1/ Here's a recent @Nature article definitely worth your time. #LongCOVID: answers emerge on how many people get better by @m_c_marshall

The short answer *from me* is: it depends...
It depends on what, you may ask?
Well, here's a short thread.
nature.com/articles/d4158… 2/ First, thanks Michael for citing our preprint which found that the risk of #LongCovid following reinfection is not negligible though lower than after a first infection for those aged 16 years or over.
@mlbosworth @DanAyoubkhani @Know_HG
medrxiv.org/content/10.110…

Tomorrow is #LongCovidAwarenessDay
If you have colleagues, friends or family who’re not informed about #LongCovid talk to them about it. Tell them it’s real & it can be a life-changer even for young people. Tell them to be understanding & supportive of those who live with it. Tell them it could’ve been you or them & that we still don’t know why some people get it & some don’t after covid. Tell them that it’s not ‘in their heads’. It’s not created by anxiety. It’s not ‘an excuse that lazy people use to skive’. Dispel harmful & stigmatising narratives.

1/ Some highlights from my @TheLancet article reviewing The #LongCovid Handbook by @Daltmann10 & @gezmedinger

thelancet.com/journals/lance…
🧵 @TheLancet @Daltmann10 @gezmedinger 2/ "I especially liked the way the authors separated their sections, with Altmann's contributions contained inside boxes and Medinger's outside them. The reader is warned at the outset that Altmann and Medinger do not always agree. This approach is a great model of co-authorship"

We get told we give up or quit because of imposter syndrome. If only we have enough confidence & self belief. We get told it’s our fault. An internal malfunction. Too much sensitivity & self doubt. The longer I experience & see the more I realise how nonsense such narratives are.

https://twitter.com/HelenClarkNZ/status/1626550593656332289

If the outside world keeps chipping away at your confidence & self belief all your life of course they’ll get hit. Of course you’ll run out of energy to constantly build them up. You start realising I’m not gonna live forever so I’ll use this energy elsewhere to make me happy.

Wow, this website on anonymous stories of #sexism & sexual assault in healthcare has just been shared with me and it's so powerful @ScrubSurvivors
survivinginscrubsorg.wordpress.com/your-stories/ It reminded me of a more senior male doctor who used to repeatedly stand behind me when I was sitting at the desk writing in patients' notes & stroke my hair. It was so distressing but you wouldn't dream of doing anything about it at the time- no one would take you seriously.

As a junior doctor I worked with a consultant who sat me down once & said it’s not your fault that u often doubt your skills & judgement. It’s the schooling system. You see these super confident young docs & they’r not necessarily better they were just trained for years to be so. That was over 20 yrs ago but still resonates. I was not only blaming & shaming myself for not being good enough but also blaming myself for thinking &sometimes showing that. With one affirmative sentence he changed the second bit. He halved the psychological load. Amazing really!

1/ Quick thoughts on this recently published healthcare records #LongCovid study which concluded that mild disease does not lead to serious or chronic long term morbidity in the vast majority of patients.
TL;DR I don't believe this conclusion! Here's why:
bmj.com/content/380/bm… 2/ Study results themselves say otherwise:
Shortness of breath, weakness, smell & taste disorders, concentration & memory impairment all remained higher in those with +PCR compared to controls at 1y. It seems the authors considered these not serious to reach the above conclusion

1/ Kick-off question from @DJDevakumar in the launch of @TheLancet racism and health series @raceandhealth

What does #racism mean to you?

This made me reflect on my personal definition of racism so here goes 🧵 2/ To me personally I think of #racism as discrimination whether *by thought and/or action* based on skin colour or geographical place or culture or religion or language or social attitudes that never operates in isolation, which brings us to the concept of #intersectionality

1/ I watched the men’s WC opening ceremony last night because as someone with an Arab background I wanted to see how an Arab country would do it. I wasn’t impressed and personally didn’t feel any sense of pride or representation. However I understand that other Arabs might. 2/ I get why some of those negatively stereotyped and routinely discriminated against in Western settings might feel it hypocritical that once a country that speaks their language & carries elements of their culture hosts a global event like this many call for boycotting it.

