The problem with infectious disease scares is a) they happen ALL the time and b) most of them flame out.

But this (H5N1/ Bird Flu) is starting to feel a lot like 2020 again. And we seem to be making the same testing and communication mistakes. 🤦🏽‍♂️

amazon.com/Crisis-Chaos-L… In 2020, we had an incumbent President running for reelection who was loathe to overreact and spoke the public- especially if it meant harm to the economy. Because the truth is, these things really do typically “just disappear” on their own…

Once you get past all the “it’s just a cold” bluster, it’s amazing to consider how many people who will tell you they still have a cough/ wheeze/ are taking an inhaler/ fatigue/ are “not back to normal” long after they’ve had Covid.

I know I’m not the only one who hears this.🤷🏽‍♂️ I get it- people don’t want to give us socialization / have their lives and plans impacted. That’s human nature. I also think most people KNOW covid can be really harmful, and the downplaying of it is really is psychological compensation to justify the risk to themselves.

Bird flu /H5N1 update: 🧵

On April 1, 2024, a Texas resident with exposure to dairy cattle tested positive for highly pathogenic avian influenza (HPAI) A(H5N1), also known as bird flu and avian influenza. The person was treated and has recovered.

cdc.gov/media/releases… This incident is separate from a March 2024 report confirming this year’s first U.S. human infected with an influenza virus that normally spreads in pigs and not people. This person also was treated and has recovered.

Interesting #COVID_19 stats- a 🧵:

1) 95% of current covid hospitalizations are in people who are not up to date on their vaccinations. So especially if you or a loved one is in a higher risk group, please consider a vaccine or boost. 2) Covid fell from the 3rd leading cause of death in 2021 to 10th in 2023. Things ARE objectively better. And we have to also focus on the other top 9 causes of death (eg opioid overdoses, heart disease, cancer).

Latest update on my @MayoClinic ER visit bill dispute:
They talked to their coding company (whose primary purpose is to maximize THEIR collections), and said they also checked regional average charges… and say they are justified in charging $9000+ for IV fluids and labs. 🤦🏽‍♂️ Disputing a medical bill can feel like facing an unjust justice system, as hospitals are police officer, judge, and jailer. Despite my familiarity with the system, I’ve hit the same dead-end as too many in U.S. - pay up or face collections. 🤷🏽‍♂️

businessinsider.com/former-surgeon…

Recently had an ER visit for dehydration while out of town. Received some labs and 3 IV bags. Here's the bill- AFTER insurance. It's no wonder medical debt is the top cause of bankruptcy in the U.S. 🏥💸 #HealthcareCosts #MedicalDebtCrisis I’m a doctor who is in the top 1% of earners. And even I don’t have $4896.43 lying around. So I clicked “billing options” and was relived to see that I was offered an alternative to “pay us $5k right now or have your credit ruined.” I could go on the $1632.15 per month plan! 🤦🏽‍♂️

ICYMI: A “systematic review to evaluate the evidence for effectiveness of child mask mandates in reducing transmission or disease severity in COVID-19.” 🧵

adc.bmj.com/content/early/… As with the prior Cochrane review, many - including the authors of this study - conflate masking efficacy with mask mandate efficacy.

One is a medical / health intervention and the other is a policy intervention, and it’s imperative to distinguish one from the other…

The pandemic school closure debate is now often framed as being solely about the kids. However, it's important to acknowledge that in 2020, the focus was mostly about using the kids as guinea pigs (ie subjecting them to a new virus) to achieve herd
immunity + faster reopening.👇🏽 Instead of prioritizing learning loss and social isolation, most discussion was about using kids as a means to help the adults. In the future let’s remember to truly prioritize the holistic well being of our kids (especially vulnerable and caregivers). amazon.com/Crisis-Chaos-L…

🌟 Exciting News! 🌟

Hey there, amazing friends! 💙 I hope you're all doing well and staying safe. Today, I wanted to address some frequently asked questions about the COVID-19 vaccine, flu shots, and RSV. Let's dive right in and spread some positivity!👇🏽 🌍 Who needs the COVID vaccine, flu shot, and RSV vaccine? 🌍

Everyone should consider updated Covid + Flu shots ! These vaccines play a crucial role in protecting ourselves and our loved ones from potentially severe illnesses. While each vaccine targets different viruses, they all contribute to building a healthier and safer community.

Hey everyone! 👋🏽
Want to say I absolutely agree with Dr. L about the importance of lifestyle!👍🏽

Unfortunately due to conditions and policies in some places, not everyone everywhere can focus on “making healthy choices.” So today, let's talk about the incredible significance of social determinants of health! 🌈✨


🏠 Did you know that our living conditions, access to education, employment opportunities, and even our social and economic status - all things greatly impacted by state and local government laws and policies- can greatly impact our overall well-being? It's true! So, let's dive into the importance of these social determinants and how they shape our health outcomes. 🌻🌍

Anecdotally (ie family and friends), professionally (in the hospital), and from the data (wastewater + hospitalizations) covid cases are skyrocketing.

