Lots of chatter in my feed & my DMs this AM about Paxlovid & “rebound.” Let’s be mindful of the diff ways this term is getting used & interpreted, #MedTwitter. Some are referring to return of symptoms after feeling better, others to triggering more severe symptoms… /1
Others are using “rebound” to mean going from rapid test neg (not contagious) back to positive (contagious) again; still others are using it to mean increased short-term risk of new infection w/ same #Covidvariant. People are suggesting alt dosing, duration. Stop, stop, stop. /2
Learn from #pandemic yr 1&2. This conversation has gotten way ahead of the data. We risk inadvertent #publichealth harm from the mis/dis-info machinery if we speak/act imprecisely here, esp without data. Next tweet has an article w/ a good summary of what we do & don’t know. /3
apple.news/A5N_VQqTpQH62W…

This 🧵 was directed at #MedTwitter & all those not in science/medicine who count on us for good info in this #pandemic, but same admonition to #SciComm. (Thanks for all you do, fellow drs, scientists, & journalists.) This article is a good summary. /End

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More from @tmprowell

May 7
Here are 2 family members, similar ages/#MedTwitter history, #vaxxed & #boosted, dev symptoms & tested pos same day, got Paxlovid same day. Day 4 tests below. Why are we still using a 'one size fits all' strategy to exit isolation when rapid tests are readily available, @CDCgov ?
I doubt policy will change (note: shortening isolation to 5d was done to minimize societal impact from loss of essential workers to isolation in Jan #Omicron wave), so you should choose to rapid test to exit isolation. A positive = contagious, no matter how many days it's been.
Here's another example. Two more people, again similar age/health history, both vaxxed and boosted. On the left, patient #1 on day #13. On the right, patient #2 on day #5. We'll see what happens with patient #2 but I'd be willing to bet they can leave isolation well before 2 wks.
Read 4 tweets
Apr 28
There's another 🌊 of #COVID19, y'all. I have gotten more texts since Mon asking questions about monoclonal antibodies, about Paxlovid, about rapid tests, & on & on than I have in the whole month preceding. Be aware. All these folks tested at home & are uncounted in tallies.
This is anecdotal, but a pattern recently: people staying pos longer on rapid test. Here's an older pt, 4 doses Moderna #COVID19 #vaccine, mono Ab on d1, feels 100% now, & still quickly/strongly pos (ie very contagious) on d10. Had he not retested, he might be infecting others.
@CDCgov shortened isolation to 5d in Jan b/c they were concerned society may fail to function w/ huge #s of essential workers out for 10d in #Omicron surge. This has to be changed. People are leaving at d5 w/o masking or testing. They need to rapid test to exit or isolate longer.
Read 4 tweets
Apr 27
Invited to a destination wedding earlier in Apr. Awesome place that holds a special place in my ❤️(Vail). Lots of people I miss. All #vaxxed. Many boosted. No masks required. No rapid tests. Declined. One positive couple next AM. Groom & all but 4 guests got #COVID19. #pandemic
In care you’re wondering who did NOT get infected, the common elements were 4 doses of #COVID19 vaccine OR known/suspected past infection + 3 doses of vaccine, with last dose being recent.
That includes the bride. But if you want to know how to put that “in sickness and in health” thing in action, having discordant #COVID19 test results when you should be honeymooning is one way. 🤒👎

I now know where Paxlovid is & isn’t available is about a third of US states.
Read 5 tweets
Apr 22
Well, it was fun while it lasted. And remember that official case counts are just the tip of the iceberg. Most people are being diagnosed via rapid testing at home & never appear in these totals at all. If you aren’t #Boosted, now’s the time. #MaskUp #COVID19
Let me add that my major reason for concern at this point is less about deaths in the short-term. Though we continue to lose a couple thousand Americans per wk to #COVID19, & it wasn’t mild for any of them, deaths are much lower than they’ve been in a long time. /2
I’m worried about the people we are now seeing with persistent cognitive impairment (like early dementia kind of symptoms), given that we now know #COVID19 can shrink the brain even in otherwise “mild” cases. forbes.com/sites/williamh…
Read 9 tweets
Apr 21
I am a dr who has dedicated her career to people w/ #cancer.
I am the grateful daughter of a #lymphoma survivor.
I have #asthma.
Why wouldn't I #wearamask if it might prevent an illness, death, or #longcovid disability?
If you find masks uncomfortable, I can suggest some to try.
(And then I'm going to talk to you for the ENTIRE flight & all the way down the terminal to baggage claim & ground transportation about masks, so be ready if you're in the seat next to me & do this. Might be better just to #WearAMask.😂)

#MedTwitter #TrueStory
And then when I change your mind, you'll be in an airplane thumbs-up selfie with me wearing your favorite of the several brands of spare N95 masks I have in my backpack.
Read 5 tweets
Apr 19
.@Delta @united @americanair @southwest, can y'all break it down for us why seatbelts, why bags "fully under seat," why seat backs & tray tables "full upright & locked position for landing"? We can't choose to risk ourselves & others at risk on the plane...or something? #maskup🤷‍♀️
You know, it's a hassle to have to contort myself to get my bag out from under the seat when we arrive. And I often have to make slides on my flights. I like to use every minute to work on them from boarding to exiting. Also it's a lot easier to do that with the tray table down.
It's almost as if you expect passengers to sacrifice their own needs & comfort a little for the safety of themselves & those around them. That's wild. I thought we had quit that.
Read 4 tweets

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