Dr Vyom Sharma Profile picture
wharfie with a stethoscope. Broadcaster: ABC Melb, RRR FM . Unclaimed Treasure, apparently https://t.co/UUPnRgzryC
Andrew Profile picture Christine J Howard 😷copingwthsuicide@aus.social💉 Profile picture 2 subscribed
May 11, 2022 14 tweets 3 min read
There is a worldwide shortage of IV contrast, and it's happening in Australia too. What is 'contrast', why is it important, and why is this happening? 🧵 Contrast is a dye that is sometimes injected into patients during investigations such as CT/MRI/Angiograms... wherever the dye is carried by blood vessels, it 'lights up' in the image of the scan.

Sometimes it's nice to have a scan with contrast.
Other times it's critical.
May 6, 2022 27 tweets 4 min read
Last night, I did what I thought'd be a small call out, asking:

"Is every emergency department in Metro Melbourne fucked right now, or is it just some of them?"

I've been hit with an avalanche of messages.

Here is the problem, some causes and solutions, in plain words🧵: > All the emergency departments (EDs), not some, are fucked, and have been for a few weeks

> It's not just metro Melbourne, but regional EDs too

> It's not just Vic, some other states too

How fucked?
Mar 28, 2022 16 tweets 3 min read
I'm seeing a lot of people say that Will Smith couldn't have done much damage with his 'slap'. Here's why that's not quite true.🧵 (1/15, for real) Dying from a strike isn't somehow impossible if it is an open handed strike vs a punch. There are other factors that arguably matter much more.
Jan 2, 2022 14 tweets 2 min read
“Careful it’s spicy”
‘Haha Yeah all good I asked for it spicy”
“No it’s really spicy, a few times while cooking I was coughing, I couldn’t take it”

When the Thai cook of the Thai restaurant tells you it’s too hot for him to breathe, you know you’re fucked.
Will report back in 20 I’m fucken scared tbh
Dec 31, 2021 4 tweets 1 min read
I can't wait to hear the non-explanation for the 24 hour Tokyo-drift hairpin u-turn reversal of the isolation+ day 6 RAT policy.

It's not that either decision is right or wrong, it's that the decisions are poorly made and communicated. A shorter 7 day isolation period has tradeoffs that plausibly will confer a net positive benefit, at a population level.
Nov 6, 2021 8 tweets 1 min read
The world has 2 new COVID pills. But there's an issue.

After symptom onset, you must get tested, get result back, see Dr, start meds, all in 5 days.

If you're likely to follow that process, you're prob also the kind of person who's had access + inclination to get vaccinated🧵 Authorities could recommend the pills to people who're already vaccainted, but the vaccines are already great! That's not the population with most to gain from treatments.

Plus, in 2022, it could be hard to convince fully vax/booster folk with a sniffle to go thru above process
Nov 6, 2021 9 tweets 1 min read
Last night, for 30 min, I couldn’t get any volume from my laptop as I watched YouTube. Tried everything. Gave up.

And then, horror: I faintly hear a sound, of people arguing and yelling, coming from outside.
Nov 4, 2021 4 tweets 1 min read
Love this vision of a Killer T-cell attacking a cancer cell. Yeea fk him up boiii WORLDSTAR It’s so goddamn amazing.
Aug 23, 2021 4 tweets 1 min read
This is a big claim, right? I'm assuming optimal public health measures here is referring to Test/Trace/Isolate/Quarantine.

