Feels like a good time for a little reminder: Countries aren't supposed to be run like businesses. Countries are supposed to spend money to support and serve their people. This means spending to support those living below the poverty line, the disabled and historically 1/
excluded groups. This means investing in research that doesn't immediately have a profitable output so that future innovations can be incubated and accelerated through companies that form within the country that supported the work. This means engaging in international aid so 2/
that when terrorism and anti-freedom sentiments try to take hold in other countries, it is shut down because the country being organized against is viewed as an ally. Government spending is supposed to serve the people. There's nothing wrong with questioning it, but so far, it 3/
is very well worth mentioning that the current administrations last few weeks of rapid government decisions have disproportionately hurt red states, favored the wealthy business owners and eroded the majority of citizens' fundamental safety nets and protections. I'm not here 4/
trying to argue the right or wrong of these decisions, but I'm tired of the spin. Wealthy people show be comfortable with the idea that governments will make decisions that don't help them - they should be comfortable with the idea that the country that enabled them to become 5/
wealthy makes policies that allows others to build wealth and be prosperous at their fractional expense, rather than aggressively fighting to destroy the middle class and increase the wealth gap because they feel entitled to control government due to campaign contributions 6/
they were able to make. That's a good way to think about investing in a company, not in a country. We can all agree that spending patterns could be changed and different levers can be pulled to change things, but there are some fundamental truths we cannot ignore: the current 7/
US administration vowed to "make america great again":
A country that can't provide aid to the unhomed and poor is not a great country
A country that cannot provide free healthcare to old folks, disabled folks, kids and veterans is not a great country
A country that cannot be 8/
viewed as a thought-leader and force of compassion and peace internationally is not a great country
A country that is so insecure about its identity that it bans words and concepts from general discourse and discussion is not a great country.
These are not judgements from me 9/
about any one administration or any country, these are reminders of some of the core values of the US. It's up to every person to ask if we're living up to these core values every day. If we're contributing our labors to a country that intends, through its words, actions and 10/
policies, to live up to these core values. I think this is a time for soul-searching and I hope that people can take this thread in the spirit of that. Who do we want to be? How do we want to be perceived? If you want respect, be worthy of respect. end/
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Wanted to check-in with these new @NIH changes that are going to affect so many. First let me remind everyone: I run 6 hybrid clinical/research centers, each with a specific clinical focus. Unlike the vast majority of my colleagues, federal funding sources account for less 1/
than 20% of my operational budget across all of these centers, so understand that my thoughts on this topic have nothing to do with self-preservation or any sort of self-serving agenda. First, sweeping change of this magnitude is going to cause great pain for thousands and 2/
thousands of Americans. Researchers, research staff, and administrators. This will cause layoffs, unemployment and for some, abandoning of scientific careers. To be clear, the people being affected by this aren’t going to be “lazy govt workers” or people “gaming the system”, 3/
With everything that has happened over the past few days with regard to layers of censorship being imposed upon workers for US federal agencies around reporting gender, race, ethnicity and disability status, I just need to make an appeal to my colleagues who work in spaces 1/
adjacent to government: federal governments of any country can make uninformed policy decisions about what their workers are and aren't allowed to do. This is what democracy means and although this may lead to unconscionable consequences for historically and currently excluded 2/
groups in science and healthcare, sometimes in a democracy you get what you vote (or don't vote) for. However, what these federal agencies cannot do is stop people or concepts from existing and to all my non-gvt employees, this is where you come in. Every time you see gvt 3/
Reflecting on the past week a few basic themes and lessons that strike me as worth repeating over and over: 1) First contact providers for #LongCOVID, #MECFS, chronic tick-/vector-borne illness and other infection-associated chronic conditions should be PCPs/family medicine. 1/
These are the folks that most people will come to with the non-specific symptoms that often emerge at the start of IACCs, so it is imperative that these professionals know how to identify and diagnose them. IACCs should be a categorical part of a coherent differential Dx for 2/
first-contact providers hearing patients describing fatigue, post-exertional symptoms, exercise intolerance and cognitive symptoms. This is a critical educational goal that we need to meet on the ground floor this second.
2) Physiatrists and neurologists should be trained as 3/
Those who have been following me for a while will know that I have been a voice for @NIH reform for quite some time. Regardless of the changes the current administration will bring to NIH, the events of the past 24hrs have been extreme and have caused, IMO, unnecessary stress 1/
and instability to hundreds of thousands of researchers and research support staff. I would strongly argue that whatever steps toward reform that the NIH want to take can be done without media blackouts, mass confusion and complete shutdown with no indication of next steps. 2/
As a researcher who is NOT reliant on NIH funding, I would ask the incoming @NIHDirector to please consider that the longer everyone is kept in the dark, the more mental health emergencies we are going to have to manage in researchers around the country. Many researchers 3/
Since my episode with the wonderful @longcovidanswer has been released highlighting viral persistence as a major driver of some #LongCOVID pathology, I’ve been asked repeatedly, “what should we do about it?” - totally fair question. Here is my proposed roadmap: 1/
First, let me point out that there are antiviral programs and drugs out there that people have been trying to mixed effects: e.g. Truvada, Maraviroc, Maraviroc + Statins, Valtrex, Valtrex + Celebrex, Paxlovid and various combos of these. This is NOT medical advice or urging 2/
anyone to try these things without knowing your history, but more to say that people are trying them for persistence and the results are mixed. Similarly, there are many monoclonal products that may hold promise on their own and in combo with antivirals: evusheld, aerium, 3/
@Gmwetz Hi Marco, what a great question. I'll start by saying that unfortunately it is hard to get drugs approved for improving mitochondrial function because it is so hard often to measure modulations in mitochondrial function in a person. There are supplemental approaches, of course 1/
@Gmwetz but many of these supplements haven't necessarily been proven to boost mitochondrial function, but they are able to boost materials that mitochondria need to make energy or reduce oxidative stress. These are supplements like NMN, NAD+, nicotinamide riboside, glutathione, 2/
@Gmwetz alpha lipoic acid, vitamin C, CoQ 10, Astaxanthin, Curcumin and many others. However, as I said: we can't guarantee these will boost mitochondrial function or remove reactive oxygen species - that is yet to be proven definitively and that is also hard: genetic and epigenetic 3/