I was honored to testify today in front of congressional @EnergyCommerce committee:

"Lessons from the Front-Line: #COVID19's Impact on American Health Care."

My opening statement ... followed by congressional member questions...

#mentalhealthishealth

🧵 1x
Mental, physical & behavioral health are inseparable.

The pandemic has laid bare our vast vulnerabilities.

#Primarycare is where ppl can be fully seen & heard, where trust is born & where we apply broad public health advice to pts' unique medical issues & lived experience ...2x
Approx 80M Americans don't have a primary care provider.

We must scale up/increase access to needed #primarycare services, as a hub for problem-solving for medical conditions like obesity, diabetes & depression, in order to heal from trauma & prepare for the next pandemic...3x
On the erosion of trust in public health institutions & the critical important of truth, transparency & trust in medicine - in addition to access to #primarycare 👇 4x
This is a parallel pandemic of mental health in crisis. The @Surgeon_General @AmerAcadPeds et al declared a #mentalhealth emergency in children/teens.

Moving forward, we must recognize the broad & diverse array of health risks. Health is abt more than the absence of COVID19..5x
Proposal: school-based #primarycare & mental/behavioral health services.

Let's meet people where they are. 👇 6x
On the need for a more diverse range of experts at the table during a global pandemic.

The more voices, the better - during & after a collective trauma. ..7x
Trust is the commodity in patient care. We must incentivize doctors graduating from medical school to go into #primarycare. We also need more NPs & PAs!

We must recognize that *time* & the *relationship* with a primary care medical provider is the public health ground game...8x
Two big public health failures:

1) Prolonged school closures, and
2) Failure to protect our frail nursing home population in 2020

In the future, we must tailor our mitigation efforts to degree of risk & recognize the potential harms of any/all interventions 👇 9x
More on the harms of school closures. 👇 10x
On the absence of compelling real-world data (to date!) that masks *mandates* in schools meaningfully reduce the risk of SARSCoV2 transmission within schools ...11x👇. .
Link to today's full hearing 👇👇👇 .... 12x

On infection-acquired immunity versus vaccine-induced immunity.

The human immune system is *not* a political body; it’s an immune system. 👇 13x

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More from @drlucymcbride

Feb 17
My tripled vax'd, COVID-recovered, PCR-tested, masked son in college w/ a 99% vax rate got to see the inside of the University's dining hall for 1st time in *2 yrs* last week.

Today? It closed again. Student dining is back to *outside* only - or alone. Socializing limited ...🧵
My son has been loathe to speak out, worried abt being shamed for not caring abt other ppl (this kid has a ❤️ of gold - a lover not a fighter) or being labeled anti- x, y, z. But watching his friends suffer from anxiety, depression, substance use issues, he spoke out tonight...2x
My son is an old soul. Wise, empathetic, kind. (Not that I'm biased.) He's had struggles. He has made lemonade out of lemons. He has tolerated the loss of normalcy w grace & maturity. Not a complainer. But enough is enough. How safe is safe? When have I done enough, mom?....3x
Read 7 tweets
Feb 15
Just bc #mentalhealth is harder to quantify doesn't mean it's any less important to our physical health ... or to policy-making.

After talking teens & parents for the past 2 yrs, it's never been more clear to me (& my #primarycare colleagues) that #mentalhealth is health. 1x
Not every child, teen, or parent is suffering from mental health issues. Our lived experiences during COVID have been varied & diverse. Indeed, some kids are pandemic-proof. Some of my teen patients have actually thrived during COVID... but 2x
I think it's fair to say that the absence of normalcy has been hard for many kids, adolescents, & parents - & the disruptions to school life have disproportionately affected the same populations who have tragically been disproportionately devastated by COVID-19. 3x
Read 8 tweets
Feb 4
THIS WHOLE OP-ED is 🏅

“There is not a single right answer for how to proceed. Within the set of legitimate strategies, the choice of strategy is often less important than whether or not people follow and support it.” 🧵

nytimes.com/2022/02/04/opi…
“Within the set of legitimate strategies, the choice of strategy is often less important than whether or not people follow and support it.” — @M_B_Petersen 2/n
“According to our data, the Omicron wave has also chipped away at the trust of those who have been supportive of their govt’s approach up until now. Lifting restrictions while cases are soaring can seem like betrayal after 2 years of seeking to ‘flatten the curve.’” @M_B_Petersen
Read 6 tweets
Feb 3
"It is time to recognize the myriad threats to children’s safety – beyond that of a single virus – and to appropriately balance these risks."

Proud to co-author this piece w/ virologist @DrScottBalsitis, peds psych MD @carol_psych & peds MD K Walsh 👇👇

usatoday.com/story/opinion/…
..As scientists & MDs, we are concerned that COVID mitigation measures for children are doing more harm than good. Too many policymakers have viewed health as the mere absence of COVID-19, putting children into a loop of mitigation measures that are uncoupled from actual risk. 🧵
...After two years of living with one disruption after another, the evidence is clear: The pandemic & the loss of normalcy are taking a tremendous toll on students, with the data on mental health being particularly alarming...
Read 14 tweets
Feb 1
"Another approach, which I am beginning to favor, is to state that every person age 5+ can be vaxd & high-quality masks can protect individuals well. Therefore, masks can be optional, not required, even at high rates of community transm'n"

@DrLeanaWen 👏

washingtonpost.com/opinions/2022/…
Thank you, @DrLeanaWen, for messaging the importance of *balancing* risk & reducing *total* harm.
Ppl differ in their recommended threshold for lifting mask mandates etc

That's ok. A robust debate is healthy.

But talking abt trade-offs right now is critical when suffering is social, emotional, occupational, economic & physical.

It's time to more broadly define heath
Read 4 tweets
Jan 22
I’m on call this weekend for my group medical practice. Lots of vax’d patients w COVID—cough, sore throat, headache, body aches, fatigue. Mild to severe.

Other top symptoms?

Guilt
Shame
Fear

“I did everything right.” “I feel like a failure.” “Doctor, I’m terrified.” 1/x
Even if ppl know intellectually that their risk for severe illness is greatly reduced after vax, fear is natural & real. It’s *normal* to get scared when a rapid home test turns positive or when we’re notified abt a positive PCR test 2/x
So when I’m talking to a newly-diagnosed COVID patient, we go thru their symptoms, decide +/- ER care, discuss various treatment options from Ibuprofen to monoclonal Abs & oral antiviral meds (latter for high-risk patients), & how to monitor themselves at home. 3/x
Read 17 tweets

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