As a doctor, Trump's announcement tonight sends a shiver down my spine. Medical professionals are still burned out, still dealing with the fallout of Trump's presidency. In case anyone forgot, here's a list of how he harmed our patients and attacked health care access (🧵): 1/10 Data show as many as 40% of COVID-19 deaths (nearly ¼ million) during Trump's presidency could have been prevented had he handled the pandemic like wealthy peer nations. We still mourn the loss of our patients and neighbors. It didn't have to be that way. 2/10

I am genuinely pissed that a know-nothing Federalist judge lifted the travel mask requirement.

I'm not pissed for partisan or personal reasons, I am pissed as someone 11 days from receiving my MPH (#GoBlue)

Here's why: A 🧵

1/ Masks should never have been political. They're a simple, risk free method for lessening the risk of COVID19 and yes, saving some lives.

But for a thin skinned, vane, know-nothing former President, this would not be partisan, and many more people would now be alive.

2/

After seeing more and more unvaccinated COVID19 patients coming to the ER and having to be admitted to beds that are miles away and hours away from being available, I get more and more pissed at the offensive display of anti-science and anti-Semitism in DC yesterday. 1/9 And today, @SenRonJohnson held a "hearing" with some of the same anti-vaxxers who spoke at the rally, and whose disinformation has led to hundreds of thousands of unnecessary deaths since the vaccines became available over a year ago. 2/9

Well #COVID19 has finally hit my house. My oldest tested positive a few days ago, and being vaccinated and boosted, she is isolating in the basement with minor symptoms. But even for a 2-doctor family, navigating this has been a challenge. Here is what we're doing>> 1/8 She is a college student in NYC, and learned of an exposure after she returned home late last week. With a mild headache and sniffles, home testing ensued over the weekend, and a positive PCR returned Tuesday. She is isolating in the basement, and having only minor symptoms. 2/8

A 🧵👇

Another heartbreaking day in the ER.

A healthy 40-something dx w/ COVID a week ago.

So was their spouse.

Both unvaccinated.

My patient came in today with an oxygen sat of 64%.

Their spouse has a mild cough.

1/10 We can predict who will more likely than others get very sick from COVID19.

The elderly.

The immunocompromised.

Those with underlying lung disease.

Others.

It's not a guarantee, but those folks are more "at risk."

2/10

Some observations from the ER over the last few weeks in a low vaccination rural part of Michigan where COVID cases are again on the rise. 1/12 The feel is eerily similar to the wave in December/January and the wave in March. We have again seen several weeks of slowly rising test positive rates followed by several weeks of rapidly rising test positive rates. 2/12

I ordered a #COVID19 test on a patient who refused the test because he heard we could “give any result we wanted” and that they weren’t reliable. Also heard the vaccine would “make you sick” 1/7 My initial, visceral reaction was to be pissed off. I exited without any fuss and proceeded with the rest of his evaluation. After everything was back and he was ready for d/c I went back in. 2/7

As you may have heard, NV & CO have been leading on health care policies lately, passing public options & an Rx drug affordability board. They faced RECORD backlash from the industry, but physician-advocates w/@cmteetoprotect didn't back down. Here's why this fight matters (🧵): Drug and insurance corporations went to great lengths to protect their ever-growing profits. In Colorado alone their dark-money front groups BROKE RECORDS to try to block the #ColoradoOption. (2/13)
coloradosun.com/2021/04/29/hou…

My ER is now offering #COVID19 vaccinations. The conversations are long and somewhat non-conducive to ER visits, but I am trying.

A brief thread on how the conversations are going broken down by the type of resistant patient with whom I am speaking. 1/10 First are the folks who want to be vaccinated, but have barriers to getting the shot(s).

In my rural area, the barriers seem to be transportation and getting time off of work to get the shot(s) and for the day after for those who need it. 2/10

As an ER doc, here's why the #AmericanRescuePlan must be passed right away: I’ve seen 2 of my sickest #COVID19 patients ever in the last 2 weeks. It's great that 3 safe, effective vaccines are available, but we MUST get shots in arms ASAP. Without this plan, we can’t do that. I know #Pandemicfatigue is impacting the most ardent supporters of public health. But getting 70-90% of Americans vaccinated is the light at the end of the long tunnel through which we’ve travelled over a year. The final % needed is time sensitive. We haven’t a moment to waste.

Here's a little pep talk for those experiencing Pandemic Fatigue. First off, this is a real thing & you shouldn't be ashamed. I’m hearing from patients, family & friends that you’ve been doing your best to follow guidelines for a year, but are simply sick of it! I get it. But... Help is on the way. We have an amazing, miraculous scientific advancement -- a vaccine that is helping us return to normal. We just need to hold on a little longer, get our vaccines, and continue to follow safety protocols. There is light at the end of the tunnel! I promise you.

