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Eric Feigl-Ding Profile picture
@DrEricDing
Nov 22, 2023 • 21 tweets • 9 min read • Read on X
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⚠️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
Image
@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

Eric Feigl-Ding Profile picture
Jun 16
📍 THE 17 FIRED MEMBERS OF CDC’s VACCINE ADVISORY COMMITTEE (ACIP) speak out…

📍“As former ACIP members, we are deeply concerned that these destabilizing decisions, made without clear rationale, may roll back the achievements of US immunization policy, impact people’s access to lifesaving vaccines, and ultimately put US families at risk of dangerous and preventable illnesses.” 🔥

Full text:

Vaccines are one of the greatest global public health achievements. Vaccine recommendations have been critical to the global eradication of smallpox and the elimination of polio, measles, rubella, and congenital rubella syndrome in the US. They have also dramatically decreased cases of hepatitis, meningitis, mumps, pertussis (whooping cough), pneumonia, tetanus, and varicella (chickenpox), and prevented cancers caused by hepatitis B virus and human papillomaviruses.1 Recent scientific advancements enabled the accelerated development, production, and evaluation of COVID-19 vaccines, leveraging novel technologies that are estimated to have prevented approximately 1.6 million hospitalizations and 235 000 deaths in the US alone.2
For more than 60 years, the Advisory Committee on Immunization Practices (ACIP)—codified in the federal regulations (42 USC 217a: advisory councils or committees)—has served as a panel of experts that reviews the most up-to-date evidence on vaccines and monoclonal antibodies (eg, against respiratory syncytial virus [RSV]), providing sound recommendations to the US Centers for Disease Control and Prevention (CDC) regarding how vaccines should be used. ACIP recommendations are the cornerstone of the immunization program in this country. First, they serve as guidance and are the national standard for the use of Food and Drug Administration (FDA) authorized and licensed vaccines, providing a unified and trusted approach to vaccinations for the diverse array of immunization providers across the US. Second, they ensure science-based and tested immunization schedules that are optimized for well-timed protection against serious diseases. Third, the recommendations affect insurance coverage and safeguard broad access for vaccines. Fourth, ACIP’s continued monitoring of disease epidemiology and scrutiny of vaccine safety inform timely updates to recommendations that have maintained the trust and protection of the population. This transparent and ongoing surveillance of vaccines is one of the most stringent around the world, historically making the deliberations and decisions of this committee a beacon for immunization programs globally, while also serving as the foundation for recommendations harmonized with leading medical organizations in the US.3,4
ACIP committee members have always been selected through a rigorous process based on their expertise in immunology, epidemiology, pediatrics, obstetrics, internal and family medicine, geriatrics, infectious diseases, and public health. Historically, committee members were chosen because they worked at hospitals, clinics, health departments, universities, and other organizations where they dedicated themselves to caring for patients, conducting research, and helping to prevent and treat infectious diseases. Members’ deep understanding of immunization issues ensured that vaccine policies were grounded in scientific evidence, aligned with the needs of economically, socially, and medically diverse US communities, and always considered the public value, trust, and acceptability of vaccines.
Despite recent suggestions to the contrary, health care providers and the US public trust ACIP. For the past 18 years, the National Immunization Survey has shown that 99 of every 100 children in the US have received at least some recommended vaccines by 2 years of age, consistent with acceptance of ACIP recommendations implemented by trusted clinicians (National Immunization Survey - Childof Healthy People 2030).…Image
2) Full text part 2:

