Given recent events with #POTUS, there's a renewed interest in the typical clinical course of #COVID19.

Here is a quick refresher for all audiences:

1) Symptoms severe enough for patients to seek hospital care often don't occur until 5-7 days after symptom onset.

a med🧵
1/ Week 2 of #COVID19 symptoms is, on average, the "danger window" when some patients become abruptly and critically ill.

2/

Kudos to @MACSports for stepping up and postponing #CollegeFootball.

The fact is we still don’t know what the long-term complications of #COVID19 will be, so student athletes cannot yet make an informed choice on the risks and benefits of playing.

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1/3 We know that if the Big 5 conferences decide to go ahead with football this fall, despite the unknown (but potentially serious!) risks to the athletes, many athletes will have circumstances that, rightly or wrongly, compel them to participate.

2/3

I’d like to use some #popculture to highlight a truly awful, but yet-unmeasured impact of the current #COVID19 pandemic in the U.S.: restrictions on visitors to hospitals.

I’m currently reading Becoming by @MichelleObama. It’s fantastic.

Finished chapter 10 and... ...I couldn’t help but think of the countless people who've been robbed of this type of moment in their own lives because of COVID-19’s effect on hospital visitor policies. Perhaps it is just another unquantifiable tragedy in the midst of many in this pandemic...

Great opinion piece in @statnews co-authored by my colleague @Ateevm re: why #telemedicine is already losing it's precarious foothold in the U.S. healthcare system. Below is a summary of their line of reasoning in 3 tweets 🧵💡

statnews.com/2020/06/25/tel… 1) In any business, uncertainty in future conditions dampens interest in investing resources 💰 to establish a new, long-term capability.

2) Most US healthcare organizations are run as businesses that have limited resources and must make a profit to survive.

How COVID-19 spread like wildfire 🔥 via a series of well-attended indoor church events in a town in rural Arkansas.

A #MedTwitter summary of this paper in 7 tweets:

James A, Eagle L, Phillips C, et al. in @CDCMMWR
DOI: dx.doi.org/10.15585/mmwr.…

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2 persons attended church events while symptomatic on March 6-8 and later tested (+) for COVID-19 (primary cases).

The church pastor and his wife also attended these events and became ill ~4 days later (Mar 10-11) (index cases).

A lot of people have been asking: “Should I be wearing a surgical #mask?” Q: While running?
A: No. Use a cloth face cover, NOT a surgical mask.

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Is my hospital workstation contaminated with SARS-CoV-2?

Here’s: #HowIreadThisPaper from @CDCgov's J of Emerging Inf Diseases on aerosol and surface distribution of the virus that causes COVID-19 in a hospital in Wuhan, China.

wwwnc.cdc.gov/eid/article/26…

#Tweetorial 🧵 2/
Study goal: systematically assess contamination of hospital environment w/ SARS-CoV-2. Areas studied were a COVID+ ICU and an isolation general ward (“GW”). Authors stated the ICU had 15 pts w/ “severe” dz, and GW had 24 pts w/ “milder” dz. No mention of mechanical ventilation

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Though we may continue to hope for the best, in Massachusetts we are approaching the #COVID19 crisis we have sought to avoid: the upper limit of critical care capacity. This has enormous #ethical implications.
Here’s what you should read to be informed:

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First, a broad and thorough assessment of the ethical principles involved in allocating resources during pandemics and applied to COVID-19 in @NEJM.
nejm.org/doi/full/10.10…