Lazarus Long Profile picture
Nov 5, 2022 19 tweets 10 min read Read on X
Another absolutely horrible take by #FireWalensky, @CDCgov

“If you go two years without getting that infection, without getting that protection from infection and then all of a sudden, boom, everybody from zero to three years gets RSV, you see the impact on health care.”
Except. That's NOT WHAT the data shows

As we can see, the biggest spike is in 0 to 6 months, and in comparison to 2018-2019, it is much greater. Roughly, per 100k, 130 versus 70, and it is still spiking.

Second biggest spike is in 6 to 12 months, at almost 80, versus 30 at
its highest.

In the 1 to 2 year olds, almost 40 this year vs. almost 20.
(The Y-axis is higher this year because of more cases).

If what Walensky is saying was true, we'd expect to see the 2 to 4 year olds screaming higher.

It's not.
But the big hitter was the zero to 6 months. What happened there?

Walensky's immunity silliness simply is irrelevant.

But this is relevant:
She really will do everything in her power to minimize CoVid, won't she?

Free version of that article here!
archive.ph/gRg9p

RSV dashboard is here - play with it, see what else you can find

cdc.gov/rsv/research/r…
This is Jose Romero, director of the NCIRD at the @CDCgov.

Jose is not thinking clearly. Has he been infected?

Why do I say he's not thinking clearly?
At the most recent CDC briefing, Jose was asked, why RSV is spreading so quickly and early.
"So we’re seeing more RSV because in the last past two years, we’ve not seen infections in children as we have previously. And so these children, if you will, need to become infected to move forward because it’s a disease very common in children. "

Literally, the XKCD comic.
But the same problem exists.

The biggest spike in hospitalizations is in the babies. 0-6 months and 6 months to 2 years. And the 0-6 months was the BIGGEST spike.

What could cause hospitalizations in that group?

Well, first what causes RSV hospitalizations?

"Pre-F antibody titers were significantly lower in mothers whose infants were hospitalized with RSV bronchiolitis compared with those mothers whose infants were not hospitalized..."

academic.oup.com/jid/article/22…
So, maternal antibodies are important. Could the maternal antibodies have not been passed on because the mother did not get infected?

Fortunately, 95% of people are exposed by the time they are two, so the mother would not have had to be exposed to pass on those antibodies.
Can you imagine?

"Now that you are pregnant, let's schedule your infections. First trimester, we'll do RSV and Ebola."

Silliness.

Let's take another look at that preprint that @fitterhappieraj found

Every infant inherits their microbiome from their mom, and mom's
microbiome diversity was reduced by Covid.

And we know those infants had a unique microbiota, per above, compared to Covidians (those infected).

Indeed, SARS-CoV-2 infections during pregnancy are associated with a compromised initial microbial seed of the infant.
No big deal, right?

Wrong.

"The inherited microbiome exerts marked effects on immune programming with long-term health consequences, including susceptibility to infections or chronic inflammatory diseases and reduced vaccine efficacy"
"Therefore, this “window of opportunity” at birth, either renders infants with a healthy immune system or alternatively establishes a divergent path leading to severe immune-mediated disease susceptibility (16-24). "

Well, that sounds like pediatricians are going to be busy.
To be crystal clear, this study is NOT saying that Covid is responsible for the increase in RSV.

But it is saying Covid causes negative changes at a very important moment in the baby's life, immunologically speaking.

And since we are talking about more severe RSV cases?
It seems to be directly related.

Or, at the very least, much more plausible than a concept invented last year. A concept that Fox & Friends has been pushing.

Was it bleach they last pushed? Or herd immunity?

In any event, both Walensky and the director of the CDC are also
pushing immunity debt like universities pushing student loan debt.

Someone needs #FireWalensky, and put Jose on notice.

@CDCgov? That microbiome spoiled once #FireWalemsky got hold of it.

Maybe probiotics could save the #xkcdCDC. Maybe.
The RSV surge in the 0-6 month old babies, which eliminates "immunity debt/gap" as a viable hypothesis?

Will have very real consequences down the road. This is not surprising given measles ability to wipe out immune memory

frontiersin.org/articles/10.33…

H/t @Gene_PHL @Comm_in_Care

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More from @LazarusLong13

Nov 22
I am not a fan of nasal sprays to stop The 'Vid, but I respect you having it as a layer in the Swiss cheese package.

But, some people have said they got bloody noses.

While at the ER yesterday, I picked up a pretty good at home technique. Let our $1,000 lay-out
Image
save you money.

Use tongue depressors to make a nose pinch clamp.

Leave it on for 30 minutes. Still a problem? Two sprays of Afrin, and re-apply nose pinch clamp. Wait 30 minutes.

Still a problem? Cotton balls sprayed with Afrin, clamp, 30 minutes

aliem.com/trick-of-trade…Image
Image
Image
Afrin- in generic form is $3.32 at Walmart.

Also, put a ice compress at the back of the neck, while doing the above.

