Dr Gary Payinda Profile picture
Mar 6 12 tweets 4 min read
It's probably worth people learning about Epstein-Barr virus (human herpes virus 4).
It's a virus that pretty much everyone gets, the one that causes glandular fever, also known as #mononucleosis. 🧵
For many it's a simple cold, but for others it causes hepatitis, immunosuppression, autoimmune disease, and sometimes, several decades later, the neurodegenerative condition known as #MultipleSclerosis...

healthline.com/health/epstein…
It's worth talking about because it could easily be blown off as just a cold or a flu-like illness. Just like covid.
It infects white blood cells, lymphocytes, just like covid.
And it can cause a litany of acute and chronic medical problems, just like covid...
The major difference between Epstein-Barr virus and covid, is that we studied EBV for decades. In fact, it was only in the last couple of years that we firmed up the connection between EBV infection and MS. We're still learning how bad #EBV can be...
Therefore, it's only reasonable that we would apply a little bit of a precautionary principle to covid, too. We know it causes blood clots, flares up #autoimmune disease, creates inflammation in the smallest blood vessels, and markedly increases heart attack and stroke...
Yet somehow some social media thought leaders have drawn the conclusion that covid is trivial, rather than learning the lesson Epstein-Barr virus has taught us: even mild viral infections can cause severe chronic complications, months or even decades down the line...
Over the past couple of years, worldwide, there have been some notable surges in mild, moderate, and severe viral infections. We know covid can 'exhaust' lymphocytes, and increase our susceptibility to other illnesses...
We also know that RAT tests are severely limited in their ability to pick up Covid cases.
This would be a great time for governments to be carefully ensuring clean air standards, ventilation, and HEPA filtration in indoor settings like schools and workplaces...
And ensuring the people have great access (and the knowledge that goes along with it) to Covid boosters, influenza vaccines, and childhood immunisations... as we enter a period of widespread and repeated covid infections, and the immunocompromise these reinfections cause...
And for those in countries with unresponsive governments + public health systems, individuals will have to take steps of their own: putting Corsi-Rosenthal boxes in their crowded workplaces, using decent KF94 or better respirators (masks), and staying up-to-date on boosters.
The goal (as always) is to get re-infected with covid as infrequently as possible.
There's no wisdom in 6-12 monthly covid reinfections.
No winning, just health risks.
We would do well to respect the risk of viruses to cause long-term damage. Whether old DNA viruses, or old RNA viruses like Hep C, which is capable of causing cancer decades down the line, or novel viruses like #Covid.

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More from @GaryPayinda

Mar 6
There is virtually no comparing the harms of tobacco/cigarette smoking and vaping.
Cigarettes are a one-way trip into a world of emphysema, heart disease, stroke and cancer.
I treat these conditions every day.

That we allow corporations to profit off this is repulsive.
At the same time we have a teen vaping explosion.

It's an 'adult only' product but of course that's just fiction.

Youth, especially teenagers (and even younger), are a vast and avid market for one of the fastest growing business sectors in New Zealand: vape sales.
If you spend any time around kids, you will have a stunning exposure to the extent of nicotine addiction in teenagers.
The growth of nicotine vapes marketed to kids (and used by them), is the #BusinessOpportunity of the decade.
Read 5 tweets
Mar 6
I'll offer up one possible answer.

But first, some comments 😀 For-profit health care will always neglect poor and working class folks.

Pvt biz will suck up health money treating the profitable patients. They'll avoid the sick, elderly, poor, and infirm like the plague.
🧵
So any health system that is predicated upon turning sick people into profits is doomed to failure.

The smart, profits are not in treating people with actual health needs.
Once we accept the basic truth that for-profit health care is about making as much profit as possible, and delivering as little health care as possible, we're getting somewhere.
Read 12 tweets
Feb 19
Guideline summary for #ED docs on early pregnancy loss/miscarriage:
acog.org/clinical/clini…
10% of all #pregnancies end in #miscarriage, though the rate approaches 80% by maternal age 45yrs.
Half of early pregnancy loss (AKA miscarriages) are due to chromosomal abnormalities. 🧵
Crown-rump length (CRL) 7mm or greater and no heartbeat. Mean sac diameter (MSD) 25mm and no embryo.
Each one is an #ultrasound feature diagnostic of early pregnancy loss.
#POCUS
#medtwitter
80% of patients with early pregnancy loss can be safely managed with an expectant management (watch and wait) approach.
Relatively few miscarriages will require ED care; most of these will involve significant and symptomatic haemorrhage or infection.
Read 15 tweets
Feb 16
Ok, so he owns or part-owns investment companies, and private medical practice Whangarei doctors, and Primecare.
I'd really like to know that he does not own a stake in White Cross urgent care, who get taxpayer $ directly.
Maybe he'll address that. He's a recent follower.
In the past, Whangarei GPs have part-owned White Cross urgent care corporation. Is that still the case?
And ED patients get 'free' white Cross vouchers (paid for by your tax dollars of course) to go to (private corporation) White Cross when ED is understaffed/underresourced.
This takes away tax dollars from your public health service/ED/hospital.
Read 4 tweets
Feb 16
I can't believe this abomination of a law passed. It deserves to get destroyed in court.
Saliva drug testing is so inaccurate as to be untenable.
And you can be 100% sober, last sleeping pill days ago, or joint weeks ago, and you'll still test positive.

knowyourstuff.nz/2022/03/16/roa…
I'm no fan of drugs. I've never used drugs. I'm just a doctor telling you this "drug testing of drivers" is, scientifically speaking, rubbish.
People are pretending it's accurate, pretending it works, pretending it saves lives.
Mostly it penalises people who smoked marijuana.
It will be most effective at causing Maori and poor people to end up losing their jobs, or ending in court or jail, for having smoked cannabis days prior.
It's as inaccurate and regressive as it gets.
Read 6 tweets
Nov 17, 2022
Are we in a health crisis? Certainly.
Is it new? No, it’s been brewing for a long time.
What we’re seeing is the end-game of four decades of neoliberal policies feeding on the corpse of civil society. Finally it seems to have played itself out.
We’ve reached a point in time where the common man actually thinks taxes are bad. The same taxes that pay the surgeon who performs his gallbladder surgery, the teacher that educates his children, and the firefighters who protect his home.
People have been conditioned to not see taxes for what they are: the means by which citizens fund a functional and democratic society.
Read 17 tweets

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