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Abraar Karan

Mar 13 • 11 tweets • 7 min read

1/ Over time, the effects of #covid19 on heart, brain, lungs, vascular system, sensory system, kidneys & more will become better understood

Until then, any reassurance that massive levels of infection are ‘ok’ for society is a gamble—a gamble with unknown long-term costs.

2/ Recent work highlighting effects of #SARSCoV2 on brain structure
nature.com/articles/s4158…

3/ Risk of heart disease, heart attacks, strokes sig higher even after mild cases of #covid19

nature.com/articles/d4158…

4/ effects on vascular system, including erectile dysfunction (would suspect this alone would promote more vaccination & mask use in men…) #covid19 #LongCovid

nytimes.com/2022/03/01/hea…

5/ Lung disease perhaps one of the better characterized problems post-infection — many w #LongCovid have ongoing shortness of breath or decreased lung capacity

bbc.com/news/health-60…

6/ Effects on kidneys was clear early on even from first cases we were seeing in 2020– long term effects outlined here:

nature.com/articles/s4158…

7/ Effects on ability to smell (& taste)— personally know people in whom symptoms were persistent for weeks - months

scientificamerican.com/article/covid-…

8/ Increased risk of clot formation — also well known, secondary to inflammation

npr.org/2022/01/09/107…

9/ For some, even potential for long term effects is not enough to convince them that we need safer buildings, cleaner air, better masks, more equitable vaccine distribution, more tests.

Many have instead used this time of lower incidence to mock & make mitigation seem futile

10/ But regardless of anyone’s opinion now, if we are wrong— if the long term inflammatory effects of this virus are worse than we are recognizing short term—no one will be held accountable (certainly not those who are reassuring you that infections aren’t a problem any more)

11/ This isn’t about masks or restriction or politics. Ask any infectious disease doctor— we regularly are consulted on cases Post-Covid with ongoing inflammatory processes. Some are mild, some are moderate, some are severe. All are new to us— we are only a couple years in.

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Abraar Karan

@AbraarKaran

Mar 10

1/ Over the past two years, we have discovered therapeutics that work for #covid19 such as Remdesivir; later we figured out the optimal time to use them. Months from now, we will have even more data & meds to use.

Delaying infections does have a benefit

2/ Over the past two years, we have discovered that #covid19 has effects on the body that are significant, even if they don’t kill you. The virus affects the heart, brain, vascular system & more. The costs become clearer over time.

Delaying infections makes those costs clearer

3/ When big waves of infection come down, the chance of getting infected during any given activity also goes down. We have certain measures— such as high filtration masks— which, if used right, can protect you through a wave. There are many who haven’t been infected.

Read 6 tweets

Abraar Karan

@AbraarKaran

Mar 10

Perhaps unsurprising, those most readily downplaying the risks of #covid19 infection, incl #longcovid, have also never treated a covid patient.

You’ll be hard pressed to find many doctors doing this— we have seen enough patients die, or survive & still suffer afterwards.

2/ We have had a lot of spread — & we are at risk of a lot more (unmasking of course not helping). Telling ourselves it is mild doesn’t make that true, esp re more chronic health consequences.

Masking alone won’t solve this either. There’s a lot more needed than that.

@jlsalinas7

3/ While many have been infected with #Omicron, there are likely many who have not been. With increases in BA2 variant, I suspect we will have enough susceptible people to sustain some level of resurgence soon, but unclear what that will look like. I hope I’m wrong. @jlsalinas7

Read 5 tweets

Abraar Karan

@AbraarKaran

Mar 1

1/ The US #covid19 dialogue is overly focused on how restrictions are being lifted and what experts think about that

The questions I care about right now:
-what are we doing for preparedness?
-what are we doing for health equity?

2/ I want specifics from my government and leaders

How is indoor air/ventilation going to be improved in schools, businesses and public places? What's the timeline? What's the cost? Who is paying? What's the accountability mechanism if this doesn't happen?

3/ When will N95 mask supply be increased and to what extent? How will it be distributed? What were previous bottlenecks & how have they been addressed? When will more comfortable options be added? Will poorer communities have more access & supply? What about the terrible comms?

Read 5 tweets

Abraar Karan

@AbraarKaran

Feb 20

1/ Unmasked exposures & Long Covid 🧵

There is potentially a relationship between inoculum dose (amount of virus you are exposed to when you get infected) & development of #LongCovid

Having higher early viral load may increase risk of Long Covid

nytimes.com/2022/01/25/hea…

@MonicaGandhi9

2/ Earlier in the epidemic, @MonicaGandhi9 & Dr Rutherford from UCSF brought up variolation hypothesis as it relates to masking

Could masks have the benefit of reducing the viral load you are exposed to & could this potentially lessen severity of disease + prime immune system

3/ What is concerning now— if you pull back on mask mandates with high community incidence, especially in places with low vaccination / low booster rates

Lots more unmasked viral spread

Higher potential proportion of #LongCovid cases esp in these areas

Important to track this

Read 4 tweets

Abraar Karan

@AbraarKaran

Feb 20

@politico

More hospital-based spread of #covid19 during #Omicron than any prior waves. We knew this was a problem from prior waves— yet there is ongoing resistance to acknowledge it, to test for it, or do more to prevent it.

@politico
politico.com/news/2022/02/1…

@JAMA_current

2/ We wrote about this issue in @JAMA_current outlining ways to slow hospital-based spread with Omicron.

It remains to be seen whether this will be utilized in hospitals, or if we’ll keep the status quo and pretend this isn’t a problem.

jamanetwork.com/journals/jama/…

3/ & even this is an undercount!

“The total # of people who contract Covid-19 while in the hospital remains unclear bc these figures only count patients who were in the hospital at least 14 consecutive days & don’t account for people who test positive after leaving.”

Read 5 tweets

Abraar Karan

@AbraarKaran

Feb 19

False dichotomies like lockdowns versus dropping all safety measures (“restrictions) are largely unhelpful & serve only to polarize

We can have safer schools.

We can have safer workplaces.

We can have safer public spaces.

We can drive & keep incidence down.

2/ The immediate reflexive response to this is always “but vaccines”

‘Vaccine only’ strategies will not work

The roll out of boosters every season (or more) will not keep up with future virus surges

They won’t fully protect us if we are faced urgently w a deadlier variant

3/ Vaccines are amazing - they prevent severe disease & death. They likely play a role in reducing Long Covid/ significant inflammation. Get vaxx’d

But even now our roll out of both primary doses and boosters has been too slow and/or patchy across states. Omicron outpaced us.

Read 4 tweets

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