Megan Ranney MD MPH 🗽 Profile picture
emergency doc @Brown_Emergency🔸Director @BrownDigiHealth🔸️CoFounder @researchaffirm https://t.co/suWBtCYTyc #thisisourlane & @getusppe🔸️Board @NVIinstitute
mike norrie Profile picture Hugh Manatee ... Who was that masked man? Profile picture Brian Branagan Profile picture Karen Salitis Profile picture MY Profile picture 18 added to My Authors
31 Jul
Three new important studies came out in the past week about kids & #COVID19. All have limits (the science isn't perfect). But together, they matter, & you deserve to know about them!

A thread on the takeaways for all of us, as parents / teachers / communities? 🧵
1) First, this one from S Korea and @CDCMMWR: wwwnc.cdc.gov/eid/article/26…

Like all the studies, this one wasn't perfect, but the takeaway: Older kids most likely transmit #COVID19 to their household at rates similar to adults. And younger kids transmit the virus, too.
What does that mean for the rest of us? It means that:

a] in schools, kids can likely transmit to teachers & vice versa, BUT

b] this study was done in households: so NO MASKS OR DISTANCING. (Very important point!)
Read 18 tweets
5 Jul
Today I read @paulmromer thread - particularly the part about schools (I recommend it!).

And we need to talk about #SchoolReopening, from a scientific perspective.

So here goes, with thanks to @sarita @ambilinski @RobinCogan @abuttenheim & others:
1) First, there is so much we still don't know about the science of #SchoolReopening. So it's tough to say "you will be safe" given that we still aren't sure.

For instance, we aren't sure whether kids spread #COVID19. We THINK they don't spread it:
npr.org/sections/goats…
.... but this goes against the science of MOST respiratory outbreaks, where kids are MOST likely to spread the virus.... so a lot of us are scratching our heads on this one.

For more details, check out this great piece by @HelenBranswell statnews.com/2020/06/18/how…
Read 25 tweets
3 Jul
I frequently get asked about risk of catching #covid19 from various activities.

I love this diagram.

As your personal risk goes up (bc of your own health, or because of #covid19 prevalence in your area), engagement in risky activities should stop.
And a clear, consistent list of what to NOT DO right now (regardless of personal health or local #covid19 prevalence) - DO NOT:
* go to bars
* go to indoor parties (50+ people)
* go to public indoor events where people are yelling or singing

#StaySafe #MaskUp #July4th
😷🎆🇺🇸
Read 7 tweets
30 Jun
This is such BS. WE KNEW THIS WAS HAPPENING. The spread of #covid19 is not a shock. We, a bunch of ER docs, said this was happening -

And ps: there is still time. It is NOT inevitable. We know how to stop it. The question is, do we WANT to.

My cup of anger overflows.
But because I am not simply an angry person, I will be more specific. This is what we need to do.

1) Get & share good data. Test as much as we can. Track hospitalizations, deaths, basic epi. This is KEY.

2) physically distance, & wear masks, & stay outside as much as we can
3) #GetMePPE - not just for hospital workers, but also for grocery store workers, bus drivers, home health aides, and anyone high risk

4) #WearAMask (yes I've said it 2x)
Read 7 tweets
21 Jun
A short smattering of the research I'm following this week re #COVID19, and why my editorial take on why these matter:
1. Not surprisingly, but quite relevant to those of us working in #healthcare with reuse of masks: N95 masks stop fitting when you reuse them. Why #GetMePPE @getusppe still matters.

jamanetwork.com/journals/jama/…
2. Reassuringly, kids may be less likely to *contract* #COVID19 (we already know they're less likely to get really sick).

This may help us re-open schools. Note, though, that this model depends on testing data - therefore, it has LOTS of limitations.

nature.com/articles/s4159…
Read 12 tweets
8 Jun
This piece is critically important for us to read as we think about the future of #COVID19. A few thoughts below.

acpjournals.org/doi/10.7326/M2…
1) The authors do a great job of summarizing the strengths & weaknesses drawn from the data

2) They ask as many questions as they answer. Which is appropriate, at this point in the pandemic.
3) Clear takeaways:
* asymptomatic spread is real
* asymptomatic spread is likely more common than we knew
* some people who are asymptomatic will nonetheless have effects from infection (e.g., lung findings on CT)
* we don't know who is asymptomatic, or why they don't get sxs
Read 7 tweets
5 Jun
The callousness and inhumanity of this police force, in broad daylight no less, takes my breath away.

