WesElyMD Profile picture
Aug 10 4 tweets 3 min read
1/🧵 Is MonkeyPox airborne?

I’m not an ID specialist, but evidence from this often cited 2001 @Nature study does NOT speak to usual #MPX exposure.

The Methods describe high dose, highly lethal variant. This is more like being sprayed w viral fluid.

go.nature.com/3vMCbkP
2/ Is MPX airborne?

This 🧵 is to alert readers that methods of studies are critical to analyze. These authors set up an experiment that was designed to be as HIGHLY infectious as possible w a dose & delivery highly unlike what we see in society. They even got rectal lesions.
3/ There’s no doubt that respiratory secretions from prolonged close physical contact (kissing) are a way to transmit monkeypox. That is NOT the type of droplet transfer across multiple feet of physical separation we have to worry about.
4/fin
More data are coming. Let’s be cautious.

We’re waiting to clarify standard & alternate modes of #MonkeyPox transmission.

Meanwhile, our best bet is to avoid close skin to skin contact and for high-risk people to be vaccinated.

The best reason to mask up is #COVID B5!

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More from @WesElyMD

Aug 8
1/🧵 The Animal Rule & TPoxx for MonkeyPox

Huh⁉️
 
📌This antiviral drug Tecovirimat or TPoxx was FDA-approved for SmallPox by testing it in animals (not humans) w #MPox

📌 We need lots more data in humans to know how good it is.

What does this mean?

bit.ly/3PWJWwI
2/ First, be clear that the vesicles & pustules of #MonkeyPox rash can be super painful.

The infection can include eyes and soft tissue super infections.
 
Stay clear of close skin to skin contact with anyone infected (contagious for duration of rash, ie, 2 to 4 weeks-ish).
3/ I highlighted this fascinating @NEJM paper for you...
 
Essentially the drug approval process for TPoxx, a med you’ll get if you get seriously sick with MPox, goes back 34 years to the HIV epidemic and also Small Pox.
 
Read up…link to this paper is in tweet #1
Read 7 tweets
Aug 3
1/🧵 MonkeyPox, ChickenPox, SmallPox:

Let’s talk poxpoxpox…
 
✔️#MonkeyPox has 4 deaths
✔️Is it a panedmic?
✔️What do you need to know?
✔️Here are key take homes
 
JAMA -bit.ly/3S6IKs9
2/ Many people are holding off calling #MonkeyPox a pandemic.
 
Epidemics that “get passports” travel.
 
Mpox seems to have a global passport.
 
Sustained spread in >80 countries seems likely.
 
bit.ly/3ShYQzf
3/ The window for controlling Mpox is closing - eternal optimists are hoping enough vaccination can beat it.
 
Judging by how we handled #COVID, I’m betting Mpox will win.
 
@DrEricDing @kavitapmd make great points:

wapo.st/3NSdGcr
Read 18 tweets
Jul 29
1/🧵 Worrying
 
If I’m #worrying, I’m usually either troubled over a past event or fearful of some hypothetical future event that might never happen.

📍Neither is real time.

The #present moment is where the action is if I really want to make a difference & find peace.
2/ In #Al-Anon (a spiritual but non-religious program I attend), we say that worrying is like a rocking chair. I’m doing something, but I’m getting nowhere.

If I want to get to a place of spiritual enlightenment, I must learn to #Live in the #NOW.

It’s easier said than done.
3/ Try moving thoughts of the past & future from your mind to create space in your 🧠 to completely soak up the “now” you’re living in. Imagine when you remove those past & future thoughts that are you actually have space to allow the present moment to fill your thoughts.
Read 4 tweets
Jul 18
1/🧵 Training Young Docs & Nurses💥

#JULY is a big time of year for medical trainees who move to the next level of their careers.

Question: How do I best serve them as a teacher & help them succeed?

Tip: this helps me be a better dad & husband, too.

#NurseTwitter
#MedTwitter
2/ As a “coach” of younger doctors (or my kids or athletes, etc), there are certain truths I have learned:

Ultimately, students’, athletes’ and children’s successes and failures are their own. Not mine.

I shouldn’t take credit for their successes nor blame for their failures.
3/ I must, of course, protect patients from misdiagnoses & treatment errors.

While overseeing younger physicians’ progress to independence, I have to prioritize patient safety.
Read 8 tweets
Jun 27
1/🧵 Hacked on Twitter - what did I learn⁉️

I & other physicians’ @verified @Twitter accts were hacked last week…
 
This “micro-dose” of being silenced reminds me to do all I can to amplify the voice of others.
 
And it made me want to share a few thoughts about this platform…
2/ How did it make me feel?

📍Vulnerable
📍Silenced
📍At the mercy of others
📍Out of control
📍Small

Of course, it’s just social media

But how we handle ourselves here prepares us to fight #Testimonial #Injustice

No one wins if we stifle the voice & truth of another person.
3/ Detachment

I’ve been working on detachment from the lure of worldly things.

When the hackers stole control of my account, my 1st thought was that this was a perfect opportunity for me to practice detachment.

If I’m truly detached, my pulse should remain a calm 46 bpm 😎
Read 11 tweets
Jun 15
1/🧵 Long COVID Brain Science: 🧠

For ~100M suffering 🌎, let’s use data to combat myths & #Misinformation

COVID is biologically dangerous long after virus is gone

#LongCOVID affects our….

📍Olfactory & Limbic Systems
📍 Interferon Autoimmunity
📍PET scans
📍Astrocytes

How? Image
2/ First, Epidemiological comparisons…

FLU vs. COVID

Survivors of viral infxns like #Flu don’t complain of 200 long-term symptoms & ~90% ongoing mood disorders.

#LongCOVID pts do.

Flu kills 0.5M/year vs COVID has killed 10X that (5M) in just 2 years.

bit.ly/3mJTBK4
3/ Consider this:

A study of 150k COVID survivors, hospitalized & not.

COVID survivors had 10-15X ‼️higher risk of considering #suicide at 1 year than 11M control patients.

This is horrifying, yet people still deny #LongCOVID’s importance.

WHY?

bit.ly/3HnHZpB ImageImageImage
Read 27 tweets

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