.

I'm not saying that in a hierarchical, elitist way.

But rather to communicate how much scarcity is dictating prices at this moment.

Read 7 tweets

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