ID Physician | COVID-19 Health Ops @WHO | US Congress COVID-19 witness | IDSA Global Health Committee Chair | ELBI @JHSPH_CHS| @PLOSGPH Ed Board -Tweets my own
Jan 31 • 4 tweets • 6 min read
New data out today from #Denmark demonstrating that #Omicron#BA2 is more transmissible than #BA1 and has immune evasive properties reducing protective effect of #vaccination
Full 🧵👇 1/ medrxiv.org/content/10.110…
- Of 8,541 primary household cases with #Omicron, 2,122 were #BA2
- There were 5,702 secondary infections among 17,945 potential secondary cases
- In households with #Omicron, secondary attack rate was
29% - #BA1
39% - #BA2 2/
1⃣Transmissibility of #variant
2⃣How protective vaccines & prior infection are
3⃣Virulence of variant
4⃣Understanding of dynamics & uptake PHSM
Full 🧵👇 (1/) who.int/publications/m…
Epidemiology (1)
-#Omicron has large growth advantage over #Delta - grows significantly more than Delta in countries with community transmission
- Evidence that immune evasion contributes to rapid spread
-Wk 52, global weekly #COVID19 incidence ⬆️ 71% compared to prior wk
(2/)
Jan 1 • 5 tweets • 4 min read
This narrative is exactly what I was worried about👇
We still don’t know #Omicron causes less severe disease but has become so politicized leaders say it only causes a “sore throat” without thinking of the immediate & long term (post #COVID19 condition #LongCovid) effects
#COVID19 and #Omicron most certainly does not only cause a “sore throat” we are seeing ⬆️⬆️ numbers of ICU admits and hospitalizations.
Yes some may have mild disease (thank you #vaccines) but these people can still transmit and put others (ie immunecompromised) at high risk.
Dec 30, 2021 • 5 tweets • 3 min read
💯agree with @jabarocas - in the past 24 hours 5 healthcare worker friends in different parts of the #US have been diagnosed with #COVID19.
At this rate as hospitalizations ⬆️ there will be an ⬆️ shortage of HCW's- who will care for patients & what will it look like a🧵 1/
✅The provider: patient ratio ⬆️⬆️⬆️
✅Patients wait longer for things like water, ice, food, & meds as nurses are stretched caring for more patients
✅The lab is stretched thin so bloodwork takes longer to return
✅Radiology is busier so it takes longer for an X-ray
2/
Here is some of the @CDC data that was looked at and published by @washingtonpost to make the recommendations to re-implement #masks earlier this week
Note that the #DeltaVariant is MORE transmissible than
- MERS & SARS
- Ebola
- Seasonal Flu and the Flu of 1918
- Smallpox 1/ #DeltaVariant associated with lower Ct value in breakthrough cases, longer duration of Ct < 30, and higher risk of re-infecton 2/
Apr 14, 2021 • 8 tweets • 3 min read
1/
Information regarding the six patients who have developed CVST after the #JohnsonandJohnson#CovidVaccine
- All were white females
- Only one was on oral contraceptives 2/ Clinical features of the patients
I see a lot of suggestions/posts about #vaccine rollout and since I have been involved with this thought I would provide insight based on my experiences
See thread below 👇
1/1. Expecting our hospitals/healthcare systems to absorb the #CovidVaccine rollout without support is unreasonable.
- Hospitals are running on empty and short staffed trying to manage caring for patients
- Rolling out this vaccine takes a lot of support and planning
2/
Dec 13, 2020 • 4 tweets • 3 min read
Since I am helping lead the #Pfizer#CovidVaccine rollout at our institution I have spent a lot of time doing town halls and engaging with people on the vaccine.
One of the most common questions I get is in regards to side effects so I thought I would post my slides
Overall localized side effects of the #CovidVaccine
Nov 7, 2020 • 4 tweets • 1 min read
I want people to understand what we mean when we say that hospitals are at "capacity"
- That means there are no more beds for patients
- If you are in a trauma and need care there is not a bed
- Your elective surgery cardiac cath, or biopsy is will be postponed
- When you come to the Emergency Room you are going to wait much longer because doctors and nurses are busy trying to manage all the patients
- You may have to stay in a bed in a hall (if you are lucky)
- Nurses will be further stretched and have less time to tend to you
Nov 7, 2020 • 4 tweets • 3 min read
Given the #surge of #COVID19 in the US we need to focus on containing the pandemic. Here are some things we need 1. We need a #NationalPlan to combat this infection
- Right now we have 50 states doing 50 different things 2. Scale up testing
- Use of PCR, saliva, rapid, Ag
1/3. Focus on community engagement at the local, state, and national level
- Empower communities and people to be proactive 4. Statewide #MaskMandates 5. Limitations on crowd and gathering sizes 6. Support of I&Q
- Paid sick leave, mental health, and healthcare
-Food delivery
2/
Aug 3, 2020 • 4 tweets • 3 min read
This statement made concerns for a "October surprise" alive and well. I can't believe I am typing words that say we may have a #vaccine for the greatest public health tragedy of the modern day that may not be vetted through the @US_FDA advisory panel of experts.
