Noha Aboelata, MD Profile picture
Family Med, Oakland ❤️ Founding CEO @RootsEmpowers, HU med grad, weekly public health briefing. Community health, jail/reentry health, street med, mental health
Ross Grayson, MPH, CIH Profile picture Christina Cat Profile picture Nancy J. Smyth, PhD, LCSW - covid aware Profile picture 6 subscribed
May 6 8 tweets 3 min read
Documents obtained under FOIA reveal "at least 6,212 patients caught COVID in hospital in 24 months...Of those, 586 died...with men dying at a higher rate than women [11% vs 8%]."

Nearly 1 in 10 patients who caught COVID in the hospital died. How can anyone find this acceptable? Hundreds of patients died after catching COVID in Victorian hospitals, new data shows An infection mortality rate of 10% is staggering, and studies have shown it's much higher in certain areas of the hospital (e.g., oncology). Yet we're still doing a "you do you" approach to infection control in hospitals. Unacceptable. 2/
Mar 28 4 tweets 2 min read
Post-covid vs post-flu: retrospective study based on a global research network investigates post-infection conditions, long-term risk of ED visits, hospitalization & death. Looked at 6614 patients in each group hospitalized 1/22-1/23 w/90-180d followup. 🧵
doi.org/10.1186/s12916…
Comparison of post-acute sequelae following hospitalization for COVID-19 and influenza The Covid group had a higher incidence of overall post-infection conditions compared to the influenza group, including a difference in what each group was experiencing. The Covid group had more abnormal breathing, more abdominal issues, more fatigue, and more cognitive issues. Comparison of post-acute sequelae following hospitalization for covid-19 and influenza
Mar 22 6 tweets 2 min read
Prop. 1 will help the state fully implement:
- a new court system for those with mental illness, even if no crime has been committed
- the recent CA law making it easier to force some with serious mental illnesses into involuntary treatment. 🧵
calmatters.org/health/mental-…
With Prop. 1 passage, Gavin Newsom again changes how Californians with mental illness get help The plan seems to be to force *more* people into a system that's already overstretched. To layer in the court system, which is already biased. To empower lay people to compel the court to force individuals into treatment for mental illness, substance use, even chronic alcoholism.
Mar 17 11 tweets 2 min read
The latest wave of covid propaganda is to claim that ~covid anxiety~ is the biggest pandemic problem we're facing. I have yet to see the data. I have, on the other hand, seen mountains of data indicating structural and functional changes to heart, lungs, brain, and more. 🧵 "But same with the flu!"

No. Via ACE receptors and otherwise, SARS-CoV-2 can affect every system, even damage inside blood vessels (yes the tubes that deliver blood everywhere). True, we've likely under-appreciated post-influenza sequelae. Still, it seems less and fewer organs.
Mar 10 8 tweets 4 min read
Metformin & Covid. Metformin is widely used, accessible/cheap, and has been around for decades, so we'd love if it could help in our ongoing struggles with covid. So far it looks promising to prevent long covid, and those already on it should continue it during acute c19 infxn.🧵 In the COVID-OUT trial (multicenter randomized quadruple-blind parallel-group phase 3 trial), in 30-85yo's w/"overweight or obesity," Metformin cut the risk of long Covid by ~41%. And when started within 3 days of Covid symptoms, it reduced the incidence of long COVID by ~63%!
Feb 4 11 tweets 2 min read
It's sad to see so much venom towards scientists, doctors, and covid-careful individuals on this app - one of the reasons so many have left. I left FB because it became a cesspool of disinformation, and I was impressed with the quality info direct from scientists and docs here.🧵 Having a common enemy - a mutating virus infecting, sickening, and killing so many - should have brought us together. And I think it did for a brief moment. Then, it became highly politicized, and bad actors exploited folks' uncertainty, unfamiliarity, and fear.
Jan 28 6 tweets 2 min read
Despite baked-in racial bias, pulse oximeters continue to be relied upon for covid, qualifying for home oxygen, and more. They're used at home, on ambulances, in clinics and hospitals. The FDA is aware but moving slowly, which is why we filed a lawsuit.🧵
nature.com/articles/d4158…
Image This lawsuit demands pulse ox manufacturers/distributors fix the devices, label them as to their flaws, or stop selling them in California. But even if we're successful, this doesn't extend beyond CA, and the FDA can continue approving faulty devices as they've done for decades.
Jan 23 4 tweets 1 min read
Thank you, @DrJudyStone and @Forbes for interviewing me for this fantastic article about California's shocking move, recklessly encouraging contagious people to go unmasked into schools and pubic places - in the middle of winter no less! 🧵1/4
forbes.com/sites/judyston… Just 1 contagious child can infect many more in 1 day, let alone coming to school contagious many days in a row! The order admits that the contagious period begins 2 days before symptoms start through 10 days after. There's a buried *recommendation* to mask x 10d. Seriously? 2/4
Jan 20 8 tweets 2 min read
Thanks, @CalMatters, for interviewing me about these wild new "guidelines" encouraging contagious people to get back to school and work, despite our ability to easily test and prevent much unnecessary spread. Promoting reckless disregard for everyone.🧵1/8
calmatters.org/health/2024/01… “'Instead of staying home for a minimum of five days, individuals may return to work or school when they start to feel better,' state public health officials said in an unsigned statement."

