Key q for discussion: How will #climatechange address the timing and severity of infectious outbreaks in the years to come?

🦠 influenza, #covid19, & other respiratory dx’ed
🦟malaria & other vector-borne illnesses
🚽diarrheal & other fecal-oral disease

@Brown_SPH
1. Heat, cold, & water/drought change these pathogens’ evolution

2. Heat, cold, & water/drought also change how humans act

3. And health systems are changed, too! (Just look at the effect of Katrina)
We are at a unique moment of “coupled risks”: urbanization, easy trans-national travel, large agricultural industries…

We get to make decisions every day both to adapt & to prevent. @Craig_A_Spencer
Top q’s to answer:
🔥 need to better understand CURRENT impact of temp/climate on disease transmission
🔥need good models to predict FUTURE spread- needs interdisciplinary work
🔥need data on what works to mitigate (& prevent) effects - to inform decisions
@Brown_IBES @Brown_SPH
🔥& I will add…. We need to understand the impact on *non* infectious epidemics (like #opioid overdose & #GunViolence ).
Per @JenniferNuzzo our biggest goal (besides reducing the risk of natural hazards) is to BUILD RESILIENCE.

“We can’t ever let anything upend our lives like #covid19, or Hurricane Sandy, ever again.”

Her point is that we can build systems that are ready to respond, when needed
“Don’t wait until there’s a fire, to create a fire department.”

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More from @meganranney

Jan 30
Research can help us fix our nation’s firearm injury epidemic - and maybe not in the ways you think. My new piece for @washingtonpost outlines 5 key questions we need answered:

washingtonpost.com/opinions/2023/…
1. What are the actual numbers (of injuries, defensive gun use, stolen guns, averted shootings, etc)?

Believe it or not, we don’t know. (This is why CDC websites mostly discuss death rates - that’s what we actually have semi-reliable data on.)
2. Who is at risk?

We can’t reliably identify what makes someone higher risk for gun suicide, homicide, mass shootings…. (Kudos to folks who are trying… but we need better data and prediction tools, both in the moment and over time.)
Read 7 tweets
Jan 24
Lots of talk about the new @US_FDA proposal for yearly, updated #covid19 vaccines.

This is not surprising.

It’s been being signaled for months.

It’s also how we handle other shots - like flu.

Still, I have some questions.

nbcnews.com/health/health-…
1. Who chooses the variant strain?

For the flu vaccine, we (in US) choose based on what’s circulating in the southern hemisphere. But we have no data to support that approach for Covid. FDA is proposing a June decision on dominant variant… ok.
2. Why bivalent, vs updated monovalent?

This is the big debate in the scientific community & lots of folks have strong theories. The OG (Wuhan) strain is clearly passé. Will monovalent (single variant) be more effective? Stay tuned.

medpagetoday.com/infectiousdise…
Read 7 tweets
Jan 22
This uniquely American epidemic of #gunviolence leaves none of us untouched.

Our communities & our country deserves better.
Waiting on details.

But I will bet 1000:1 that (as with almost every one of these) there were missed signs. Someone that should not have been allowed to own a gun. Hatred & desperation.

theviolenceproject.org/key-findings/
We can fix it.

Recent bipartisan steps will help - they have not had time to work.

More is needed. Policies make a difference but are not sufficient. WE CAN DO IT.

theatlantic.com/health/archive…
Read 4 tweets
Jan 9
Important new study on #covid19 vaccines and *non-Covid* mortality, published over the holidays — looking at SAFETY of these vaccines.

(We already know they work to reduce #covid19 death)

sciencedirect.com/science/articl…
They matched people in a HUGE database - > 6 million recipients of the 3 most common vaccines (Pfizer, Moderna, J&J) and > 6 million people with similar age/race/gender/co-morbidities/neighborhood characteristics who had not been vaccinated.

They matched well (tables 1-3).
They then examined, using standard statistical techniques, the likelihood (“hazard ratio”) of:
1. any death other than Covid (the primary outcome of interest)
2. hospitalization for trauma (vaccines shouldn’t affect incidence of trauma!)
Read 7 tweets
Jan 3
Qs from my ER doc brain:
- was it commotio cordis?
- an unstable Cspine injury (Unlikely given that he got up right away)?
- a regular cardiac arrest?
- a ruptured aneurysm?

Regardless, waiting; & thankful for great medical professionals in Cinci. @BuffaloBills #billsmafia 🙏🙏
If not breathing spontaneously, but still had a pulse, more consistent w/ c-spine injury (Although the mechanism is admittedly not typical)

sciencedirect.com/topics/medicin…
Read 6 tweets

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