The continued politicization of this pandemic is a grave danger to the health and wellbeing of not just the public but to the very foundation of our democracy. I keep saying we need to let science lead and that is no where more true than with the development of a #vaccine.
Jul 27, 2020 • 9 tweets • 3 min read
I recognize that $22,200,000,000 a year to prevent a pandemic sounds astronomical, but honestly we should have been proactive and been doing this way before the #SARSCoV2 pandemic. We have had numerous warning signs over the years this was coming and did not take them. (1/9)
We have seen re/emerging infections increase over the past 40 years. We have had SARS, MERS, Zika, and numerous Ebola outbreaks as warnings this was coming. Yes we did invest after the 2014 W Africa outbreak but it was not on the scale needed to prevent, prepare, for this (2/9)
Jul 17, 2020 • 5 tweets • 4 min read
#SouthKorea has done a fantastic job with #ContactTracing This article analyzed reports for 59,073 contacts of 5,706 #COVID19 index patients. I believe it has important info for decision making related to #SchoolReopening
wwwnc.cdc.gov/eid/article/26…
- Of 10,592 household contacts, 11.8% had #COVID19
- Of 48, 481 nonhousehold contact, 1.9% had #COVID19
- All contacts were monitored for an avg 9.9 days after #SARSCoV2 was detected
- In houses with index 10-19 y.o, 18.6% of contacts had #COVID19
Apr 11, 2020 • 7 tweets • 4 min read
Exciting article in @NEJM on #remdesivir (Rx I had my eye on from the start, NOT #HCQ). Info below 1. Pts confirmed with #SARSCoV2 with O2 Sat < 94% 2. Received 10 days of drug (200 x 1 then 100 daily) 3. 36/53 patients (68%) had clinical improvement
nejm.org/doi/pdf/10.105…4. 30 (57%) on mech ventilation and 4 (8%) ECMO 5. Median f/u 18 d
- 36 (68%) improvement with oxygen support
- 17/30 (57%) on mechanical vent, extubated 6. 25 pts (47%) were discharged 7. 7 pts (13%) died 8. Mortality
- (18%) (6/34) pts inv. vent
-(5%) (1/19) not w/ inv. vent
1. Inclusion:
- >18
- RT-PCR positive #SARSCoV2
- Chest CT w/ PNA
- SaO2/SPO2 ratio >93% or P/F ratio >300
- Willing to be randomized
2. Exclusion:
- Severe/critical illness not deemed to meet benefit
- Retinopathy/Retinal dz
- Conduction block or arrhythmia
- Liver Dz (Child-Pugh >C or AST >2x ULN)
-Pregnant/Breastfeeding
-GFR <30 or CRRT
-Received other tx for COVID w/in 30d
-Transfer to OSH in 72h
Apr 1, 2020 • 18 tweets • 6 min read
Here are some additional slides from my presentation I gave to the @MDAndersonNews#Oncology healthcare providers. While I covered a lot, here is further information on #therapeutics for #COVID19
Not enough time to discuss everything so I highlighted a few.
1. 20 HCQ pts (200 mg TID) & 16 controls with SARSCoV2 2. Pts w/ URTI, LRTI, or asx 3. 6 HCQ pts received Azithro x 5 d
4. Pts received Azithro to prevent bacterial superinfxn 5. At day 6 post-inclusion 70% of HCQ pts were virologically cured vs 12.5% in control 6. At day 6 100% (6 pts ) with HCQ+Azithro were virologically cured vs 57.1% of HCQ only (14 pts) vs 12.5% in control (16 pts)
1. Develop a daily routine/schedule 2. Limit time on TV/Internet dedicated to COVID-19
- Check news 1-2x/day
- Follow a few sources
3. Exercise
- Go for a walk/run, try an online yoga class or video 4. Schedule FaceTime or Skype calls with friends/loved ones (particularly the elderly) 5. Pick up a new hobby
-Cooking, painting, take an online course in something you always wanted to learn (@coursera)