I wouldn't want to sign it either. 2/
Jan 19 7 tweets 2 min read
I haven't said anything about this yet - at first, it was because I was speechless. Then I hoped no one would notice. Now that advocates, reporters, concerned parents, and outraged colleagues have reached out, I see that's not going to be the case.🧵1/7
ktla.com/news/californi… Contagious people are being encouraged to go to work/school. This decision is not evidence-based, and it clearly does not consider the impacts of long covid, the need for people to rest and recover when sick, or the ramifications of increased transmission such as new variants. 2/
Jan 13 5 tweets 2 min read
WHO is emerging as more reliable and vocal than any US health leadership on the pandemic, despite its lack of complete data or authority to obtain it. A dramatic turn compared to pre-pandemic times. We've heard repeatedly from WHO during this surge. It's crickets from CDC and WH. "Whether we acknowledge it or not, the world is still in a pandemic, Van Kerkhove said, citing the virus’s lack of a seasonal pattern...and its continued, rapid-pace evolution."

fortune.com/well/2024/01/1…
Jan 3 4 tweets 1 min read
A lot to unpack here. Of course we're all thankful that covid hospitalizations and severe disease are overall down. But with ~30,000 hospitalizations and 1500 deaths/wk, both heading up, I'm not feeling like celebrating. If this is what endemic looks like, it's not so great. 1/4 Post from Monica Gandhi, MD.  Update from San Francisco General Hospital winter holiday 2023 - very little COVID and no severe disease. COVID has joined the list of endemic respiratory pathogens but thanks to immunity & our medical tools (vaccines, treatments), below is the course 4 years in.. Rampant transmission, cumulative burden of reinfection, increasing incidence of long covid...all highly concerning. And of course it's not *just* a respiratory pathogen. Continued viral mutation and ongoing unpredictability are likely why WHO still characterizes this a pandemic.
Dec 3, 2023 6 tweets 2 min read
Amazing but frustrating!
3 patients with "chronic, unrelenting fatigue and cognitive impairment" plus other severe disabling symptoms experienced complete and sustained remission within days of receiving monoclonal antibody treatment. Amazing!🧵 1/6
sciencedirect.com/science/articl… Their covid infections were pre-Delta, so previous monoclonals (casirivimab/imdevimab) were effective. Each patient "rapidly returned to normal health and previous lifestyles/occupations with normalized exercise tolerance, still sustained to date over two years later." Amazing!
Oct 29, 2023 4 tweets 1 min read
Just got off the phone with a family member and I'm just 🤬

Them: Just got vaccinated, now I have fever, cough and sore throat. Could it be the vaccine?
Me: Fever sure, but not cough or sore throat
Them: On call doctor is calling in an antibiotic
Me: Diagnosis?
Them: No idea
1/2
Me: Have you tested for anything?
Them: No, should I?

Reader, this is someone who is post solid organ transplant. If they have covid or flu, they need proper antivirals ASAP to dramatically reduce their risk of hospitalization or death.