As an ER doc who's spent the last year of my life trying to stop a deadly virus from killing my neighbors, 6 words in @joebiden's speech lifted me up for the 1st time in months: "I Will Always Level With You.”
Here's why that's so meaningful to me & more importantly, our nation: As the next 4-6 months unfold, a herculean effort will be needed from the government in the midst of a pandemic & millions of Americans without health care. There's so much we don't know. But it matters that we can *trust* our government to do their best & shoot straight with us.

I see @fmanjoo has decided that traveling to see distant family this Thanksgiving is “worth it.” Reading his contact tracing experiment👇 is enraging. As an ER doc in a region getting decimated by #COVID19 right now, I have a slightly different take. (1/9)

https://twitter.com/fmanjoo/status/1329781116169973766?s=20

The missing component of his article is where he considers how his actions & writing about them impacts those outside his bubble & family. Each time a person interacts with those not in their bubble, the odds of getting the virus goes up. It may be small, but it's additive. (2/9)

As an ER doc for 20 years, I have only ever wanted my patients to get the care they need. Like many, I have been critical of @realDonaldTrump’s lack of a plan to control #COVID19 & his desire to eliminate health insurance for 25 million. Here’s why I voted *for* @joebiden: (1/11) It’s not just that he isn’t Trump, although I can’t think of anyone worse that could be President in this moment. Not being Trump isn’t enough to stand in line for hours in a mask just to vote. Biden may be especially suited to lead us out of the darkness at this time. (2/11)

I can’t believe it’s come to this: The head of the president’s #COVID19 task force, @Mike_Pence, has an outbreak in his inner circle. As an emergency physician, I can tell you this: The Vice President is putting many lives at risk & must quarantine right away. Here’s why: (1/8) As doctors we routinely tell our patients and their family members that if they are a close contact of an individual who tests + for #COVID19, they must quarantine for 14 days. We’ve learned that members of @vp Pence’s staff have tested +, yet he’s on the campaign trail. (2/8)

As a doctor who cares for #COVID19 patients the idea #HerdImmunity through infection is alarming. It's been rejected by the head of the NIH as "fringe," but is being embraced by the White House and @realDonaldTrump. Just what is herd immunity? 1/XX nytimes.com/live/2020/10/1… Herd Immunity is an epidemiological phenomenon achieved when enough of a healthy population is immune through vaccination so that an infectious organism can no longer spread in a population. 2/XX

As a doctor, it's beyond bizarre to see a potential #SCOTUS justice say she'll make decisions about healthcare (eg, denying it to millions) based on #Originalism-what she thinks people in the 1700s would have intended. How different was medicine back then? Read on... (1/11) In the 18th century, barber-surgeons were still doing blood letting, a common (deadly) practice that gave rise to the barber pole with red & white stripes representing bandages & blood. It'd be 11 yrs before surgeons would separate from barbers & perform medical procedures (2/11)

As an ER doc who admitted many new #COVID19 patients on my shift yesterday, the idea that @realdonaldtrump left the hospital early is disturbing & alarming. He's not only putting himself in serious harm, he could kill many others. Here's how: (1/5) The president wants his fans to think the virus is no big deal. Well, 1 out of 10 COVID patients in his age range die of it. If people his age listen to him & don't take it seriously, that's a huge number who will get the virus. And a huge chunk of them will die of it. (2/5)

I know we're all now immune to reports of the White House mishandling Americans' health - but this story👇 about them meddling with @CDCgov to alter their weekly reports is an OUTRAGE & will make the job of doctors like me much harder. Here's why... (1/12) washingtonpost.com/opinions/2020/… Everyday in my practice as an emergency physician I rely upon updated studies of various tests & therapies, so that I can best serve my patients. It's called evidence-based medicine & it means relying on rigorous data. Stated simply, patients depend upon it to stay alive. (2/12)

As a doctor, I fear this isn't getting enough attention: New presidential advisor Scott Atlas backs a very dangerous plan to have us all get #COVID19 so we achieve "herd immunity."👇 This could *kill* hundreds of thousands of Americans. Here's how: (1/11)

https://twitter.com/philiprucker/status/1300400865711398912?s=21

First off, who is this Scott Atlas that now advises the president on #COVID19, instead of people like Dr. Fauci? He's a right-wing think tank guy who hasn't treated patients in years. Or as doctor @kenjeong artifully puts it: (2/11)

https://twitter.com/kenjeong/status/1300622391127597056?s=20

As a doctor, I yearn for us to have effective therapies for #COVID19. However, @realdonaldtrump's rushed "Emergency Use Authorization" for convalescent plasma (an unproven treatment) may actually *harm* our ability to fight the virus. That's right - harm it. Here's why: (1/12) When someone recovers from #COVID19, their blood will have antibodies that may help others currently infected. By transferring these antibodies via plasma, immunity could (in theory) be passed to the patient to speed recovery & save lives. But we must *study* this theory. (2/12)