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Céline Gounder, MD, ScM, FIDSA 🇺🇦 Profile picture
@celinegounder
Oct 2, 2022 • 30 tweets • 16 min read • Read on X
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1/ Must read by @TheAtlantic's @edyong209:
theatlantic.com/health/archive… Image
2/ Why did the United States of America🇺🇸 fail so spectacularly?

The Death Toll Says It All
by me for @TheAtlantic last December:
theatlantic.com/health/archive… Image
3/ The American healthcare system is designed for profit-making, not to care for patients & to help them stay & get healthy.

The point is to monetize every box, circle, arrow, & line in the flow chart: Image
4/ But we, the United States of America🇺🇸, refuse to learn.
theatlantic.com/health/archive… Image
5/ We have a once-in-a-generation opportunity to fix our crumbling schools
thehill.com/opinion/educat…
by me & @j_g_allen in @thehill Image
6/ Pandemics are by definition a collective action problem, not a problem for individuals to solve on their own.
theatlantic.com/health/archive… Image
7/ How America Can Rebuild the Community Bonds It Needs to Face the Next Pandemic
time.com/6138465/covid-…
by me, @RobertDPutnam & @shaylynromney for @TIME Image
8/ We need to build a sense of community because we have MANY more "we" problems ahead of us.
time.com/6138465/covid-… Image
9/ How can we build that sense of community?
time.com/6138465/covid-… Image
10/ How can we build that sense of community?
time.com/6138465/covid-…
(continued) Image
11/ How can we build that sense of community?
time.com/6138465/covid-…
(continued) Image
12/ How can we build that sense of community?
time.com/6138465/covid-…
(continued) Image
13/ How can we build that sense of community?
time.com/6138465/covid-…
(continued) Image
14/ We are not all free to protect ourselves & live healthy lives.
theatlantic.com/health/archive… Image
15/ In the United States of America🇺🇸, we blame people for getting sick & dying.
theatlantic.com/health/archive… Image
16/ Sickness & death are divine punishments for being somehow less deserving.
theatlantic.com/health/archive… Image
17/ Epidemics & pandemics are SOCIAL problems.
theatlantic.com/health/archive… Image
18/ "Medicine is a social science, & politics nothing but medicine on a grand scale."
onlinelibrary.wiley.com/doi/pdf/10.111…

But neither healthcare providers nor public health workers are armed with the tools for this work.

We're often ACTIVELY DISCOURAGED from doing such work. #ThisIsOurLane Image
19/ Americans are blinded by scientific & technological progress, not realizing that too few us of are benefiting from it.
theatlantic.com/health/archive… Image
20/ When we need public health most, our leaders are waging war against it
washingtonpost.com/outlook/2020/0…
by me for @washingtonpost Image
21/ Tools don't work if you don't have them & can't use them.
theatlantic.com/health/archive… Image
22/ The United States of America's🇺🇸 racist history has left us blind to policies that other developed nations have adopted, like paid sick & family medical leave or universal health insurance. Image
23/ When we need public health most, our leaders are waging war against it
washingtonpost.com/outlook/2020/0…
by me for @washingtonpost Image
24/ How can we put covid behind us without guaranteed paid sick leave?
washingtonpost.com/opinions/2022/…
by me & my @KFF colleague @Mollybrodie in @washingtonpost Image
25/ The pandemic isn't over.
26/ Even when we do make the transition to endemic, it does NOT mean COVID will have come to an END.
theatlantic.com/health/archive…
27/ It's in OUR POWER to decide at what levels to control COVID:
🔹at high levels of endemicity
(e.g. HIV or tuberculosis in parts of Africa)
🔹or low levels of endemicity

It's in OUR POWER to shape the "new normal. Image
28/ What might our "new normal" with COVID look like?
29/ What might our "new normal" with COVID look like?
30/ What about 300-500 deaths per day?
or 150K deaths per year?

Is that our new normal?

The United States of America🇺🇸 can do better.

That starts by imagining better.

That should be Our American Dream.

