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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
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
Céline Gounder, MD, ScM, FIDSA 🇺🇦 Profile picture
Mar 21
1/ Billions of dollars in @NIH medical research at risk amid Trump cuts
with @jdickerson on @CBSEveningNews
cbsnews.com/video/billions…Image
2/ The total @NIH budget is $48.6B.

It's hard to say how much will be cut in total as the cuts are still in progress, but BILLIONS of dollars will be cut.
3/ This is in addition to NIH dollars that have been held up by delays in approval processes.

If universities can't make payroll, they can't hire & have to let people go.
Read 32 tweets
Céline Gounder, MD, ScM, FIDSA 🇺🇦 Profile picture
Mar 7
1/ A lesser-known fact about measles is how the virus can damage the immune system, leaving someone at greater risk of other infections even after a person has recovered.
with @nateburleson @GayleKing @AdrianaDiaz on @CBSMornings

It's called MEASLES IMMUNE AMNESIA.
pmc.ncbi.nlm.nih.gov/articles/PMC85…
2/ Let’s say you have 2 babies.

As they grow, their immune systems mature & they both gain immunity to different infections – as represented by the different colored marbles. Image
3/ One baby gets vaccinated against measles at age 1 & later at age 4.

It's recommended that babies get their 1st dose at 12-15 months (when antibodies from mom fade away) & 2nd dose at 4-6 years (when kids start school). Image
Read 12 tweets
Céline Gounder, MD, ScM, FIDSA 🇺🇦 Profile picture
Nov 17, 2024
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, 2024
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, 2024
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

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