If so, it'd be pretty incredible if with 70% vaccination of adults, and no lockdowns, TTIQ holds up well enough to limit infections to 2.7K in 6 months. I appreciate though that the Reff drops significantly when 70% of people are vaccinated, even though vaccines don't guarantee sterilising immunity.
Aug 23, 2021 16 tweets 3 min read
Great questions on #thedrum put to Prof Lewin. She confirms that once we are at 70-80% vaccination, whether we start off with 30 cases, or 100's of cases, we're in essentially the same situation. 'We're catching the same curve, just getting to the peak quicker', to paraphrase. She's pretty clear on this. @bairdjulia asked the question a few times to confirm.
Aug 21, 2021 4 tweets 1 min read
Christian is one of the doctors who looks after people on ventilators 2 km away. This stuff triggers medicos in a way that a lot of people can’t understand. I’ve told hundreds of people now that they’ve tested positive for Covid. I’ve had to decide when they were tipping over from being mildly unwell, to requiring oxygen in hospital. I’ve had to tell their family members that they’ve gone from being unwell to being critically ill.
Jul 21, 2021 9 tweets 2 min read
Holy fuck. If Vic waited, it would have been game over. We must hold it together for 3 months. If, I stress, if, we get the outbreaks around Aus under control, we can't risk another. That's playing russian roulette with 5 full chambers. Bolster quarantine chain. Strategically vaccinate, including contacts of quarantine workers
Jul 21, 2021 4 tweets 1 min read
If NSW is the only place with numerous unidentified chains of transmission, surely its in the interest of all states to divert majority of vaccines to NSW to end this outbreak? 1-2 mil doses of Pfizer in next month of lockdown could radically change transmission dynamics. Vic is getting this outbreak under control- what’s the biggest risk after its sorted and lockdowns end? Probably the reservoir of 100s of covid cases across the border. Same for QLD. Same for any state that literally doesn’t have Resident Evil style laser beams at the borders.
Jul 20, 2021 9 tweets 2 min read
Lockdown with couple of cases- this is delta life. It’s obvious now- tracing alone can’t RELIABLY control outbreaks. If we somehow avoid permanent seeding of Covid, there’s one way to avoid future lockdowns.

Bolster the shit out of quarantine chain till Aus is highly vaccinated. Mandate, enforce, audit airborne precautions and vaccination for workers.
Incentivise contacts of quarantine chain workers to get vaccinated with Pfizer. Their families. Their mates.
Big difference between making people eligible, vs actually reaching out and getting it done.
Feb 21, 2021 10 tweets 2 min read
So a few weeks ago, I met someone (not a patient) who said 'Hmm I don't think I'll get the vaccine, I heard it may cause infertility' - (a comprehensively debunked piece of misinformation).

Well, yesterday I overheard him saying something that made me laugh with joy. That first time we spoke, I asked him where he'd heard this claim of infertility (he couldn't remember). I told him I'd heard something similar too, and looked into it. I told him where the claim originated, and why I didn't believe it. He went 'huh'.
Nov 5, 2020 7 tweets 2 min read
With 6 days of zero cases, its stupid to assume Vic has achieved elimination. But 1-2 weeks from now, if we find ourselves staring at a line of donuts on the calendar, it'd be stupid to rule it out. At this point National Cabinet may want to reconsider the #covid19aus strategy. Now, some would say they already should consider it, but I have very low expectations of our federal government.
Nov 4, 2020 4 tweets 1 min read
There it is. 500,000 signatures for the #murdoch royal commission. Equivalent to almost 2% of our population. Let’s make it happen Image Can’t wait to see the Olympic level bullshit-gymnastics from the libs to get out of this.
Nov 4, 2020 4 tweets 1 min read
Oh sheeet almost there! Image Wow it’s actually gonna hit 500k Image
Nov 2, 2020 5 tweets 2 min read
These 1 hour limits need to be reviewed. Should test all customers even without symptoms. Most of those infected (if any) will test positive by day 5. No isolation required unless this becomes a cluster. #covid19aus This is something both New South Wales and Victoria should strongly consider. We have so few cases that being aggressive with cluster management comes with almost no cost. #dropthehammer on every potential cluster.
Oct 13, 2020 10 tweets 4 min read
Questions for tomorrow's presser, pls consider!
1/ Vic CMO said y'day we might be the only nation using n95 masks on COVID wards. Considering it's widely known that Singapore, S.Korea, HK etc adopted this practice in MARCH, is it concerning that our top med officer isn't aware? 2/ How's the trial of isolating 'contacts of contacts' progressing in Kilmore progressing? Do you have plans to roll it out elsewhere? Are you considering significant $ incentives to encourage people to comply, as it might be difficult to convince contacts of contacts to isolate?
Oct 13, 2020 11 tweets 4 min read
Stunning claim today by senior Vic health official today "We have the strongest PPE guidance...in the world.. one of the only, if not the only place I'm aware of where people are wearing them (N95 masks)... in our COVID wards".
But then: (1/n) abc.net.au/radio/melbourn… These are the guidelines from Singapore General Hospital, laid out for the world to learn from in MARCH. (2/n)
ncbi.nlm.nih.gov/pmc/articles/P…