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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
Jun 1
1/ FDA Commissioner Makary joined @CBSNews' @margbrennan on @FaceTheNation this morning: cbsnews.com/video/fda-comm…

Full transcript here:
cbsnews.com/news/marty-mak… Image
2/ Brennan: "...you with the HHS Secretary in this video announcement on Tuesday where Secretary Kennedy said the CDC was removing the COVID vaccine for healthy children & healthy pregnant women from its recommended immunization schedule"
3/ She's referring to this social media post:
Read 34 tweets
Céline Gounder, MD, ScM, FIDSA 🇺🇦 Profile picture
May 31
1/ Trump Administration's MAHA report is being called out for fabricated citations, AI-generated errors & misattributed authorship.

on @CBSNews with @Alexander_Tin & @MajorGarrett6cbsnews.com/video/white-ho…Image
2/ What makes this especially troubling is the report’s claim to be “evidence-based” & “gold-standard.”

Misrepresenting science while claiming to elevate it is not transparency—it’s Orwellian double-speak for sloppy, dangerous pseudo-science.
3/ At first glance, the report warns of serious issues: screen time, mental health, overmedication in children.

Important topics, yes, but the foundation of the report is now in doubt because many of the studies it cites simply aren’t real.
Read 17 tweets
Céline Gounder, MD, ScM, FIDSA 🇺🇦 Profile picture
May 27
1/ Very concerning news from HHS today:
CDC is no longer recommending the COVID vaccine for healthy children & healthy pregnant women.

Why does this have me worried?
2/ Healthy infants may not die from COVID, but they’re at higher risk for ER visits and hospitalizations… both scary & costly.
3/ Pregnant women ARE at higher risk for severe COVID (& influenza).

Pregnancy is a period of immunosuppression (so that the woman’s immune system doesn’t reject the fetus as a foreign body) & stress on the lungs & heart.
Read 9 tweets
Céline Gounder, MD, ScM, FIDSA 🇺🇦 Profile picture
May 23
1/ What’s fueling the surge in childhood chronic illness in the US?

The MAHA Commission blames ultra-processed foods (UPFs)—& their assessment offers a sweeping critique of America’s food system.
2/ Nearly 70% of American children's calories now come from UPFs—foods high in added sugars, refined grains & industrial fats, but low in nutrients.

The MAHA report links this to obesity, diabetes, even behavioral health.
3/ UPFs are designed to override satiety signals (i.e. feeling full).

Kids eat more & gain weight faster.

Plus, many UPFs contain additives that may affect metabolism, mood & gut health.

Think: emulsifiers, artificial colors & sweeteners.
Read 15 tweets
Céline Gounder, MD, ScM, FIDSA 🇺🇦 Profile picture
May 11
1/ A new study from South Korea suggests the shingles vaccine may do more than just prevent shingles—it might also protect your heart 🫀.
on @CBSMornings with @GayleKing @vladduthiersCBS @nateburleson
2/ Researchers followed over 2 million adults for a decade.

Those who got Zostavax—the older, live shingles vaccine—had a 23% lower risk of heart disease, including heart attacks, strokes & heart failure.
3/ That cardiovascular protection wasn’t short-lived.

It lasted for up to 8 years after vaccination.
Read 14 tweets
Céline Gounder, MD, ScM, FIDSA 🇺🇦 Profile picture
Apr 9
1/ My colleague @DrLaPook's interview with @HHSGov @SecKennedy raised critical questions about public health, vaccines & government responsibility.

on @CBSMornings
2/ RFK Jr, a longtime vaccine skeptic, now recommends the measles vaccine during an outbreak.

This is a significant shift, but his statements on vaccine safety testing need clarification.
3/ Vaccines undergo rigorous testing in Phase 3 & 4 clinical trials, often lasting years to decades.

Claims that vaccines are tested for only "3-4 days" without placebos are misleading.
Read 16 tweets

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