Gabriel Bosslet Profile picture
Feb 24 9 tweets 3 min read
Holy crap

I stayed up to watch the Indiana Senate Judiciary Committee meeting on HB 1077 (which would eliminate permits to open carry guns in Indiana)

It was a study in the damage the Republican Supermajority is doing to democratic debate in Indiana

A quick thread

1/
The meeting lasted 8 hours

@kaitlin_lange does a terrific job covering it for the @indystar and this article is well worth reading

2/

indystar.com/story/news/pol…
There are a few things worth noting- some from the article, and some from my musings

I could not have encapsulated the issue with how the republican supermajority is wrecking public debate and public policy better than Douglas Carter, superintendent of @IndStatePolice

3/ Image
IMO the interesting portion of the meeting came during the amendments discussion

The committee voted down (party lines) an amendment to require a background check for all gun purchases in the state (currently private sale transactions need not include a background check)

4/
Then they voted down (party lines) an amendment to require a carry permit ONLY for age 18-21

This seemed like a reasonable compromise to me

I shook my head in disbelief- to me these votes imply that these lawmakers are more interested in protecting guns than Hoosiers

5/
And then they voted to gut the bill- to keep the permitting process in place but allow for a provisional permit once the application is submitted

So people who need to carry a gun NOW are able to carry a gun NOW

This is the constituency this seems to benefit

6/
These amendment votes demonstrated that those in favor of this bill don't seem to be interested in rational compromise regarding how guns are regulated here

They voted against 2 very reasonable amendments only to then gut the bill

7/
I will reiterate that our current politics are driven as much by the structure of our election system in Indiana as anything else

It is poisoning public policy

The fight over HB 1077- a bill that is widely opposed by a VAST majority (70-80%) of Hoosiers- is not over

The shell of a bill that will go to the floor of the senate could be resurrected with enough machinations

Call your senator

fin/

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More from @gbosslet

Jan 16
I worked an unexpected overnight last night

This 🧵 is an exhausted, muddy-headed takedown of the historic but continued saddling of medical trainees with ridiculous work hours

There will be no data and I will appeal to emotion a lot

Here we go!

#MedTwitter

1/
Last night I was blessed to work with two amazing residents

We were busy with very sick patients

They were constantly working

I don't know if they ate

I arrived at 5 pm and left this morning exhausted after getting about 2-3 hours of sleep

2/
The IM resident had been in the hospital working 10 hours prior to my arrival at 5 pm and would round for another 3-4 hours after I left

I do not think that she slept

This amount of continuous work is OK according to medical norms and training program accrediting bodies

3/
Read 11 tweets
Jan 4
OK let's talk about hospital admissions (with a focus on #Indiana) and what we can maybe expect with Omicron

Last week I talked about ICU beds, but what about hospitalizations overall?


1/
A new report out of the United Kingdom suggests several things:
1. Omicron seems to hospitalize at about half the rate of Delta
2. Vaccination is protective against hospitalization, and boosters are important to extend this risk

Report: bit.ly/3Hwq0fC

2/
These data is based on a relatively small number of hospitalizations (815), so take it with a grain of salt.

These data suggest for Omicron, unvaccinated folks are 5 TIMES as likely to be admitted to the hospital as fully vaxxed folks (3 doses)

3/
Read 7 tweets
Dec 30, 2021
If you are attending a large New Year celebration with strangers, please know that in many areas of the country you are contributing to the collapse of the health care system.

This applies regardless of your vaccination status.

I know this sounds dramatic- please read on.

1/
I am not chicken little when it comes to COVID

I have been a proponent of pulling back restrictions and mask requirements for the vaccinated

But the goal of public health measures is to protect hospital capacity

In Indiana, we are worse than ever.


2/
Omicron’s spread is nuts.

I’ve followed the data closely the entire time and I am floored by it.

3/
Read 11 tweets
Dec 27, 2021
This recent COVID-19 surge has put a major strain on hospital systems

I am an ICU physician and we have felt it acutely in this area of the hospital

Indiana has somewhere around 250 ICU beds currently unoccupied in the state (out of ~2100)

How can 250 feel like zero?

A 🧵

1/
First, a word about statewide data.

Never has there been a microscope on these data like this, and the transparency is awesome.

Both @ISDH and @HHS keep track of hospital metrics regarding occupancy.

@ISDH data: bit.ly/3qLcNJh

@HHS data: bit.ly/3erSk6l

2/
We feel a major crunch in ICU beds

constantly moving people out of the ICU to accommodate transfers

currently there is always a list of people waiting to come to our facility from other places

many of which report that they are out of room

3/
Read 15 tweets
Aug 20, 2021
mRNA injected into deltoid cells lasts about 72 hours and do not travel to distant sites in the body.

I get asked about this all of the time, so I went to find the primary science on this.

A couple of quick tweets

1/
The first paper I can find on this was in @ScienceMagazine in 1990 and showed the half-life of RNA in muscle cells to be less than 24 hours- RNA encoding the luciferase protein was injected into mouse quads and luciferase was undetectable at 60 hours. pubmed.ncbi.nlm.nih.gov/1690918/

2/
In 2007, a study agreed:

Luciferase-encoding mRNA injected into human ear dermis peaked transcription at 17h and was undetectable at 3 days (panel d).

They also looked for luciferase expression at distal sites in the ear and saw none (panel e).

pubmed.ncbi.nlm.nih.gov/17476302/

3/
Read 5 tweets
Jul 22, 2021
Earlier this summer I was adamant that school would be reasonable without masks, even for the ages for which vaccines are not available.

I have changed my tune. A quick 🧵as to why.

1/
Most data suggest that the SARS-CoV-2 virus affects kids in a generally quite benign way.

I know people get frustrated when COVID is compared to the flu, but for kids the data suggest the comparison is reasonable. And this accounts for "long COVID" and MIS-C.

2/
So when I suggest that masks should be mandatory in school for kids, I am not worried about the health of my unvaccinated 6 and 11 year olds.

I am worried about it causing widespread community transmission and overwhelming hospitals.

Again.

3/
Read 7 tweets

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