1/n A small thread on what I found problematic with Dr Jha's & what I liked - first ❤ " I always lean on people getting more rest - so people who were pushing for @Potus to work dont have Dr Jha's support -Potus isn't Superman ,he should rest & that should be the messaging ctd)
2/n I have trouble in accepting that its going to be simple- already seeing pet animals being infected - a reservoir is being fast built , we wasted crucial time in thinking it will remain within the MSM circuit , didn't stop pride marches-didnt trace well - missing chance ctd)
3/n There is a big problem that there is lack of data , data has to be seen real time - There isn't enough vaccines to do ring vaccination- there should be proper state ,federal coordination - this passing the buck doesn't help ctd)
4/n the virus has been endemic- we had the plan - we created National stockpile BUT didn't update ourselves - the old vaccines are available ( though only for 1/3 US population), we missed 2 crucial months - with an animal reservoir- elimination will almost be impossible ctd)
5/n Let's remember that there is information that others are being infected as well -physicians,kids & now animals & who are the physician groups we are engaging with ?? There arent enough tests or vaccines , also we need to remember #vaccine Equity, US can't do it alone ctd)
6/n Regarding Polio - this is VDPV, we need to globally work on preventing VDPV emergence, there has to be global surveillance on it BUT we are dismantling the tools that we used for surveillance- that stands for most diseases including Covid ctd)
7/n We need to make fundamental changes- these bandaids wouldn't help -with climate change on our planet we are entering unchartered territory;#hopium wouldn't help - planning for worst case scenario will in my humble opinion 🙏🙏

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More from @Rpshahmemorial1

Jul 25
Small #monkeypox thread - detected in 10 of the 11 sewer systems that SCAN (Stanford’s Sewer Coronavirus Alert Network) tests, including Sacramento, Palo Alto & several other cities in California’s Bay Area. So we are going to see big outbreak in 2-3 weeks apparently.ctd)
2/n Bavarian Nordic can produce 30 million doses/ year and so far hasn’t turned down any orders from governments, considering night shifts & other tweaks would bring production above 30 million but in 3-4 weeks they will reach the tipping point - with the virus ripping ctd)
3/n this will throw couple of scenarios- 1) they would be forced to transfer tech which they dont want & is not east to do 2) countries may be forced to use old tech with higher incidence of myocarditis risk which will be difficult to get people to agree to use ctd)
Read 4 tweets
Jun 22
Why are we going to see an avalanche of infertility,problems in conceiving in the next couple of years?? Well this is a 500 plus young men less than 29 yrs cohort in swiss army who were evaluated & higher incidence of lipid issues,pre -diabetes found ctd)
doi.org/10.1101/2022.0…
Ctd2 we already know from past studies that 26% of young take more than 2 weeks to be " Normal", interestingly this one study used a larger number of parameters to prod a little more than others ctd)
Ctd3)They used diffusion studies in addition to standard spirometry, PRO-BNP & Troponin to evaluate cardiac function,test on treadmill to stress the system,sniffing tests , eye tests, taste tests, psychological tests, sperm count & testosterone levels in post #Covid males ctd)
Read 5 tweets
Jun 21
Long Thread on Health Risks with Reinfection . While the Herd Immunity brigade has been pushing their agenda,we need to understand the risk of multiple reinfections .It is an interesting cohort with 12.29% with 2 reinfections 0.76% with 3,.08 with 4 ctd).doi.org/10.21203/rs.3.…
Ctd2)Clearly the time for reinfections is getting shorter 79 for 2nd to 65 days for 3rd & so on.Also the hazard is not only to the lungs BUT also to heart,blood vessels ,Gastrointestinal systems, kidney , the brain, the soft tissues and bones & the brain in that order ctd)
Ctd3) clearly if you are not vaccinated you are at higher risk BUT only vaccination isnt enough #VaccinePlus strategy is important , the risk remains high for 6 months with measurable reduction every 30 days BUT we are getting reinfected in that period (now 65 days ) ctd)
Read 5 tweets
Jun 19
Was talking to a physician colleague 50/M who said he has increased incidence of migraine like attacks lately and also reported a bad #Omicron bout 4months ago that caused him bed bound with weakness 1 week , cough for 3 weeks.Then while discussion he casually described ctd)
Ctd2) That after 3 months of the infection he faced a peculiar situation- for 4 days he was trying to remember the name of anti fibrotic agent , he said he could have easily opened the book or internet and checked BUT he wanted to assess , the antifibrotic he was trying to ctd)
Ctd3) remember he has used in at least 300 pts during the wave 3 months before & at least 500 overall , still his memory was failing him for 4 full days ,he also reported that he is unable to remember the songs that he was singing on & off which he loved ,remembered earlier ctd)
Read 5 tweets
Jun 6
1/Prolonged discussion with Pediatric colleagues in the core group @Rpshahmemorial1- findings - we are having increased incidence of red eye, apthous ulcer ,recurrent fever every month & Lymphopenia like this in kids , we will watch this but we are very concerned #COVID19 ctd)
2/ Though it is currently anecdotal information we hope that in a day or two we will be able to collate more data on this , most of these kids turn out to be negative on testing BUT have had family members who were positive in the recent period , others ctd)
3/n in the core group noted that apthous ulceration has increased multi fold over the last 1.5- 2 years and so have red eye syndrome , in many these kids are an overlap group. There is also anecdotal information of vague joint pains which appear like post reactive synovitis.
Read 4 tweets
May 31
Top 225 updates on #monkeypox, we posted until 200 here , again posting them & will start a thread from 201 onwards below this tweet
Here you go ....
201/n @mdc_martinus posted how #PublicHealthOntario accepted potential for #airborne transmission of #monkeypox, agree that this is the correct public health policy ctd)
202/n @BNODesk reported 134 cases globally today with the peak crossing the previous high of 100 , globally 700 plus cases ctd)
Read 21 tweets

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