Rupa Marya, MD Profile picture
May 23 11 tweets 3 min read
The reason the Bay Area is now a hotspot for Covid is because the things that made us ride through well at first (an abundance of caution/masking) now have been thrown to the wind by people who think vaccines and paxlovid will get us through this. These tools will help but not 1/
on their own. Masking is a simple intervention that works to prevent the indoor spread of Covid. Shutting down indoor dining also helps. But the Bay Area has been taken over by libertarians in medicine/public health. The worst possible political orientation for getting through 2/
a collective, infectious challenge such as a highly transmissible virus is libertarianism. Because health of the collective here is greater than the sum of the individuals being healthy. It emerges when we all work together to ensure the possibility of health. 3/
The logic I have seen put forth by some Bay Area doctors is indicative of a certain kind of will to power ethos that you can see in other contexts. Why should I inconvenience myself for a poor/Black/infant/chronically ill person? Why doesn't my own personal liberty matter? 4/
Instead of thinking only of one's rights, it helps to shed light on our responsibilities, to one another. I am responsible for the health and wellbeing of people I don't know, who I don't share the same class with, who live in different neighborhoods, with whom I may never 5/
directly interact. This reality chafes against the political logic of libertarianism that seeks to emphasize our atomization, obliterating our obligations to one another for collective care. But this collective care is exactly what we did in the beginning of the pandemic. 6/
It is why we have done so well. Capitalists and libertarians and libertarian capitalists have pushed their agenda so far and hard in the media that we have forgetten the basic principles of care, how to keep each other safe. Wishful thinking won't do it. This isn't the last 7/
variant. This is only the beginning. We may in time realize how criminal it has been for people who carry MPH after their names to abandon so many protocols we know keep the public safe and guard the public health of our communities. We have lost more people and more people 8/
will now be chronically ill from Long Covid than we had to. It is the misdirection from these experts that has been a great moral injury to those who work on the frontlines, seeing the bodies wracked by this virus in the acute and its more drawn out, life-altering chronic 9/
form. I advocate for caution and care still. Mask up indoors. Keep your gatherings small and outside. Keep the babies and elders safe. Don't eat indoors. Enjoy the beautiful Bay Area in the Spring. This pandemic is not over and we are only making it worse 10/
with our willful disregard of public health measures we know work. We are not atomized individuals. We are people who live in interconnected, interwoven, interdependent communities. Let's act like it and step up to our responsibilities to care for one another. #CareRevolution

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More from @DrRupaMarya

Feb 25
Yesterday I met the guy who developed EPIC. He told me that this was never meant to be a clinician note-taking tool. It was created by accountants to do billing and to capture billable moments. No wonder we hate it so much. Can we please stop now?
If you want to capture billable moments, HIRE SOMEONE to follow me around and capture them. But let me write notes that don't take hours of my work day and then hours at home completing then hours more responding to billing people telling me to rewrite my notes to capture more $$
I wish @UCSF would do that for us. It's crushing how many emails I get telling me to change my language. They should just get it done right by people whose job it is to do billing.
Read 4 tweets
Feb 11
I had shivering chills under 6 blankets, sore throat, myalgias, fatigue, racing heart rate, diarrhea for 16 days in March 2020 after the first Covid patient was transferred to our floor. Occ health refused to test me b/c I didn’t go to China or have “fever & cough.” 1/
They insisted there *no* in-hospital transmission and it wasn’t airborne. Front-facing (lower wage) staff were told not to wear any masks and several got sick. Our response at @UCSF has been a challenge for me from the start. ☹️
@UCSF By the time I convinced them that Walky talky Covid might look different from dying on the ventilator Covid, they tested me on day 18, when symptoms were better. It was negative. I had 8 months of chest pain, dizziness, diarrhea. By the time they ordered antibodies, negative.
Read 6 tweets
Feb 11
One of the things that drove me to learn more about soil health and farming practices was meeting the farmworkers and their children who show up at UCSF with bizarre anaplastic cancers and who refuse to be counted because of our racist border policies and 1/
how that creates a labor pool of people willing to do *anything* including working in toxic fields where synthetic pesticides/fertilizers are sprayed. We don't know the true human cost of Big Ag because they choose to stay invisible for their family's safety. 2/
We must advance a different food system in California--one that is centered in justice and health--for the Indigenous communities, the land workers, the soil, the water and the people who eat the food. We are prototyping an example with the Deep Medicine Circle. In 3 years we 3/
Read 4 tweets
Feb 10
With the Frisco5 Hunger strike I had doctors at @SF_DPH emailing me at work asking me to divulge health information about the hunger strikers. I had to remind them that they were violating federal privacy laws by asking me without consent. @OUSDNews is now 1/ Image
@SF_DPH @OUSDNews saying their concern for the Oakland Schools hunger strikers is motivating them to send EMS. But there’s not an emergency—except the racist policies around depriving Black/brown schools of resources to ensure student success. If OUSD was so concerned for their health, 2/
@SF_DPH @OUSDNews it behooves them to show up in person and bring others to the table to bring this hunger strike to an end. Moses and André have full capacity to refuse EMS intervention. Forcing it on them if they refuse and have capacity to refuse would be assault. 3/
Read 4 tweets
Feb 9
When I share my thoughts on how to create equity in medicine or in society at large, people who I would characterize as liberal often say "Well, I'm not a 'burn it all down' kind of person" to put clear blue sky between ideas of transformative action and their ideas 1/ Image
to offer small adjustments to a highly toxic system.

And with this I ask myself--am I "burn it all down" kind of person? I do recognize the transformative and cleansing aspects of fire, as do most traditional people in human history. It is why fire plays such an important 2/
in customs, rituals and ceremonies. It is a powerful medicine that restores balance, dictated by the earth's tempos.

When people say "Oh, I'm not a 'burn it all down' kind of person," they are creating a false narrative, situating fire as destructive and bad, denying 3/
Read 9 tweets
Jan 18
To spare myself the barrage of emails and concerns from our community, I’m putting out this statement—

UCSF doctors Jeanne Noble, Monica Gandhi and Vinay Prasad have been giving the most reckless and at times, blatantly false analyses on the pandemic. 1/
Monica celebrated the pandemic being over in July 2021. In case you haven’t noticed—It’s not over.

Vinay compared masking mandates to the Holocaust.

Jeanne Noble is putting out FALSE interpretations of our hospital data to support her agenda, which is to be over 2/
and done with the pandemic. We all would like to be but wishful thinking isn’t an analysis of reality.

All 3 have advocated for kids who are vaccinated to be unmasked in schools. I consider their reckless recommendations racist, classist/casteist and ableist. 3/
Read 7 tweets

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