Eric Feigl-Ding Profile picture
Nov 22, 2023 21 tweets 9 min read Read on X
⚠️UNDIAGNOSED PNEUMONIA OUTBREAK—An emerging large outbreak of pneumonia in China, with pediatric hospitals in Beijing, Liaoning overwhelmed with sick children, & many schools suspended. Beijing Children's Hospital overflowing. 🧵on what we know so far:
2) An alert 🔔 went out on ProMed epidemic network last night. They warn of an unknown “walking pneumonia” without coughing, but HIGH FEVER + pulmonary nodules. Hospital’s full of kids now on IV drips.



Chinese report
promedmail.org/promed-post/?i…
ftvnews.com.tw/news/detail/20…
Image
3) Some school classes have even been canceled completely. Not only are all students sick, but teachers are also infected with pneumonia. ...

Mr. [W], a Beijing citizen: "Now you are not allowed to report to school. If you have any symptoms such as fever, cold, cough and then you are hospitalized”
Image
4) “It is too early to project whether this could be another pandemic but as a wise influenza virologist once said to me "The pandemic clock is ticking, we just do not know what time it is."”
5) Also of note- Beijing and Liaoning are 800 km apart!! This epidemic isn’t localized anymore. That worries me a lot. 🤔

Chinese hospitals have been “overwhelmed with sick children” as an outbreak of pneumonia escalates in cities across the country.
telegraph.co.uk/global-health/…
6) In an editor’s note, ProMed said: “This report suggests a widespread outbreak of an undiagnosed respiratory illness ... It is not at all clear when this outbreak started as it would be unusual for so many children to be affected so quickly.“ — this is worrisome too.
7) one speculation—outbreak could be a type of Mycoplasma pneumoniae, aka “walking pneumonia”, reportedly surging in China. ➡️But this is a vague lumping. We don’t know the infectious agent. And this is not typical “walking pneumonia” since this new outbreak is not mild.
8) Let this photo sink in— students in China keep doing homework in the hospital while getting IV fluids.

What a world. Image
9) The pneumonia started surging
in October… doctors noted also that:

“Compared to previous years, we found more patients with mixed infections, **drug resistance**.”

Maybe it’s a new virus or it’s maybe it’s a nasty antibiotic-resistant bacteria.
chinadaily.com.cn/a/202310/24/WS…
10) Here are direct reports from the scene on Chinese from locals— I’ll try to provide excerpts from this conversation…

=====
So there was no movement for a whole hour after No. 406, and the parents couldn't bear it.
Call the police. The police are here. They understand the situation and go to another hospital.
Triage, triage is not moving, Children’s Hospital is no longer treating children.
The institute is also full of people. These parents are from the institute and children
The hospital didn't call me.
02:00
This is the current overall situation, and we all should consider it together
judge.
02:01
02:00
01:50
The situation is indeed difficult, not only for the hospital, but also for the patients and the police.
Image
11) “Disaster. I had a chat with an older brother, who is a student in the third year of junior high school in No. 35 Middle School.
She is a 15-year-old girl. She has had a fever for 2 days and has been cooling down physically. See
I was looking at the textbook and suddenly fainted. The emergency department came to the hospital for help.”
Image
12) “It's an emergency. A child has been having a high fever and it can't be brought down even by taking antipyretics.
Go down, face red, a little boy
01:52
Basically half of the children who go to school have fever and [pneumonia].” Image
13) “01:55
If you haven’t come to the hospital, you may not be able to imagine the severity.
Basically, the medical system is at its lowest point, and every hospital is empty of people.
Well, the final solution given by the police was to report it to Xicheng District first
The government coordinates the solution, and the second oldest children over 14 years old are divided into
He went to the emergency room of Peking University Hospital and went through the procedures for adult medical treatment.
01:59
At present, children’s hospitals and pediatric research institutes are basically unable to get admission
No., the pediatric emergency department of Friendship Hospital requires waiting for more than 24 hours.”
Image
14) The respiratory department at Vietnam's children's hospital (HCMC) has run out of beds, forcing patients to lie in hammocks in the hallway. Video via @trongnhan9500

