You talked to the wrong experts. #1 should have been PPE. You remember the inability to get PPE early in the pandemic? We still don’t have our own manufacturing & supply chains. #2 Ventilation & Masking. No amount of tests, vaccines & staffing will decrease transmission.

https://twitter.com/amymaxmen/status/1656301717703499777

#3 Education to combat public health misinformation. If people rely on the internet to get health information then no amount of tests, vaccines, or hospital staff will get them to do the right thing to prevent transmission. Social media creates Typhoid Marys. Thousands of ‘em.

This is excess death data. This is all that matters. It means NZ/Aotearoa rocked the pandemic response and this is the most important metric.

How did NZ do it?
A 🧵 NZ shut down early & hard.
NZ had leaders who knew to educate their population about the complexities of science so that they would all work together and “be kind.”
NZ invested in propping up businesses, housing, public health infrastructure. 2/🧵

One of the biggest public health failures was the notion that if something doesn’t work 100% it’s not worth doing. This is why people scoff at masks, hand washing, even vaccines. Viral load is a factor. Any way you minimize exposure helps. The other day I was in a restaurant. Came in with two students. Asked to prop the door open to increase ventilation because it was stuffy, and a guy in there told me I should remove my mask rather than open the door. I told him I was keeping it on until the food came. He scoffed.

It isn’t unexpected. It was completely predictable. The surprise among so many “experts” in the field is what is shocking to me. Didn’t they pay attention in public health lectures? This is just evolution at work. Apply selective pressure & 🦠 evolves.

https://twitter.com/lauramiers/status/1548692328990269440

Since I seem to be a lot better at predicting this stuff, this is my prediction based on what I see:
- COVID variants will evolve that look sufficiently different from one another that rapid tests and current vaccines/boosters will not work to curb repeat transmission

As a pathologist who certifies deaths I understand why: Excess deaths capture deaths from Covid + all the deaths that are Covid-related. e.g. If you get myocarditis from Covid but die of heart failure months or years earlier than you should, we wouldn’t know it was from Covid.

https://twitter.com/MicahPollak/status/1477727474003894274

I would just do an autopsy and sign it out as “probable cardiac arrhythmia due to myocardial intertstitial fibrosis” or maybe blame your concomitant atherosclerosis. The way Covid19 attacks endothelial cells, it causes long term damage in the heart and brain.

Cognitive Bias in Forensic Pathology Decisions was published today by Journal of Forensic Sciences onlinelibrary.wiley.com/doi/pdfdirect/… From the abstract “We examined all death certificates issued during a 10-year period in the State of Nevada in the United States for children under the age of six.” /2

Marijuana and death. A thread👇🏻
As a forensic pathologist it is my job to certify death in cases of drug intoxication. I can’t think of a single case in my 20 year career where THC (the active ingredient in weed) was ever the cause of death on its own. /1

https://twitter.com/ryanmarino/status/1358084701559390210

THC may be present in combination with other drugs such as synthetic cannabinoids, alcohol, or methamphetamine in mixed drug intoxication deaths. In those cases we may list THC on the death certificate (DC) with the other drugs. This is to acknowledge its presence /2

In response to @nytdavidbrooks
A thread. 👇🏻
You can’t argue studies & reports with fear. Minority communities have been disproportionately affected by their families dying. The unions are representing the teachers who are also POC, at risk & don’t want to die. I see both sides of this issue and it’s only a problem because of a lack of a Federal response and Federal leadership. If the US had a functional @CDC last year and had set out guidelines for school reopening we wouldn’t be here.

So we just landed in New Zealand. Temperature checks and symptoms screening on landing. Now taken on a bus to a quarantine hotel for two weeks in Auckland. This is how you properly manage a border in the age of #COVID19 We are staying at the Sudima hotel. This was breakfast the first day. Little adorable meat pies and porridge. The meat pies were good. I chomped one before thinking to take the photo.

So what does "no physical findings that support a diagnosis of traumatic asphyxia or strangulation" mean? google.com/amp/s/amp.www.… #GeorgeFloyd - a thread /1 Without seeing the actual autopsy report or autopsy photos it’s hard to tell based on that phrase alone. Generally it means that there’s no trauma to the front strap muscles of the neck, hyoid bone, thyroid or laryngeal fractures. /2

Thread. Jeffrey Epstein photos are out and here’s my take: cbsnews.com/news/jeffrey-e… 1 Disclaimer: I wasn’t consulted by the press & don’t have access to all the photos, just the ones in the news reports. The quality is not as good as if I had originals digital files. 2

@neiltyson 1. The medical errors number is wrong. It’s based on grossly extrapolated data with no autopsy confirmation and assumes that if someone died after surgery it was due to the surgery and not to the underlying disease the surgery was for. 2. Mass shootings are homicides. @neiltyson 3. @neiltyson do you really want to use comparative data to effectively minimize the human reaction to the horror of a mass fatality incident? All of these deaths are preventable and we should be working on all of them. #NotOneMore

These are the guidelines @NRA was complaining about: Reducing Firearm-Related Injuries and Deaths in the United States: Executive Summary of a Policy Position Paper From the American College of Physicians annals.org/aim/fullarticl… @ACPinternists 1. The American College of Physicians recommends a public health approach to firearms-related violence and the prevention of firearm injuries and deaths.