"Surviving the COVID-19 #Pandemic: Things I Have Learned (So Far)"

A pandemic mitigation primer geared toward my students.

Full video (40 mins):
vimeo.com/showcase/10115…

Refs in the PPT notes:
psychmike.com/Hoerger_pandem…

Video segments in thread🧵 Picture of video segments
1. Introduction

COVID cases and deaths were surging in New Orleans right when I launched a project working with people who are seriously ill.

Thus, I began studying COVID mitigation.
vimeo.com/789390581
2. COVID is NOT "A Cold or the Flu"

It is among the most serious illnesses.

COVID has caused life expectancy to plummet. Ppl are getting disabled. 1.5 million Americans can't work. Vascular dysregulation is concerning. Effects are cumulative.

vimeo.com/789392012
3. SARS-CoV-2 is Airborne

We need to understand, "How do you get COVID?" in order to understand how to NOT get COVID.

#COVIDisAirborne -@kprather88
#COVIDispurelyairborne -Jha😉
vimeo.com/789391914
4. Multi-layered Mitigation

I would always take the risk reduction offered by vaccines & we need a multi-layered approach.

-Fed $$$
-Surveillance
-Contact reduction
-Testing/isolation
-#N95
-#IAQ
-#Vax
-Treatments
-#Palliative & more

vimeo.com/789391999
*≈17% not "18.5%"
5. Quarantine, Isolation, & Testing

"The federal guidance on this is... underdeveloped."
"The time course issues are very serious."
"Often a combination of #PCR and rapid testing (#RAT) can be very useful."

h/t @michaelmina_lab (pinned)

vimeo.com/789392025
6. Masking - High Quality, Well-Fitting, Authentic!

We need N95 or #BetterMasks. Earloop masks are insufficient. Always buy directly from the manufacturer or a trusted site. Universal masking is best.

vimeo.com/789391967
*PAPR = powered air-purifying respirator
7. Cleaning the Air

Let's remove viral-laden aerosols from the air so people do not inhale them & get COVID.

We need much higher air-cleaning targets to create inclusive public spaces, such as schools.

#IAQ #CorsiRosenthalBox #HEPAisReallyPretty
vimeo.com/789391932
8. Dealing w/ Illness

Take immediate action in the home when someone is ill. Get Paxlovid. Rest! Take symptoms seriously. Seek #LongCOVID care.

An inclusive society protects ppl w/known vulnerabilities & unknown vulnerabilities -- which might be you.

vimeo.com/789391951
The video is required viewing for my graduate students before they attend class this week.

If you found my pandemic video helpful, you are welcome to share it with your students, friends, and family. No need to ask.

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More from @michael_hoerger

Dec 23, 2022
In an Invited Editorial in @JAMAOnc today, my colleagues & I call for health systems to develop “Comprehensive #Pandemic Support Programs” for their most vulnerable patients.

These are our Top 10 Tips!

THREAD 🧵
jamanetwork.com/journals/jamao… JAMA Oncology article, "Variability in COVID-19 Vaccine
Tip #1: Health systems should explain to all patients that #COVIDisAirborne and is best avoided through multi-layered mitigation. Swiss Cheese model of COVID mitigation
Tip #2: Health systems should prioritize getting the most vulnerable patients vaccinated & boosted.

Offer #vaccines on-site w/the SAFEST options.

Vulnerable patients want highly-ventilated or outdoor options & high-quality (e.g., N95) masks for safety. Make it happen. Vaccination given while clinician wears an N95 outdoors
Read 15 tweets
Dec 17, 2022
THREAD: 19 Tips for a DIY mask fit test to reduce your risk of #COVID19.

H/t @amandalhu & @__philipn__

What did I miss? Assorted fit-testing pictures
Fit-testing Tip #1: Keep it Simple.

Get a nebulizer (usually $30-40) & some 3M FT-32 Bitrex solution ($24). The FT-32 fit-test solution (right) goes in the nebulizer. J
Fit-testing Tip #2: Taste the Failure.

Use the nebulizer to spray the bitrex solution (barely visible). Breathe through your mouth. If you taste it, there’s a mask leak.

"It’s not rocket science," as @CorsIAQ likes to say.
Read 21 tweets
Dec 15, 2022
Our #pandemic global strategy:
"If I paint a rosy picture, will you promise not to cry?"

ascopubs.org/doi/full/10.12…
1/5 Image
Written a decade ago, the article was about how clinicians too often falsely reassured patients w/terminal #cancer that treatment was working just fine.

There are many parallels b/w cancer cancer, the pandemic, & climate change.

Mortality salience elicits #denial.
2/5 ImageImage
Don't believe me?

Look back at the 1960s. Only 12% of patients were even told they had #cancer.

Society will tolerate BS for a long time to avoid immediate discomfort. So too w/the pandemic. Hardly a mask in sight & reinfections mount.

jamanetwork.com/journals/jama/…
3/5 Image
Read 5 tweets
Dec 2, 2022
If you're advocating for more cautious and compassionate COVID policies or generally "doing the right thing," please keep pushing.

I've had three extremely validating interactions in the past week I wish to share (details disguised)....
#1 - A vulnerable family member had a cable guy come to her home. The cable guy refused to mask, so she refused to let him in and called to complain to the cable company. One of those big, hated cable companies.

Know what they did? Fired him on the spot. 🔥
#2 - Met with a ped's specialist (just a follow up, all is well). The hospital is anti-mask, "wash your hands," full droplet dogma.

BUT she was wearing an N95, says she's never going back. Asked thoughtful questions about the #PAPRbuggy. Shared how scary the pandemic onset was.
Read 4 tweets
Nov 15, 2022
I've yet to see a well-designed study showing that #COVID #RapidTests are no longer efficacious.

This one is no exception. Why?
5 reasons.

clinicalmicrobiologyandinfection.com/article/S1198-… Image
1. They compare same-day PCR against self-administered/interpreted rapid tests.

For most ppl, that's not reality. It's RAT today or PCR result in 1-3 days (or do both).

A fairer comparison would be a RAT today versus a PCR yesterday (since you'd have to wait for results).
2. They excluded 13% of the sample who were "confirmatory testers" (weird term) -- basically, people who had just tested RAT+ and were coming in for a PCR.

Basically, they excluded the people for whom the test easily worked. Drug trialists pull this stuff all the time.
Read 8 tweets
Nov 14, 2022
Cloth masks could be customized to look amazing. BUT they offered weak protection (poor filtration, many gaps).

What if you could safely customize an N95 or #BetterMask with a small logo, decal, or other decoration?

THREAD 🧵

1/ 3M N95 with monotone cancer ribbon (or interpret as another
H/T 🎩 to @amandalhu for recommending rub-on “dry transfers.”

Follow her & see her amazing thread of several examples. Very fun, especially for kids. Many pre-designed options.


2/
But can dry transfers be customized?

YES. I ordered a 6” x 6” sheet with >50 monotone #cancer ribbons from @stickermule. Cost about $20. Price goes waaaaay down the more you order. Comes with free hot sauce for some reason.

If you find other deals, please post.
3/ Sheet of dry transfers with >50 cancer ribbons.Randomly comes with hot sauce. Probably don't want to eat ri
Read 9 tweets

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