Brief Summary of Travis County Ruling allowing for emergency abortion:
texastribune.org/2023/12/07/tex… 1/n Kate Cox was 20 weeks pregnant when she received the diagnosis of trisomy 18 for her pregnancy with only 5-10% chance of survival at 1 year- more info on what that is here: my.clevelandclinic.org/health/disease…

It took this insane tweet and its falsehoods to put me back on twitter. There are so many things wrong with this and shame on any physician but especially someone with a platform on twitter for spreading this level of misinformation.A 🧵about what is REALLY happening tomorrow 1/n

https://twitter.com/NBSaphierMD/status/1582359718068043777

2/n- @CDCgov ACIP is meeting to discuss adding the Covid-19 vaccines to the VFC (vaccine for children) program. What is that you may ask?

Monkey Pox Public Health Emergency Declaration- much of it were familiar phrases but the GAME CHANGER- @US_FDA @DrCaliff_FDA announcing that 1 dose of Jynneos MIGHT be split into 5 doses by injecting intradermally (versus subcutaneous)- pic below for difference- BUT...(1/ -Monkeypox contd- important to see if the dose sparing technique suggested by @US_FDA allows for similar immune response. Generally vaccine administration route matters in order to achieve the desired immune response- currently only rabies and BCG vaccines are intradermal (2/

.@mehdirhasan is right. Here is the teachable moment which is crystal clear to people who see patients & supported by science-

1. COVID is real and even a mild infection can lead to a number for of devastating effects

2. Repeat infections even among vaccinated are dangerous

https://twitter.com/mehdirhasan/status/1550320593341497344

Science of reinfections (which to be clear POTUS does not have) higher risk of death and morbidity
assets.researchsquare.com/files/rs-17495…

(1/) So much will be written as it should about guns and violence.

But let me tell you about Uvalde,TX a beautiful town w/beautiful people -home to friends whose lives will never be the same 2/Uvalde is about 80 miles west of San Antonio where I grew up- we used to joke it was the suburbs of San Antonio where tornadoes went since it was not infrequent to get tornado watches/warnings in Uvalde

#triggerwarning #RoeVWade
This is a very long 🧵from a MD colleague who wanted to share her whole story regarding what is at stake with the likely SCOTUS decision -I will use her words in this thread.

This is a story of what is at stake. Read all of it.

1/n 2/n
If you're on the fence about being an ally for those fighting for the span of women's reproductive options that American women deserve, here's her story

Moderna initiating eua for under 6 will potentially be part of a larger eua app related to their under 18 cohort which has not yet had action (likely due to concerns about safety signals in 12-17) - so what does this mean potentially ?
/1 Means that moderna has more data than their interim analysis announced March 23 but still not sure if they have 2 month follow up on half the patients yet /2
investors.modernatx.com/news/news-deta…

1/n New CDC Guidance-what it does and doesn't say:
1.Greater emphasis on hospital capacity (for those asking its BOTH hospitalizations for and with covid which is only a thing for people who dont see patients)
2.Allows for higher cases/100k=shifting to phase w/less disease burden 2/n 70% of country is in medium-low transmission= no universal indoor masking recommended including schools (note that color scheme has changed from blue/yelllow/red to green/yellow/orange) - I liked the red-its a universal sign to stop and take it seriously.

Long 🧵on kids vaccine for under 5-understanding how we got here, where we are going and what we need to know. 2/Lets go back to 12/17/21 Pfizer press release:

Compared to the 16- to 25-year-old population in which high efficacy was demonstrated, non-inferiority was met for the 6- to 24-month-old population but not for the 2- to under 5-year-old population in this analysis.

Japan has an incredibly robust set of requirements around "abnormal deaths" including examining suicide notes/emails, interviews with family members and reviewing documents. They identify major categories (family/health/economy/work/school etc) which also gives us great detail.

https://twitter.com/miller7/status/1488201067212914689

Analysis has some serious limitations including exclusion of 30% of deaths/takeaway for the US:
1.we could use similar detail/standardized methods for reporting death by suicide
2. as @miller7 points out we have seen this coming-cont-

Omicron BA.2 -what we know and some possible scenarios. This is also referred to as the "stealth variant" which has only added to the confusion since the variant IS detected by PCR and Rapid Ag and not as stealth as the name implies.
🧵 2/Omicron not one variant but a family of 3 variants- BA.1/BA.2/BA.3

BA.1 is responsible for almost all cases in the US (the OG variant)

BA.2 has been detected as early as Nov 2021 and is responsible for 45% of infections in Denmark + increasing number of UK infections

Nursing Homes and Covid-19- the state affairs- thank you @JonLemire for taking time to discuss this topic @MSNBC @WayTooEarly a long 🧵 that I start with a picture from a NH in rural Michigan: yep, thats right- 14 staff out with covid-19 infections. 2/ A series of Graphs with situation today: data from @CDCgov illustrating cases by vaccine status-

clear decoupling among those w/ boosters vs not boosted

cases of vax but not boosted quite close to unvax-this is unadj data but reflective of highest efficacy of 3rd dose in NH

Thread on Variants- building on excellent work cited by @DrEricDing @CarlosdelRio7 @BhadeliaMD but I am trying to distill it for mere mortals (me+my mom) (1/n)

B117 (from UK):
1. in 42 states but really everywhere (see @CDCgov page here): cdc.gov/coronavirus/20… B117 (2/n)
2. People infected have higher viral loads (likely making it more transmissible) academic.oup.com/jid/advance-ar…
3. has mutated in a bad way-evidence of the E484K mutation which is in the SA and Brazil variants-possibly making it even more problematic: sciencemediacentre.org/expert-reactio…

Agree that COBRA subsidies will likely not survive the Byrd rule along with a number of other provisions like vaccine funding/discretionary spending; get familiar with Senate Parliamentarian Elizabeth MacDonough, first female in that job, named to the office by Sen Reid (1/n)

https://twitter.com/leonardkl/status/1361735167665197063

The Senate Parliamentarian imho is one of THE most powerful positions in the Congress-past Parliamentarians have been fired bc their rulings have rubbed 1 party or the other the wrong way-something we might see if her ruling does not sit well with Dems. (2/n)

2/15: Federal Xchange open for a special enrollment period-in most states you have until May 15 to try and get health care-many will qualify for subsidies including millions being able to have fully subsidized health insurance. Important first step but more needs to be done (1/n) Paul Starr describes what we are in as a policy trap-referring to the "creation of a costly, inefficient system of health insurance that satisfies enough individuals and powerful stakeholders to neutralize an effective constituency for change" h/t Dr. Mical Raz (2/n)

Thread of how we got to the point where the President is accusing FDA of being part of the Deep State. And why its shameful that neither the Secretary of HHS/FDA Commissioner/Director of the NIH have not vocally and frequently defended their agencies. (1/4) (2/4):Hydroxychloroquine:3/30-EUA for HCQ issued with questions raised by sr staff about political pressure to approve drug prematurely. 4/8-POTUS said "what do you have to lose?" followed by warnings by MDs about deadly cardiac effects. 6/15: EUA revoked 7/28-Trump defends HCQ

(1/5)Breakdown of some dynamics resulting in today's headlines around single day record of COVID cases (over 36k since 4/25. Drivers are multifactorial, but there are a few themes which are making this more difficult than we thought. (2/5)1. Stay at home orders generally work, particularly when reinforced at national level; Curves were flattened and pressure to reopen too early won/no masks/inadequate testing/tracing/isolation support leading to community spread