Atul Gawande Profile picture
Surgeon, Writer, Researcher. https://t.co/CLiBR5HWkf https://t.co/oRUiBxSmli https://t.co/W5OzSkCtQo https://t.co/ZdaIiD2ecQ
@reenum Profile picture dhruvaray Profile picture Michael McWilliams Profile picture Vel Ravimohan Profile picture Nicolas Rocq Profile picture 11 added to My Authors
18 Oct
Masks work? YES. This is appalling. Atlas offers no explanation for the increasing mountain of evidence in support, and instead offers only a bizarre and incoherent paper. I don't know why the administration wants to die on this hill.
So, once again, what is the evidence?

In my May article on the regimen hospitals have used to stop spread of COVID19 (hygiene, distancing, masks, and testing at least symptomatic people), I review the copious evidence to then on why masks work. newyorker.com/science/medica…
Since that article, numerous corroborating studies have come out. This comprehensive review lays out the strong laboratory evidence of the ability of surgical masks and cloth masks to prevent transmission. europepmc.org/article/PPR/PP…
Read 12 tweets
17 Oct
Warning for COVID scientists: An impostor is asking scientists for an interview using the email atulgawande65@gmail.com (not mine) and signature “Atul Gawande, Staff Writer, The New Yorker.”

These are fake. Do not respond. I use a bwh.harvard.edu address for work. 1/4
One scientist did respond. It led to back-and-forth emails and a brief phone call to settle on an interview time. The impersonator sent a Microsoft Teams-like link. The result was a hack that accessed the victim’s computer, phone, apple ID, business and home gmail accounts. 2/4
They also accessed Twitter and other social media accounts.

They have possession of the scientist's financial account details.