This does not suggest the population is so distrustful that it warrants dismantling the process by which vaccines have been recommended. ACIP standard procedures have minimized the risk of alleged conflicts of interest and biases. For decades, members of ACIP have undergone a thorough application and review process to participate. Proposed members submitted letters of support from other known experts and peers, completed an interview process, underwent a background check, and disclosed financial interests that might be considered a conflict, including any professional or financial relationships of immediate family members. Historically, it has taken up to 2 years for nominees to be approved to join ACIP.
Once part of the committee, ACIP members spent significant time preparing for meetings, reviewing the scientific evidence, and chairing work groups that, along with many CDC public health officials, led to the final recommendations that were determined during public meetings, which also included opportunities for public comment. Recordings of these meetings, agendas, and presentations were publicly available. Additionally, members agreed to ongoing monitoring and disclosure throughout their tenure. For example, potential conflicts of interest were reviewed throughout their time on the committee. Statements about potential conflicts were required during each meeting and before each vote, and members recused themselves from voting if any conflicts were identified. These disclosures have also recently been posted on the CDC website for public scrutiny. ACIP was among the most stringent and transparent of the federal committees, and we hope those criteria will apply to any new members joining the committee.
The abrupt dismissal of the entire membership of the ACIP, along with its executive secretary, on June 9, 2025, the appointment of 8 new ACIP members just 2 days later, and the recent reduction of CDC staff dedicated to immunizations have left the US vaccine program critically weakened.5,6 These actions have stripped the program of the institutional knowledge and continuity that have been essential to its success over decades. Notably, the ACIP charter specifies that committee members serve overlapping terms to ensure continuity and avoid precisely the disruption that will now ensue. The termination of all members and its leadership in a single action undermines the committee’s capacity to operate effectively and efficiently, aside from raising questions about competence.
Compounding these concerns, recent changes to COVID-19 vaccine policy, made directly by the HHS secretary and released on social media, appear to have bypassed the standard, transparent, and evidence-based review process.7 Such actions reflect a troubling disregard for the scientific integrity that has historically guided US immunization strategy. The newly stated strategy to replace ACIP members with individuals who will “exercise independent judgment, refuse to serve as a rubber stamp, and foster a culture of critical inquiry” is already leading to warnings by academic and scientific institutions, professional organizations, and the public who for decades have known well that these sought-after qualities precisely characterized the now-dismissed members of the ACIP.5
3) Part 3:

As former ACIP members, we are deeply concerned that these destabilizing decisions, made without clear rationale, may roll back the achievements of US immunization policy, impact people’s access to lifesaving vaccines, and ultimately put US families at risk of dangerous and preventable illnesses. Vaccines and the anti-RSV monoclonal antibodies are lifesaving, and people in the US deserve to have recommendations and broad access to use them to prevent serious diseases. In this age of government efficiency, the US public needs to know that the routine vaccination of approximately 117 million children from 1994-2023 likely prevented around 508 million lifetime cases of illness, 32 million hospitalizations, and 1 129 000 deaths, at a net savings of $540 billion in direct costs and $2.7 trillion in societal costs.8Finally, as individuals, we remain committed to evidence-based vaccine policy, both through our ongoing work in immunization science, public health, and medical education, and by supporting future efforts to keep America healthy that uphold scientific rigor and the public’s trust.
Read 4 tweets
Eric Feigl-Ding Profile picture
May 8
⚠️Tariffs On Medications Will Make America Sick

We might soon see the Trump WH impose tariffs on pharmaceuticals—patients will suffer and die.

During the past few weeks, President Trump’s on-again, off-again tariff wars have rattled the stock market, decimated many Americans’ retirement funds, and promised to send grocery prices soaring—and his administration hasn’t even gotten to critical pharmaceutical tariffs yet. But that will likely be the next shoe to drop.
Trump exempted pharmaceuticals from his first round of tariffs in early April, but recently declared that he intends to impose “a major tariff” on imported medicines “very shortly.” These tariffs, he claims, will prompt pharmaceutical companies to leave countries including China and India and begin “opening up their plants all over the place.”
Commerce Secretary Howard Lutnick said in a television interview in mid-April that these tariffs are coming in the “next month or two.”

What will this mean? 

Read on:
progressive.org/op-eds/tariffs…Image
2) The majority of brand name drugs used in the United States are imported. Even generic drugs often rely on ingredients and direct imports from China, including pain relievers and cardiovascular drugs used by millions.
3) The United States was already facing a drug shortage crisis before Trump’s tariff announcement. Now, his policies will drive upnot only the cost of medicines, but also other health care items such as X-ray machines and medical instruments.
Read 8 tweets
Eric Feigl-Ding Profile picture
Apr 10
It’s a trap: CATCH 22—if you register, ICE will deport you. If you don’t register, you’ve now committed a crime for the first time, and ICE will deport you. Trump doesn’t care if you’ve paid all taxes and followed all laws—ICE will deport you.

apnews.com/article/illega…Image
2) The Department of Homeland Security announced that it was mandating that all people in the United States illegally register with the federal government, and said those who didn’t self-report could face fines or prosecution. ***Failure to register is considered a crime***
3) Registration will be mandatory for everyone 14 and older without legal status. People registering have to provide their fingerprints and address, and parents and guardians of anyone under age 14 must ensure they registered. The registration process also applies to Canadians who are in the U.S. for more than 30 days, such as so-called snowbirds who spend winter months in places like Florida.
Read 4 tweets
Eric Feigl-Ding Profile picture
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
Eric Feigl-Ding Profile picture
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
Eric Feigl-Ding Profile picture
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

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