Yes- many have some residual immunity and will get milder sickness than past waves, but ⬆️ hospitalization rates don’t lie. Cases will continue to grow exponentially as we end summer, weather events (heat and rain) force people indoors, k-12 and colleges start, and we approach the Labor Day holiday. In other words, it’s going to get worse before it gets better.

Except:
80% not up-to-date on vaccines – worse for black and brown communities.

Updated vaccine is not available for another month at least.

Marginalized communities can’t access treatment / tests/ N95s.

I just don’t understand the reason for such disregard for vulnerable.🤷🏽‍♂️

https://twitter.com/ashishkjha/status/1690774099373559808

Also, it’s not “every new variant” people are worried about. It’s the documented uptick in COVID-19 ED visits and hospitalizations.

As I said, I prefer to address policies over people, but I just truly am baffled at a Dean of public health saying these things these ways.

I try to focus on policies (vs people), but I’ve been asked a lot about this specific article. The premise is YOU CAN IGNORE COVID (…if you’re up to date on vaccines and take Paxlovid when sick…).

But the headline buries the lede, almost to the point of being disinformation. The first problem with the article is, less than 20% of the United States is actually up to date on vaccination.🤦🏽‍♂️

So perhaps the headline should have read: Four out of five in U.S. should think twice before “ignoring covid?” 🤔

(Especially given our recent summer surge...)

A lot of “so what” to the reported covid increases in FL and TX. The so what is that there is currently essentially no testing of anyone who isn’t already sick enough to go to the hospital. So these increased cases likely represent real societal harm- not the sniffles.

https://twitter.com/bnofeed/status/1685797252399308801

Acknowledging this doesn’t mean we’re on our way to “lockdowns” and mask mandates. In fact, most people have at least some baseline immunity. But from a public health standpoint, we should be alerting and protecting the vulnerable among us, and making treatment more available.

I’ve been seeing some posts suggesting doctors and scientists shouldn’t say vaccines don’t cause autism, because, “hey, you could be wrong, and it’s arrogant, and even unscientific to suggest otherwise.” Here’s why this reflects a misunderstanding of the scientific process… 🧵 Science tells us to question previous beliefs, but a) there’s a process to prove or disprove those beliefs. And b) when that process is followed, science says we coalesce around the conclusions. At some point “science” had to agree the earth is round, and the moon is real.

My problem with the GBD? They both misunderstood and never worked to enact their strategy of “focused protection”- allowing “those at minimal risk of death to live normally while better protecting those at high risk”

The COVID strategy that proved lethal latimes.com/business/story… They misunderstood that with a majority of US adults being obese or hypertensive (or both), most of working America actually falls in the “higher risk”, and not the “minimal risk group.” They also rarely if ever advocated for policy measures to actually protect high risk adults.

Out for a morning walk and marveling at the diversity of American experiences. Crazy to imagine how many kids in this country grow up without ever seeing this much open space, or being able to walk outside for 30 minutes straight & see lots of animals, but not a single person. 🤯 If you haven’t been to this part of America, it can be difficult to understand how so many people are more concerned about defending their homes against a coyote/ Wolfe/ bear (or a nighttime intruder when the police are 45 minutes away), than they are about firearm violence.

Annual reminder: prior to 2020 the belief was that most respiratory infections were spread by people with overt symptoms.

So instead of “wear a mask,” public health advice was “stay home / isolate when feeling sick.”

(It presumed most people would/ could actually isolate) The pandemic revealed several things:

1) SARSCoV2 demonstrated more asymptomatic spread than anyone anticipated
2) The U.S. was forced to acknowledge many couldn’t isolate, due to lack of sick leave/ childcare/ societal support

-> This changed the calculus on mask advice

If I only had a nickel for those who had no clue what a Cochrane Review was a week ago, yet this week would seemingly jump out of plane with no parachute if Cochrane told them they found no difference in people who used parachutes vs those who didn’t…🤷🏽‍♂️

theconversation.com/amp/yes-masks-… Also, if you are a new believer in all things Cochrane- no questions asked- here’s another review they did. Please share and use it to guide your behaviors!👇🏽

cochrane.org/news/cochrane-…

So you are 96% likely to walk/sit by/ breathe the air of someone infected while flying. You can choose to rely only on air filtration (which helps on a running plane- NOT in TSA, boarding, etc), but this ends debate on utility of N95 use during air travel. audacy.com/wwjnewsradio/n… And to the pilot who advised me to take off my mask and “breathe free,” I hope you didn’t harm one of your vulnerable passengers with your actions and advice, and that you don’t have or get long covid from your 96% daily chance of encountering the virus.

https://twitter.com/jeromeadamsmd/status/1516842036132909058

I never thought a supposed puff piece in the Washington Post Lifestyle section would be what pulled me back to Twitter, but apparently other people are (falsely) telling our story. 🤦🏽‍♂️

A few weeks back a Post reporter asked about doing a story on my wife’s cancer journey…
1/ The reporter asked my wife if she would mind being interviewed about her metastatic melanoma recurrence for their “Style” section (eg weddings and recipes and family stories). Seems harmless, no? They asked to interview me after her- and I did. To support my wife.
2/