A Dignified Death

An elderly loved one is worsening, your heart says it’s futile, but the doctors are NOT giving you straight answers? Read this 🧵

Here is what I have learned about end of life issues after treating >25,000 patients.

Read on… What?
Death is part of life. I’ve learned that most doctors, patients and families avoid this topic.

Perhaps it generates anger, shame, guilt and other -ve emotions

We forget that there is a time to save a person’s body and then there’s a time to save a person’s dignity…

WHO declares Monkeypox a public health emergency of international concern (PHEIC)

What does it mean, how to protect yourself and why it’s not the end of the world

Read on. A 🧵

who.int/director-gener… Context matters: In the past dozen years, there have been six other similar PHEIC declarations

2009 Swine flu
2014 Polio
2014 Ebola
2015 Zika
2018 K. Ebola
2019 COVID

Point: Not all PHEICs become pandemics. But it’s the right precautionary step by WHO

en.wikipedia.org/wiki/Public_He…

Depressed? Tired? Exhausted?

Complaining won’t make us feel better; an attitude of gratitude will.

Despite the pandemic, there’s so much to be grateful for. Here are a few samples that work for me…

Read this short 🧵 and think… Hate COVID restrictions?

1000s if not 100s of 1000s of innocent people are wrongfully imprisoned. Be grateful.

link.springer.com/chapter/10.100…

Personal News: Omicron got me:)

Two weeks ago I developed symptoms and tested +ve

Sharing five lessons I learned from that experience and hoping you’ll find them helpful Lesson 1: Masks work

I’ve been around COVID patients over 1000 times in ~2 years and didn’t get infected due to masks/PPE

But was exposed for 2-days at a maskless family gathering and COVID got me

So yes. Masks work. Wear an N95 or KN95 if you can

Debunking 4 Claims of a Nobel Laureate (respectfully)

Short version: ALL claims are wrong. Opinion is always weaker than scientific evidence; ANYONE’S opinion

Long version: Lets debunks all claims: ppl will die in 2 ys, cases have exploded, vaccine causes variants, ADE. Read on Claims 1 & 2
1. Anyone who is vaccinated will die within two years

Wrong. He didn’t even make the 1st statement. That’s that

2. COVID has exploded

Wrong: In US, 70,000 ppl died from Mar-May (after vaccines) while >250,000 died in 3-months before vaccine

Same in other nations

1/ The pandemic has caused unprecedented stress and isolation. Reach out to someone this weekend. And say “I miss you.

Important thread. Read on: 2/ Make time. Call a loved one you haven’t spoken to in a few months

1/ When will COVID end? **Thread**

No one knows. But:

Remain extremely cautious till April 2021.

Why? Read on... 2/ How it may end in 2021?

- actual infections + cross immunity higher than counted
- plus masks/social distancing reduces the R <1
- more tests/treatments
- select populations get vaccinated
- meaning herd immunity achieved faster than expected

Outbreak slows down. Then dies

1/ **Thread**

Giving COVID tips to all. Yet getting hate from...

...Indians for being a Muslim
..Pakistanis for being an Ahmadi
.Americans for being Scientific
Others for being an American!

I embrace ALL my ⬆️ identities & don’t need pity. But we need to talk:) Read till end.. 2/6: Dear Indians, pandemic is a sobering time. Who lives, who dies, who knows. Let’s be kind

Don’t judge people by their names; don’t judge a faith by its nutcases. Broad brushing any large group is a bad idea. Watch below for a ❤️ perspective ⬇️

1/ Important Thread: COVID and Children

Children are more likely to beat COVID than adults.

Plus the what, why, and how of careful schools re-opening.

If you like to self study, read article 👇below

If you like bite-sized pieces, read on...thread

services.aap.org/en/pages/2019-… 2/ Key (reassuring) facts. Children are:

- 3-fold less susceptible

- less likely to spread

- asymptomatic rate ~20%

- less likely to be hospitalized

- mortality less than flu

- multisustem inflammatory disorder is extremely rare and largely treatable

1/
COVID is likely here for >2 yrs. Lockdowns are one extreme; Denial of science is the other

Let’s learn to LIVE with the middle way - CAUTION - without gravitating to either extremes

There are many parallels of this new reality with learning how to drive a car. Read on... 2/
Before driving a car, we learn/abide by certain rules. That’s not giving up our freedoms

We wear a seatbelt before driving; during pandemic, wear a mask before going in public

Just like we keep a safe distance between cars, maintain >6 feet between each other in public

So many treatments for COVID and so much confusion. Why?

Does plasma work or not? Will steroids be life saving or life threatening?

This thread explains why this “confusion” is the normal scientific process and how to deal with it.

1/ With every disease, we conduct studies to see whether a certain treatment would help/harm

Just like anything else, studies vary in quality. Some are well done; others are poorly conducted.

Doctors and scientists carefully review them in academic circles.

2/

How to treat COVID at home?

This thread is for COVID + folks who avoid hospital due to cost/trust/capacity issues

What to take, what to avoid, when to worry, when not to, protecting family etc.