@trongnhan9500 15) Is it mild? I’m not so sure. But this worries me— “One-tenth of the patients come from out of town … because bronchoscopies are unavailable in their hometown.” ➡️According to Chinese CDC, bronchoscopies are not needed for mild cases of the infection.”
sixthtone.com/news/1014131
@trongnhan9500 16) China’s official news outlet blames the outbreak on “Influenza, adenovirus, RSV, rhinovirus”,… but says something further. They don’t acknowledge any unknown source of the outbreak… is it just those 3 viruses, or coverup of something else? 🤔 Image
@trongnhan9500 17) there has been a reported rise in influenza A (brown) and discussions of flu and many other viruses on Chinese Weibo (WeChat). Not sure if it’s the cause of this surge, but worrisome… trying my best to find clues what it is…

whatsonweibo.com/sick-kids-worr…
Image
18) China is a place of extremes for emergence of outbreaks and what it can do to a society. Last winter, after dust settled, experts estimated 2-3 million people died when COVID mitigations were dropped. It was thermonuclear bad. Hope this winter won’t be the same.
19) This graph showing a sudden spike in H9N2 was provided by @EPIWATCH_bsp, an AI-driven system that scans for signals worldwide. And their system found an uptick in avian H9N2 reports in China that stick out in the last 2 weeks. @CIDRAP also notes an case of H9N2 in a HK report.

EpiWatch founder @Globalbiosec notes that:

“A google search in English will only give you a fraction of what is out there. our early research on Asian languages showed you will miss most reports if you do not search in specific disease and syndrome terms in original languages. Over 70% of our intel is NOT in English.”

Image
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@EPIWATCH_bsp @CIDRAP 20) I pray it’s not an avian flu that jumped to humans. We will know more in the coming days. I’ll keep folks updated. Meantime, please SUBSCRIBE (for free, no paywall) for updates later. Thank you:
drericding.substack.com/subscribe
@EPIWATCH_bsp @CIDRAP 21) the WHO has made an official request to China for more data on the unknown pneumonia outbreak. But while their post is vague, the WHO summary is clearly worried to make their demand to China 🇨🇳 public. It suggest the situation of my thread 🧵 above is very real…

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More from @DrEricDing

Apr 3
Now economists know how scientists felt back when he pushed “hydroxychloroquine”
2) HCQ preventing COVID deaths has been debunked— and it’s now been linked with deaths.

@JoshuaPCohen1
forbes.com/sites/joshuaco…Image
@JoshuaPCohen1 3) JPMorgan on Trump Tariffs: “The largest tax increase since 1968” Image
Read 6 tweets
Mar 28
My god—Earthquake (a Richter ~7.7) causes a skyscraper to collapse in Bangkok. Hope all the construction workers made it out.
2) this skyscraper collapse was captured from a distant car’s dashcam while on a highway

3) another view of the collapse. For those who lived through 9/11, this collapse is a bit triggering.
Read 5 tweets
Mar 27
Welp—kiss public health & medical research infrastructure in America goodbye for the next 4 years. RFK Jr plans to cut 10,000 jobs from Trump HHS. Image
2) this will not make America healthy again… not by a long shot. So dangerous and irresponsible.
3) “Kennedy is set to announce Thursday the planned changes, which include axing 10,000 full-time employees spread across departments tasked with responding to disease outbreaks, approving new drugs, providing insurance for the poorest Americans and more”.
Read 5 tweets
Mar 15
SICKENING—Trump’s DHS just deported a surgeon from Brown University Medical School—who is here legally on an H1B visa that doesn’t expire until 2027, and has committed no crimes. Trained in the U.S. at Ohio State, University of Washington, and Yale as a **transplant surgeon** (one of the most difficult surgical fields in all of medicine!!!), she is a highly trained doctor on kidney transplants, which cannot be easily replaced. Her phone was seized at the border. A federal judge handed down an injunction against her deportation—but she was already deported on a plane en route to Paris. Brown’s kidney transplant clinic is now strained by her deportation.Image
Image
2) Full text:

PROVIDENCE — A Rhode Island doctor who had traveled to Lebanon to see her parents was prevented from re-entering the United States at Boston’s Logan International Airport on Thursday evening, her lawyer and a colleague said.