And most disturbing, they tried to get into the person’s home security alarm system. 3/4
Read 4 tweets
16 Oct
And with the CDC under a political thumb, it’s crazy but fortunate we can rely on independent sources like Johns Hopkins’ @JHUSystems and @TheAtlantic’s @COVID19Tracking for basic facts on COVID19
Meanwhile, however, “The Trump White House has installed 2 political operatives at the [CDC] to try to control the information it releases about the coronavirus pandemic as the administration seeks to paint a positive outlook.“ apnews.com/article/electi…
Read 4 tweets
7 Oct
Recently, @BrighamWomens had a COVID-19 outbreak among 20+ patients & staff. We rapidly traced and tested all contacts and advised quarantine. We deployed PCR testing in <24 hours for ~9,000 staff. We ID’d 52 total cases associated w the cluster and are containing the outbreak.
The White House now has an outbreak involving 20+ guests and staff. They have done no tracing, no broad testing. And the outbreak is spreading outward. nytimes.com/interactive/20…
Not included in the @nytimes list are eleven more among debate prep staff reported by Cleveland public health authorities wkyc.com/article/news/l…
Read 5 tweets
19 Jul
This boggles the mind. With sky high COVID infections and deaths rising back to 1000/day, this: In talks w Senate GOP over the weekend, “administration officials instead pushed to zero out the funding for testing and for the nation’s top health agencies” nytimes.com/2020/07/18/wor…
More details in this @washingtonpost story. “Several Senate Republicans including @SenBillCassidy (R-La.) are exploring pushing a testing and tracing provision in the next stimulus package but are expected to meet resistance from the White House.” washingtonpost.com/us-policy/2020…
In addition to zeroing out $25B for testing and tracing, “The administration is also seeking to zero out $10 billion in new funding for the CDC in the upcoming bill.”
Read 4 tweets
12 Jun
Important results: Remember the 2 MO hairstylists who saw 140 clients over 8 days while infected with COVID but everyone had worn masks? Contact tracers found ZERO secondary infections. More evidence that masks work. cnn.com/2020/06/11/us/…
By contrast, in Israel, two weeks after reopening schools, at least one infected student at a Jerusalem high school led to 130 cases among students and teachers. Dozens of schools had to be closed again as the outbreak spread. npr.org/sections/coron…
The likely difference: There was wide evidence students were not taking the virus seriously and were ignoring mask guidelines. jpost.com/israel-news/an…
Read 7 tweets
2 Apr
I'm very worried about what this means for the South. But results will be different depending on how many cases they had when they finally took action. nytimes.com/interactive/20…
Ohio set the example for the US. The Governor shut down early (3/23) under intense criticism, and that is slowing spread and likely averting overwhelming ICU admissions and deaths. They'll get through the worst of it this month. covid19.healthdata.org/projections
Kentucky closed non-essential businesses later (3/26), but while COVID-19 deaths were still 1/day. So they also look on course to avoiding disaster. But it is likely to take longer for them to get through it. Sticking with the closures this long will be hard.
Read 7 tweets
28 Mar
This, from @HarvardHBS, is the best analysis I've seen on what happened in Italy. hbr.org/2020/03/lesson…
Many lessons here. Most notable to me: 1. PARTIAL SOLUTIONS DON'T WORK. Italy locked down only high risk areas ("red zones"), but it only facilitated spread as people fled lockdown areas. "Italy followed the spread rather than prevented it." Exactly what the US is doing.
2. DEPLOY THE FULL PLAYBOOK. Lombardy (10M) and Veneto (5M) both closed shops and did social distancing. Veneto added testing, active contact tracing, good controls to protect health care & other essential workers, and home care for most cases. Lombardy had 5K deaths; Veneto 287.
Read 4 tweets
22 Mar
Today, my health system took a big step: Notified staff that they're adopting the model described here, with face masks at all times & a health check each shift for even mild ill symptoms. Effective Wednesday. Kudos to @PartnersNews @BrighamWomens @MassGeneralNews
Doing this is no small matter, given rising difficulty maintaining supply of surgical masks. To conserve, we've had to centralize distribution - 1 per employee per shift. If supplies run short, there will be prioritization of those with "highest risk clinical activities."
The main value of masking, like health checks, is actually protecting others more than ourselves. It reduces risk of staff with pre-symptomatic infection spreading it to others. That means we must cover the nose and mouth, and wash hands before and after manipulating the mask.
Read 6 tweets
2 Feb
We are living the Hunger Games. nytimes.com/2020/02/01/us/…
Cancer is financially toxic in the US unlike almost anywhere else. Cancer patients have almost triple the rate of bankruptcies of others the same age. And those who go bankrupt have a higher death rate. nytimes.com/2019/02/21/wel…
Ironically, in prison they will be forced to cover the chemotherapy costs for the young woman. In some places, inmates are being released just to avoid paying their medical bills—and then rearrested when they have recovered. propublica.org/article/these-…
Read 4 tweets
9 Jan
Can we lower medical costs by giving the neediest patients better care? 9 years ago my @NewYorker article, The Hot Spotters, highlighted the heroic work of the Camden Coalition to try and prove it could. newyorker.com/magazine/2011/…
@NewYorker But an important new study shows that their “hot spotting” program didn’t lower costs. nytimes.com/2020/01/08/hea…
@NewYorker 1. Kudos to the coalition and founder Jeff Brenner for putting to an RCT their program supporting the sickest patients after hospital discharge. Few programs do. But the work identifies a key Q.
Read 10 tweets
28 Dec 18
Massachusetts’ annual state death report is out with several striking findings. mass.gov/files/document…
Mass. continues to avoid national drop in life expectancy. Average life expectancy inched upward to 80.7 yrs (vs 78.7 nationwide) in 2016 despite the state's persistently high opioid death rate. bostonglobe.com/metro/2018/12/…
The starkest differences in death rates are not by race or gender, but by level of education. People with only a high school degree or less have a *350%* higher annual rate of death than others. That's not a typo.
Read 6 tweets
22 May 18
I am at #WHA71, the 71st World Health Assembly @WHO. I see a striking pattern that is a major shift in global health: a greater focus on advancing individual systems of care—for primary health, childbirth, surgery, diagnostics—and not just controlling individual diseases. 1/6
To succeed, “vertical” programs (such as polio eradication, HIV treatment, TB care) commonly worked outside existing medical systems, because they are so broken. Expanding the efforts, however, requires making basic systems work. And the world is starting to define how. 2/6
For example, @WHO for the first time identified a list of 113 essential, cost-effective diagnostic tests—from blood sugar levels (for diabetes) to basic blood loss counts to HIV tests—that humans require for long, healthy life. 3/6 mobile.nytimes.com/2018/05/21/hea…
Read 7 tweets
1 Oct 17
What I learned from asking struggling people back home in Ohio: Do you think health care is a right? @NewYorker bit.ly/2fKThc0
My tl;dr: Many said no. A right to health care sounded like a demand to pay for others’ needs, when they don’t have enough for their own. /1
In America, working people w $3000 deductibles can be bankrupted while paying taxes for poorer people to get free Medicaid w $0 copays. /2
Read 10 tweets