This is general advice; for personal treatment Qs ask your doctor

Let’s start

1/ Use a separate room/bathroom/utensils etc for 14 d

If only one room, divide it with a thick curtain/screen and stay behind it

If only one bathroom, wear face mask before going and wipe all surfaces as best after using toilet

Don’t use steam/nebulizer/cpap in shared room

2/

Myth: Herbs, supplements, sanna makki, special diets and vitamins are harmless. Take them to boost your immunity against CIVID. What’s the downside?

Fact: The benefits of these substances are unclear; their occasional side effects are well documented

This thread explains...

1/ Traditional Asian/Chinese herbs can cause kidney or liver damage.

High concentrations of arsenic, lead, cadmium were found in 61% of herbs.

theguardian.com/australia-news…

2/

Good news: How to beat COVID without any tests, treatments, vaccines, or magic potions.

The trick lies in two words:
1. Perspective
2. Attitude

When we objectively assess the risks with data/without emotion, our future’s aren’t that gloomy. Let’s analyze. Read on...

1/ Nearly 65% of the global population didn’t get Spanish flu during the 1918 pandemic

Today’s global travel =greater risk. But we ALSO have better preventions and faster means of educating masses

Over 50% should be able to avoid COVID altogether. Just do the right thing

2/

Thread - 1/ Lockdowns ending

Common narrative:
“COVID cases/deaths are declining, economies are reopening, lockdowns ending. It’s over.”

We underestimated the first wave. And suffered.

Let’s not underestimate the second wave by declaring victory too soon.

Read on... 2/ We are far from achieving herd immunity or conducting mass vaccination

Only 5% to 20% of populations have been exposed in most big cities thus far. See attached

Goal is to get to 60-70% for broad protection

This means a second wave is v. likely

nytimes.com/interactive/20…

Thread:
Applicable to many countries but for India/Pakistan COVID is no future threat; it’s here.

Explaining: Why the real case count is likely 10-20 fold, deaths are WAY under reported, and why this is my compassion - NOT critique

So please read it without feeling attacked

1/ Real number of COVID cases are 10-20 times higher

Because IND/PK have done 10-30 times less COVID tests

India 2400/M
PK. 2300/M
BD. 1600/M

Leave the affluent West

Even Russia has done 60,000/M, Turkey 22,000/M. Even Ghana’s done 6000/M

So it’s here and now.

2/

Thread: “I’m-tired-of COVID shutdowns”

Imagine you were hiding from an active shooter in your office

You won’t come out due to fatigue/frustration...you’d want to be sure the shooter was neutralized

So how do we know the COVID shooter has been neutralized?

Read on
1/ If the number of cases, hospitalizations, deaths are going up in your state, it’s time to keep hiding

Attached are graphs of states where cases are going up. Fully re-opening these state NOW will likely generate a 2nd wave and result in a tighter, longer shut down

2/

COVID MYTH-BUSTING: Part 4

China (or the US) were behind this virus which was created in a bio-weapon lab.

Truth: An article in Nature (below) strongly suggested that the virus emerged as natural selection and is NOT a man/lab made virus.

nature.com/articles/s4159… Myth: US companies are holding patents for coronovirus for years. Plan was to first start this outbreak and then sell the vaccine.

Truth: Those patents are for developing the SARS vaccine (remember, SARS was also a Coronavirus spread in 2003). We still don’t have that vaccine.

COVID mythbusting: Part 3

Myth: Coronavirus is airborne.

Wrong:

It’s a droplet infection, requiring close contact. The NEJM article only hinted at the virus’ ability to be aerosolized in a lab.

Our air is CLEAN! Walk in a park!

WHO also approves this position. Myth: We won’t get COVID because we are (insert your religion here).

Wrong:
Coronavirus does not ask whether you are Christian or Muslim or Jewish or Hindu or Sikh or (many more) or Atheist. The virus only asks: Are you human?

Previous outbreaks didn’t spare any faith.

COVID Myth-busting Thread: Too many myths floating around. Here’s part 2.

1/10: Avoid shipped packages/gas pumps/shopping carts/ATMs or you’ll die.

Wrong.
Coronavirus surface survival is one thing; that surface causing an infection is another. Wash your hands; live your life 2/10: You can catch COVID-19 from ordering takeout food/Chinese food (or the packaging of food).

Wrong.
COVID-19 is a droplet related infection (like flu) not a food-borne infection (like salmonella etc.). There is no documented COVID risk with take-out food.

A Thread: Why the COVID-19 pandemic will take >months and what can we learn from trees?

Look at the blooming trees. But recall how they persevere a harsh winter, every year.

Previous pandemics lasted 1-4 years. This one isn’t going away just because of the warm months ahead. 2/10: Currently, the US COVID-19 cases are doubling every 2-3 days. We don’t have enough doctors, nurses, hospital beds, ventilators, facemasks, tests, medicines. There is a huge capacity mismatch.

Major turbulence (like a freezing winter for a tree) ahead. Remain patient.