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Paul Maidowski Profile picture
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Mar 14 • 8 tweets • 5 min read
1. Mechanics of SARS-acquired immune harm denial

Fascinating—I hope epidemiological sociologists are collecting all the data, so we may learn from it. This entire article describes the #LeonardiEffect - @fitterhappierAJ - without ever connecting the dots.
taz.de/Kranksein-in-p…
@fitterhappierAJ 2. Who will tell audience and artists?

What needs to happen, i.e. what level of population-wide organ or immunological damage do we need per unit time, for people to realize that this isn't sustainable AND that states could stop it any time if they cared?
taz.de/Kranksein-in-p…
3. Poor bedside manners is to ask "how many idiots need to die before people focus". Sometimes poor beside manners are exactly what we need to help normal people understand what IS ahead if they don't change direction. This thread for problem and solution.
4. The two big concerns: (1) viral load test and resistance panel. Without, we are in the pre-ART era, AIDS pre-1986. @dbdugger 🙏 (2) Intercontinental aviation. IRRELEVANT for HIV, which is easy to test+trace.

#2 is why SARS will be MUCH harder than HIV.
Image
@dbdugger 5. Become intimately familiar with the HIV timeline as we are living it.

You know the striking difference?

HIV is/was othered via the moral element: you could—in the majority's eyes, legitimately,—blame victims for lifestyle.

Works for sexual, but not respiratory transmission! Image
@dbdugger 6. Start here if folks or, God bless, you don't understand the molecular and evolutionary parallels.

Meet SARS-CoV and HIV, the two big lipid-raft surfing viruses plaguing humanity. One bound for vaginal/rectal mucosa, the other for respiratory epithelia. ImageImage
7. Said an epidemiologist,

We have had it very, VERY easy the last 30 years with ART!

HIV is extremely easy to contact trace.

HIV has biomarker tests, the same we could use for PASC!

I add, the stigma & moral element of HIV stop SARS survivors from learning.

Ongoing tragedy.
8. If you think there will be no stigma or moral element attached to COVID-19, ask #LongCovid patients now. Read this thread.

We will enter a long twilight of silent decline until+unless people start to face reality.

It’s not necessary: States can stop SARS any time (IHR 2005).

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More from @_ppmv

Paul Maidowski Profile picture
Mar 16
1. Where is the art of COVID?

Project alert! Good things on the way, perhaps @BabaBrinkman-grade scientific rap: Idea is a track on molnupiravir, a public health risk since the (useless) drug can create supermutated variants and exacerbate the pandemic.

Might do this. DM open🔥
2. Molnupiravir background.
3. Previous @BabaBrinkman rap: I shared some on climate/COVID, but leave you to discover yourself.

Great format for scicomm.

Perhaps more important, ask folks younger than us. I think @nephologue used one of Baba’s tracks in atmospheric science class?
Read 10 tweets
Paul Maidowski Profile picture
Mar 16
Good news! XBB.1.5 now classified as VoI. Criteria for VoC classification updated (=>new Greek letter)

Appreciate great work by volunteers. Now it's time to professionalize: Names matter in politics and coordinating public responses.

States need to deliver sufficient resources.
Quality memes 🤣 ImageImage
Criteria: this only took a several minutes and multiple clicks / downloads. By WHO's labyrinthine standards user-friendly! who.int/publications/m…
Read 4 tweets
Paul Maidowski Profile picture
Mar 16
1. Azvudine. Requires medical supervision and competent governance. It's no free-pass to end COVID-19. (Only share with this context.)

Fosun and Genuine Biotech donated ~400,000 bottles of Azvudine tablets worth RMB 100 million to rural counties in China. prnewswire.com/news-releases/…
2. This overview of COVID-19 antivirals for patients with chronic kidney disease notes that Azvudine may be used also for patients with HIV or CKD and COVID-19 coinfection. frontiersin.org/articles/10.33… Image
3. Nucleoside reverse transcriptase inhibitor (NRTI) with broad-spectrum antiviral activity against HIV,
HCV, EV71, and HBV infection that modulates the expression of P-glycoprotein (P-gp). Also effective against SARS-CoV-2. ImageImageImageImage
Read 7 tweets
Paul Maidowski Profile picture
Mar 15
Two types of systems thinking.

One completely irrational. The other rational—or so we think.

(1) I must admit watching systemic failure live makes it easier to apply for $ for ideas to stop total systemic failure. (2) 1-10% that we (I) are deluded, and I mix up the ir/rational. Image
Not always smoothly, but reality is forcing folks to get real.

Decarbonization by design or disaster?

We have been trying to warn you all for three years and counting.
If you're remotely aware of LongCOVID, read this timeline attentively.

You can read current COVID-19 incidence data as (order of magnitude) 1:1 LC incidence, because no one is collecting data anymore.

10-20% LC per infection, vs. 10-25 fold undercount for almost the past year. Image
Read 5 tweets
Paul Maidowski Profile picture
Mar 15
A. #LongCovidAwarenessDay.

Time for people with LongCovid to speak. Here just one high-level lesson I can add:

Use precise medical language to access care. Demand change from an establishment that hung you out to dry.

Eg, it's SAND, equivalent to HAND in HIV, not 'brain fog'.
B. Beware, few understand SARS viral persistence as cause of LongCovid (etiology). IDK why!

MDs then treat symptoms, not causes. Be sure not to waste time you don't have.

Demand a viral load test. HIV T cell depletion tests can diagnose Long Covid, just as it did for Long SARS. Image
C. Always teach the relevant scales and dynamics.

65 million patients!?!

That's twice as many as people living with HIV, and you're treated far worse: often gaslit, no POC T cell test, people mostly ignore you.

On the AIDS timeline, we are in the early 1980s.

Read this again. Image
Read 11 tweets
Paul Maidowski Profile picture
Mar 15
1. Do we see an emerging pattern of three overlapping SARS waves, one each 28 days, circling the globe?

Open question to reality-check @RealCheckMarker, whose excellent pandemic observations I often share/comment.

Three-month pattern in most data: check ✅

Details matter. Why?
2. The high-level prediction to reality-check.

Feel free to bring data; Twitter is for learning and this one is vital to effective policy.

We won’t eliminate SARS-CoV - or even just keep society in good health - if we don’t understand its basic dynamics.
3. Chinese speakers: integrate China and the rest of the world, incl. India to reflect the next big ship XBB.1.16.

We are three months out from China's big wave; IF Azvudine didn't work, we would expect the next wave to start soon.
chinacdc.cn/jkzt/crb/zl/sz…
ImageImage
Read 15 tweets

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