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Vincent Rajkumar Profile picture
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Apr 26 • 4 tweets • 2 min read
The high cost of insulin in America. #Insulin4all mayoclinicproceedings.org/article/S0025-… @MayoProceedings
If you have time, please check out my talk on prescription drug prices.
I hoped we would do something. Some states have enacted emergency measures. But overall nothing meaningful has been done to lower the price of insulin in the US.
Minor moves aside like "authorized generics" (which frankly illustrates how broken the system is) and reducing copays, nothing has been done to bring list prices down.

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More from @VincentRK

Vincent Rajkumar Profile picture
Apr 28
Some look at cases and deaths rising in places that previously controlled Covid as an indicator that preventive measures like distancing and masks don't work.

That's wrong.
1/
First, in some places the rise in Covid cases is directly related to 𝙧𝙚𝙡𝙖𝙭𝙖𝙩𝙞𝙤𝙣 of preventive measures. Eg Denmark during omicron

If you completely remove precautions & cases go up it doesn't mean precautionary measures failed. Masks don't work if u don't wear them.
2/ Image
In fact, imagine how much worse things would have been had these places abandoned preventive measures before vaccines were available in 2020 as the (not so) great Barrington folks advocated.

3/
Read 11 tweets
Vincent Rajkumar Profile picture
Apr 21
I've written about how South Korea controlled the pandemic.

But nothing captures the dramatic difference like cumulative deaths over 2 years. It's a painful watch.
Until omicron, South Korea almost completely shut out COVID, and did so without lockdowns. Just standard epi.
Thus year, just as they reopened the highly transmissible omicron hit. And caused a huge rise in cases in South Korea. Deaths also rose.
Read 8 tweets
Vincent Rajkumar Profile picture
Apr 19
Why some people have not got Covid?

Most likely reasons: Some have never been exposed; some have been very careful; some had it but didn't get symptoms; some had it but didn't get tested.

But the big question is: Are there some who are just not susceptible to COVID?
1/
The Antarctic cruise ship story early on in June 2020 raised the possibility that not everyone may be susceptible to Covid.
2/
The White House West Wing and Situation Room example shared by @ASlavitt is another from June 2020 that raised this possibility.
3/
Read 8 tweets
Vincent Rajkumar Profile picture
Apr 14
MGRS (Monoclonal Gammopathy of Renal Significance), MGDS (Dermatologic Significance), MGCS (Clinical Significance) etc are NOT names of diseases.

They are concepts: That a monoclonal gammopathy can cause medical problems besides progression to malignancy.

#MedTwitter
1/
It's akin to saying someone has a bone marrow disorder as a cause for anemia.

Unless you know the specific disease, you cannot approach therapy or prognosis. Just attributing a kidney problem to a monoclonal protein is not enough for deciding therapy or counseling.

2/
So you need to need to both know the specific pathology AND be confident that the pathology is causally related to the monoclonal protein and not a coincidental association.

3/
Read 10 tweets
Vincent Rajkumar Profile picture
Apr 12
BA.2 - Cases may be coming down in the UK, but unfortunately we now see the rise in deaths. What can we learn?

1/ The new Covid variants are not benign. They are capable of harm. ImageImage
2/ Second, it's not that vaccines are not working. They most definitely are.

You can see the dramatic reduction in deaths compared to cases compared to earlier waves. Almost a Mirror Image ImageImage
3/ Third, there is the fact that even now 25-30% are not yet fully vaccinated.

And keep in mind there are many reasons vaccine efficacy is reduced.
Read 5 tweets
Vincent Rajkumar Profile picture
Mar 31
Covid vaccines represent one of the greatest medical advances of all time. They have dramatically reduced risk of severe disease and death.

But they have worked less well in terms of preventing infections, transmission, or durability.

Why?

1/
2/ Covid vaccines were developed rapidly. Although an effective schedule was established, there simply wasn't time to find the optimal schedule.

In retrospect, the first 2 doses were given too close to each other. Also, a 3rd dose should have been part of the primary schedule.
3/ A million daily cases means too much opportunity for the virus to mutate. More replication = more chance for variants that are vaccine evasive, more transmissible, more serious, or all of the above.

In fact it's a miracle that vaccines retained efficacy against severe disease
Read 11 tweets

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