Dr. Rasha Alawieh, 34, who lives in Providence, has been working at Brown Medicine’s Division of Kidney Disease & Hypertension since last July, and she [has] been part of the transplant service at Rhode Island Hospital, according to Dr. George Bayliss, the organ transplant division’s medical director. She has been studying and working in the United States for about six years, he said Friday.

The US consulate in Lebanon had issued her an H-1B visa, which is given to people in specialty occupations requiring expertise. The visa was valid through mid-2027, said Thomas S. Brown, an attorney representing her and Brown Medicine.

Alawieh was detained when she returned to Logan airport, and family members are afraid that she is about to be deported to Lebanon, he said.

“We are at a loss as to why this happened,” Brown said. “I don’t know if it’s a byproduct of the Trump crackdown on immigration. I don’t know if it’s a travel ban or some other issue.”

He said her phone has been seized and he has not been able to contact Alawieh.

Bayliss said a lawyer filed a petition with the US District Court in Massachusetts, and Judge Leo T. Sorokin issued an order saying Alawieh should not be moved outside of Massachusetts without 48 hours notice. But he said that message apparently did not reach immigration officials in time, and a plane carrying Alawieh left for Paris.

“This is outrageous,” Bayliss said in an interview. “This is a person who is legally entitled to be in the U.S., who is stopped from re-entering the country for reasons no one knows. It’s depriving her patients of a good physician.”

A US Customs and Border Patrol spokesperson, Ryan Brissette, was not able to immediately answer questions about Alawieh on Friday evening.

Bayliss said Alawieh graduated from the American University of Beirut medical school and came to the United States for a nephrology fellowship at Ohio State University. She then landed a transplant fellowship at University of Washington and had a residency in the Yale hospital system before starting at Brown Medicine last July, he said.

“She’s really a very humble and able person,” Bayliss said. “She takes care of her patients. She is talented and thoughtful and a great addition to our division.”

Bayliss said Alawieh went to Lebanon to visit parents and planned to be gone for two weeks. He said she texted a colleague at 6:30 p.m. Thursday saying she was back in Boston, but then her family heard from immigration officials.

Dr. Paul Morrissey, surgical director of the organ transplant division at Brown University Health, said Alawieh works on getting people in Rhode Island on the list for a kidney transplants, and that’s a crucial job at a time when there has been a lot of focus on the need for kidneys and their equitable distribution.

He said Alawieh should not have had any problem traveling out of the country with an H-1B visa.

“It’s an unfortunate set of circumstances,” Morrissey said. “It’s putting a strain on our office. Her work has been exceptional.”

bostonglobe.com/2025/03/14/met…Image
3) There is a new Trump ban against many countries, including tourist visa bans against all countries in the red and orange lists. This list is still tentative. And it shouldn’t have affected people with existing visas, such and the Brown kidney transplant surgeon Image
Read 8 tweets
Mar 14
I’ve said it before, and I’ll say it again… once upon a time, liberals did have our own “Leftist Joe Rogan”… his name was Joe Rogan…

Here he is advocating for socialized medicine, healthcare for all, and supporting labor unions to protect workers.
2) Recall, Rogan was once pro Obama and pro Bernie Sanders, and pro Yang Gang, and anti Trump. It’s sad he has since failed to the dark side. But like Vader… maybe he can be redeemed someday and come back to the light.
3) *Fallen, not failed (above).

Joe Rogan was also pro gay rights and pro DACA and pro helping inner city communities that suffer economic and social injustices. It’s sad what he has become. I feel we should try to pull & welcome him back someday. Everyone can be redeemed.
Read 4 tweets
Feb 26
BREAKING—FDA suddenly cancels meeting to update next season’s flu vaccines, with zero explanations. Any delays will jeopardize next year’s vaccine supply chain. Image
2) Folks who follow me know that I’m no bullshitter. I criticized past pandemic response right and left, and have called balls and strikes without bias. And I often say things that doctors & epidemiologists are whispering among themselves but don’t say publicly. (Cough cough) ⬇️
3) While I don’t recommend hoarding… I think stocking up on flu antivirals, which you can obtain prophylactically (preventively) from doctors if you ask nicely why you’re high risk, can be a good idea. I know many doctors, epidemiologists and virologists who do for their family.
Read 6 tweets

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