• • •

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More from @celinegounder

Céline Gounder, MD, ScM, FIDSA 🇺🇦 Profile picture
Nov 17
1/ I explain how RFK Jr's plans could affect Americans' health.

He is known for falsely claiming that vaccines cause autism & other health issues.

cbsnews.com/video/doctor-e…
2/ RFK Jr: "The problem with the measles vaccine is that it's a leaky vaccine. It doesn't provide sterilizing immunity."

It's true that the measles vaccine doesn't prevent ALL infections.

It's ~97% effective after 2 doses.
3/ In rare cases, vaccinated people may get infected & transmit the virus to others.

This is all the more reason for vaccinating everyone in a community, not just those who feel like it.
Read 13 tweets
Céline Gounder, MD, ScM, FIDSA 🇺🇦 Profile picture
Nov 16
1/ RFK Jr. to lead @HHSGov US Dept of Health & Human Services

with @AdrianaDiaz & @tonydokoupil on @CBSMornings
2/ Kennedy has criticized multiple public health agencies he could now lead.

He's said the @US_FDA's "war on public health is about to end," claiming the agency suppresses anything that "advances human health & can't be patented" by pharmaceutical companies.
3/ But Kennedy's statement demonstrates a common misunderstanding about public health authorities in te US.

We are the United States of America — public health powers reside at the state level.
Read 23 tweets
Céline Gounder, MD, ScM, FIDSA 🇺🇦 Profile picture
Sep 19
1/ A new report from the American Association for Cancer Research @AACR finds that excessive alcohol use is a risk factor for at least 6 cancers.

with @GayleKing @vladduthiersCBS @tonydokoupil
2/ Heavy drinking is associated with an increased risk of:
🔹head & neck cancer
🔹esophageal cancer
🔹stomach cancer
🔹liver cancer
🔹colorectal cancer
🔹breast cancer Image
3/ Drinking during pregnancy can also increase the risk of leukemia later in childhood.

At least 5% of cancers are attributable to alcohol.
Read 19 tweets
Céline Gounder, MD, ScM, FIDSA 🇺🇦 Profile picture
Aug 15
1/ Yesterday, the @WHO declared mpox a public health emergency of international concern (PHEIC).

This is the 2nd time in 2 years that the WHO has declared a PHEIC for mpox.

with @vladduthiersCBS on @CBSMornings
2/ There have already been more than 17K cases in Africa so far this year – more than the total for all of last year.
3/ @WHO announces a Public Health Emergency of International Concern (PHEIC) when there is a significant risk to global health & it requires an internationally coordinated response.

A PHEIC:
🔹helps marshal funding for a public health response
🔹pressures governments to act
Read 22 tweets
Céline Gounder, MD, ScM, FIDSA 🇺🇦 Profile picture
Jul 27
1/ COVID study shows mask and vaccine mandates saved lives

with @CBSNews' @LanaZak cbsnews.com/video/covid-st…
Image
2/ A new study published in the JAMA Health Forum yesterday found that:
🔹mask requirements & vaccine mandates were associated with ⬇️ deaths
🔹prohibitions on vaccine or mask mandates were associated with ⬆️death rates

jamanetwork.com/journals/jama-…
3/ Activity limitations (e.g. closing schools, restaurants, bars; stay-at-home orders; restrictions on leisure time activities & public gatherings) likely provided minimal benefit while imposing substantial cost.
Read 6 tweets
Céline Gounder, MD, ScM, FIDSA 🇺🇦 Profile picture
Jul 26
1/ New Hope Against Dementia: study says singles vaccine also appears to delay onset of dementia
with @CBSMornings' @tonydokoupil @AdrianaDiaz @nateburleson
2/ A study published yesterday in Nature Medicine found that the new Shingrix vaccine was more protective than the old Zostavax vaccine in delaying dementia.

The Zostavax shingles vaccine was discontinued after the Shingrix vaccine was approved.

nature.com/articles/s4159…Image
3/ The Shingrix vaccine is also more protective than Zostavax in preventing shingles.

Shingles is caused by the varicella-zoster virus (VZV), a herpes virus that also causes chickenpox.
Read 15 tweets

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