"Cooling the nape of the neck is said to induce reflex constriction of the mucosal vessels of the nose"

✅ I agree with the authors.

pubmed.ncbi.nlm.nih.gov/1568881/Image
Image
Read 6 tweets
Nov 13
A study demonstrated 100% PERFECT protection against SARS2 w/ readily available KF94s

✅ 181 HCWs
✅ 1 got SARS2 antibodies, but an epi investigation -> the infection happened elsewhere.
😡 The final checkpoint was March 2021. N95s only became freely available 1 month later
/1 FDA: N95 masks, now plentiful, should no longer be reused  By MARTHA MENDOZA and JULIET LINDERMAN  (Associated Press)  April 23, 2021 12:44 p.m.  Medical providers may soon return to using one medical N95 mask per patient, a practice that was suspended during the pandemic due to deadly supply shortages
What is described in the tweets
in the USA.

Korean study:
jkms.org/DOIx.php?id=10…

This is in comparison to a Swiss study during the same rough time-frame. A study which did NOT show the same excellent results, but dismal results. Why?

The Swiss had the same sort of fit testing,

pubmed.ncbi.nlm.nih.gov/35123572/ Results: We enrolled 3259 participants from nine healthcare institutions, whereof 716 (22%) preferentially used FFP2. Among these, 81/716 (11%) reported a SARS-CoV-2-positive swab, compared to 352/2543 (14%) surgical mask users; seroconversion was documented in 85/656 (13%) FFP2 and 426/2255 (19%) surgical mask users. Adjusted for baseline characteristics, COVID-19 exposure, and risk behaviour, FFP2 use was non-significantly associated with decreased risk for SARS-CoV-2-positive swab (adjusted hazard ratio [aHR] 0.8, 95% CI 0.6-1.0) and seroconversion (adjusted odds ratio [aOR] 0.7, 95% CI ...
PPE monitoring.

What was the big difference?

Are N95s/FFP2s inferior to KF94s?

No, it was supply - and other reasons.
Read 10 tweets
Nov 2
Thread of debunking the myth that "babies should not be masked."

A baby uninfected is better than a baby infected.

If you oppose masking babies, you are immediately for infecting babies.

Let's get to it. A most excellent instruction page on how to mask babies.  Suck it antimaskers.
This solves an equity problem.

Not everyone has the money or technical skill to build a baby buggy PAPR.

Just like not everyone has the money to buy an adult PAPR.

Are you for people on SNAP being able to protect their babies? Or not?

Most can rustle up the money to buy some uber cute baby masks!

This is the link from the baby zine.

These need to be fit tested.

Now, let's get into the good stuff. The "OMG Laz has gone too far! We've got him!"

You better bring your A game.

aliexpress.us/item/325680749…
Read 39 tweets
Oct 22
If you are Covid Aware you have probably been avoiding the dentist. Well, the dental studies have come to you.

This edition? #CovidAwareSoReducingDentalVisits - Water flossing (WF) edition.

Or, as I like to think of it, the Gum Salon.

Thread.
Flossing is necessary for those super tight contact points as you see in the above thread, and is great to remove plaque down 1 mm deep in the gum line (gently).

InterDental Brushes are fantastic and go down 2-3 mm into the gum line to remove plaque.

And WFs in general, are, well, amazing!!

They basically go back and forth with InterDental Brushes on which is better as far as being the top of the food chain for overall cleaning of the space between your teeth.

But.

If you have gum recession, you may have this Image
Read 19 tweets
Oct 9
I remember why I got going on this run of dental care threads.

I got a root canal, and then a cleaning. The hygienist told me that masks cause dental problems. I didn't say anything, but that's complete horse...puckies.

#CovidAwareSoReducing - Plaque/ Toothbrush edition.
It upset me, to be frank, and when I get fired up, I act. Since she is very nice, albeit uneducated on masking, I let it go - with her.

But I decided to figure out what I was doing wrong.
And it was everything.

I was brushing and flossing losing 1-2 microns of enamel
after brushing/ flossing, immediately after eating.

I was nursing sweet Monster/ Starbucks/ my own sweet coffee drinks ALL DAY LONG. A bubbling vat of acid in my mouth.

I was doing the Dr. Ellie Phillips system - but just missing the boat on the importance of replacing sugar
Read 27 tweets
Oct 8
#CovidAwareSoReducingDentalVisits - less mouth open = less 'vid risk.

I am a GREAT flosser. My family thought we had genetic gum disease.

Below we can see rubber stick on the left, floss on the right, and a InterDental Brush (IDB) in the middle.

See the problem?
/1 Image
A couple more example pics on why I am sick to my stomach thinking of all that money wasted.

We THOUGHT we had great dentists. Not a single one mentioned IDBs, and how the bristles allow all interdental spaces to be reached.

And it gets better!

/2 Image
Image
IDBs actually reach down in between the gum and teeth - 2-3 mm. Floss? Only 1-2 mm.

As plaque grows down into and touches your gums, that's what causes them to get inflamed - and begin to retreat (very simplified).

If you brush that space? Problem solved.

/3 Floss, Interdental Brushes, and Waterpics Use all of them - floss works great for those narrow spaces.  Interdental Brushes (IDB) work great in larger spaces.  Waterpics work great immediately after eating, as you want to wait for an hour eating acidic/sweet just like regular brushing.  It is a mistake to NOT IDB.  Multiple studies indicate IDB is good, including this RCT where IDB was better than flossing (free version - great how to brush) - with people with chronic periodontitis.  Students found IDB to be better.  But IDB is better than rubber picks is better than floss.  IDB way better ...
Read 25 tweets

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