Lots of sadness about Twitter potentially going or significantly changing among the #LongCovid & #ChronicIllness communities. Also remember how It amplified voices that could’ve not been heard otherwise on issues like #pandemic #science #racism #GenderEquity. But don’t despair 1/ We know how to do it now so we’ll do it again. Preferably on platforms not totally controlled by billionaires and not using our connection to gain massive profit and increase inequalities. I’m an optimist on this. Because life is change. Nothing stays the same. However 2/

1/ Systematic review of the prevalence of #LongCovid

Now out as a preprint (not peer reviewed yet). It was a LOT of work. So grateful to my co-authors for their monumental effort: @MirembeWoodrow @NidaZiauddeen Darren Greenwood @vlutje1 Rebecca Thomas, @AthenaAkrami Chales Carey 2/As expected we found a huge variation between studies (0-93%). Prevalence generally higher in studies with mostly hospitalised patients. Because of our search period, studies estimating prevalence post vaccination were not included but we know these generally show lower numbers

Hey, you can say the UK needs to train more doctors and nurses without throwing NHS workers who trained abroad under the bus. Easy. Totally fine if you wanna unfollow me for saying this btw.

1/ I'm back to feeling excluded.

Recently I got an invitation to an evening networking event that thought leaders in my professional field attend. I can't go. Because it's not local to me and I have no childcare arrangement for that evening. Not a big deal? Please hear me out.. 2/ In 2020/21 I attended similar ones virtually. I didn't feel excluded then. I was able to participate, meet great people & generate new opportunities for work within my discipline. Many colleagues (mostly women) shared the same sentiment with me. A positive step for equity...

Two thirds of Leave votes believe I'm not 'truly British'. Gosh, that's pretty traumatising.

Data source: bsa.natcen.ac.uk/latest-report/… And more shocking: a third of Remainers!

“Long Covid is a problem that we have recognised early as a substantial issue” is a statement that I would very strongly dispute for the US, UK & any other country that allowed mass covid infections in unvaccinated populations in 2020 to make.
@ashishkjha

https://twitter.com/time/status/1585399257913327624

We were shouting from the rooftops and policy makers weren’t listening.

https://twitter.com/dr2nisreenalwan/status/1280896167363182592

1/ Recently I saw a tweet essentially saying that scientists with big Twitter following tend to ‘follow their crowd’ (my paraphrasing). That is they’ve build a big following by saying certain things and they tend to stick to the same themes to keep their following. Well... 2/ I agree this is a thing, but not only with scientists or only on Twitter/any online platform. It is also thing within politics , religion, social movements etc way before the invention of social media.

So is it a bad thing?

I was also held up at airport border control last year with 3 kids. Worst part of my story is that the situation got resolved by my eldest (17yo) ringing his dad (my ex) on his phone (could’ve been anyone!) & border officer speaking to dad on phone to ask if I was the kids’ mum.

https://twitter.com/samaraafzal/status/1582406226247241728

They need to see the birth certificate, fair enough (passports should have mum’s name really), but what got me really upset is that they instantly believed a man on the phone over a face to face prolonged conversation with a mother and her 3 kids.

🛎 Attention scientific conference organisers:

It is not acceptable in this day and age not to organise your face to face events as hybrid.

I’ll tell you why 🧵 1/ You can’t pretend the pandemic didn’t happen. Some people don’t want to take the health risk of airborne infections for health reasons with ongoing viral waves. Excluding them by not providing a virtual option for participation is an ableist approach. You should do better.

I don't object to people calling me by first name rather than 'Professor'. In fact first name is my preferred mode of being addressed. What I object to is the differential treatment in formal forums and introducing people differently dictated by stereotypes and unconscious bias. I've seen this happen a lot to me and to others. I think organisations should have a strict explicit policy for all their events, forums and communications of either introducing or referring to everyone equally informally or correctly using titles/qualifications equally.

Understandably people want to move on from covid, but that doesn’t give anybody a licence to dismiss #LongCovid. It’s an emotive subject, no point denying this. Everyone is a stakeholder, either directly by having it or indirectly by how they process the risk or getting it. It’s hard, you want to resume life as you knew it (again understandably) so you you may not want to be reminded of the risk this viruses poses. But you need to watch out. Make sure your process of self reassurance doesn’t deny others your belief in their lived reality.

The state of this! The full letter:

https://twitter.com/jim_dickinson/status/1541425525280935943