Doctors, please stop doing this!! 🤬🤬🤬
Oct 15, 2023 4 tweets 2 min read
Reading propaganda like this sends a chill up my spine. Not just because people will believe it and cause harm, but because it signals that we're still in a precarious situation: the powers that be are promoting covid spread, ignoring post- & long-covid, and giving false hope.🧵 Most claims in the article are demonstrably false, or fall in the hopium/copium category. Not drinking the kool-aid? You must be suffering from "anxiety." This is not some altruistic effort to try to reassure the public - if it was, they wouldn't need to obfuscate and omit facts.
Aug 10, 2023 5 tweets 2 min read
Recently overheard: "I think I got a summer flu."
Highly improbable! Here's Oakland wastewater, similar across the nation (flat lines at the bottom: flu A/B). It's not flu season & covid doesn't have a season. Reminder of the difference and why it's important to get it right.🧵 90 day graph showing SARS-COV-2, flu A and flu B in wastewater in Oakland, CA. flu A and B are flat lines and SARS-COV-2 is heading up from a low point in early June. Unlike flu, with covid we can see:
- presymtomatic and asymptomatic transmission
- superspreaders/multiple chains of transmission
- post-infection blood clots, heart attacks, strokes
- multisystem inflammatory syndrome in adults and children
Aug 3, 2023 13 tweets 5 min read
Protect the children! As they had back to school, a reminder that covid is not benign, even in children.

Very incomplete data set (>1.13 people have died in US and this only accounts for 996,981), but still we see 2,292 deaths in children 17 and under.🧵
https://t.co/La829oQzencovid.cdc.gov/covid-data-tra…
Deaths by age. 2,292 deaths in 0-17 yo Covid is now a leading cause of death in all age groups and the only infectious cause in most. Most children with severe outcomes have no underlying condition or common ones like asthma, obesity or being born premature. Of course, death isn't the only bad outcome we worry about.
Jul 22, 2023 5 tweets 2 min read
Welcome to the phase of the pandemic where "we have the tools" but are removing *access* to the tools.

"At least 3,289,000 Medicaid enrollees have been disenrolled as of July 21, 2023," (35 states + DC)

Texas in the lead with a disenrolled rate of 82%. https://t.co/De4uco40Elkff.org/medicaid/issue…
There is wide variation in disenrollment rates across reporting states, ranging from 82% in Texas to 10% in Michigan "Across all states with available data, 74% of all people disenrolled had their coverage terminated for procedural reasons."

So they're likely still eligible but kicked off due to red tape. Seems like a good argument to maintain continuous coverage and find a better "procedure." Overall, 74% of disenrollments are due to procedural reasons, among states reporting as of July 21, 2023 (range: 30-96%)
Jul 21, 2023 13 tweets 3 min read
Who should get a bivalent booster now? If you're 65+ or immunocompromised, a 2nd bivalent has been an option since April. Since then, we've learned that an updated booster will likely be here in September. We'll go back to a monovalent vaccine, now against one of the XBBs.🧵 Hopefully we're still dealing with all XBB in September! Either way, the monovalent will likely be much better coverage than the current bivalent, which consists of old & older strains. The bivalent will still provide protection, but it's presumably quite inferior. So what to do?
Jul 20, 2023 7 tweets 3 min read
Who is still dying from COVID? Thankfully, covid deaths continue to decrease, but we're still seeing >500 per week. Given a lack of testing, this is likely an undercount, but it's still the most accurate covid metric we have. Here's a closer look at covid deaths so far in 2023🧵 In at least 69% of 2023 US covid deaths, covid was the *main* cause, and it was a *contributing* cause in the remainder. The most frequently listed comorbidities are common conditions, including hypertension and diabetes. https://t.co/Zvh7YZWx9Mcdc.gov/nchs/covid19/m…
In at least 69% of 2023 US deaths, covid was the underlying cause. Covid was a contributing cause in the remainder.  Most frequently listed comorbidities: flu&pneumonia, hypertension, diabetes, Alzheimer's and sepsis.
Jul 18, 2023 8 tweets 4 min read
How will we know if a covid wave is coming? The short answer is we might not, but there are some earlier indicators that can clue us in:

1- Wastewater
2- Emergency Department (ED) Visits with/for covid
3- % positivity

Here's where we are on each: Many parts of the US are seeing wastewater upticks. Here are 4 good resources - you may be able to locate a sewershed near you. Oakland wastewater is showing a clear uptick.

https://t.co/qVD6HZGBLU
https://t.co/xtpAcPM7cj
https://t.co/aTJpDOj1va https://t.co/xPTLaawMIEdata.wastewaterscan.org
publichealth.verily.com/?v=SC2_N
cdc.gov/nwss/wastewate…
biobot.io/data/
Oakland CA wastewater SCAN showing clear upward trend.