I'm ashamed of my home town. Cc @LibertyUplink
Of course, these videos are coming from across the nation.

No need to watch. They at disturbing
But I'm thankful they are there, as physical evidence of our communities' words.

Read 6 tweets
3 Jun
Keeping it going. Share receipts with me and I will match up to $500 divided among orgs like @rorymerrittmd.
We have got $500!!!
Read 3 tweets
31 May
A week ago, I testified before @HouseDemocrats @HouseGOP about #COVID19.

I was pushed by many on the issue of "deaths of despair" - by reps claiming they would be STOPPED if we "re-open" (without testing, tracing, etc).

I pushed back. This was a false equivalence.
In this piece, @drjessigold and I outline exactly why & how this connection is WRONG.
1) Although risk is there, these aren't new
2) Deaths may not (yet) be increasing
3) We have a chance for change
4) If we really care, let's make it happen.
buff.ly/2MscO0Z @statnews
Read 3 tweets
31 May
Honored to join @JohnKingCNN with @ashishkjha this morning, to reiterate that #covid19 disproportionately affects Blacks and other minorities - and that is because of structural #racism.

thenation.com/article/societ…
As many of us have said: the racial disparities in #covid19 were not inevitable.

But changing racial disparities in a pandemic - like anywhere in health - takes focused action, not just hand wringing.
brookings.edu/blog/fixgov/20…
With #COVID19 our individual states were able to take some of this action, despite federal inaction.

Unfortunately, our federal leaders continue to be not simply ineffective -- but actively harmful. They are inflaming the fires.

Of covid, but even more so, of racism.
Read 7 tweets
30 May
Our country's history is one of systemic racism. Of oppression. Of inequity.

It has been on display in all its ugliness these past few months. In #covid19. #AhmaudArbery. #BreannaTaylor. #GeorgeFloyd.

But let's be clear - this is nothing new. It's just being *seen*.
May we all, finally, raise our voices, hearts,& minds.

May we commit to fighting both the effects of this disease of #racism & its root causes. May we uncenter ourselves from the fight. May we resolve to never be silent - & thereby acquiescent.
May we hold space for the anger and pain.

May we create change.
Read 6 tweets
29 May
Hydroxychloroquine combination risky for cancer patients with #COVID19: preliminary study & my thoughts below

reut.rs/3caURON
According to this observational analysis, "Taking the combination gives a three times increased risk of dying within 30 days of any cause."
** I personally have not seen the abstract, and suspect that the usual caveats about observational studies apply. E.g., the people who were receiving the drug may differ from those not receiving it, in important ways.
Read 6 tweets
28 May
@KoenSwinkels @AlexBerenson Sorry, how exactly was I wrong?
From Arkansas:
"Gov. Hutchinson described it as the 'second peak'. 

'It's clear and evident to me that we have one peak, and then we've had a deep dip, and then we're having a second peak right now"
 dailymail.co.uk/news/article-8…
@KoenSwinkels @AlexBerenson From Florida, Georgia, Virginia, Alabama, Maryland, Mississippi, Wisconsin, Minnesota, Ohio and Arizona:
cnbc.com/2020/05/26/cor…
@KoenSwinkels @AlexBerenson Happy to keep going.

I do make mistakes, and I do change my statements when the data changes. But here we are, 3-4 weeks out, and lo & behold, what we said would happen based on science is, actually, what is happening. 🤷‍♀️
Read 3 tweets
28 May
@DrewofallTrades @CNN There were a lot of issues with those studies from a scientific perspective.

Here's a more recent summary of data: thelancet.com/journals/lanrh…
Read 4 tweets
27 May
@hoffmann_trevor @binge_tweeter Right. But I'm going to push back. Most scientists agree that there's still debate.

Cf healthaffairs.org/do/10.1377/hbl…
and
arxiv.org/pdf/2003.08592…
and
coronavirus.jhu.edu/data/mortality

CDC is traditionally reliable; but in this pandemic its recommendations & data are not consistently as good
@hoffmann_trevor @binge_tweeter In other words: my statement about what we DON'T know was *true*. / fin
Read 3 tweets
26 May
#MemorialDay2020 is almost over here on the East Coast.

Although there were no parades or pageantry where I live, we made time to pause and remember our friends & family members who serve, or served, our country.
I am grateful for my uncles, aunts, grandfathers, grandmothers, extended family, and my many, many dear friends who have been willing to give everything for what our country stands for.

Liberty.
Free Thought.
Equality.
Democracy.
Hope.
The past few months people have called those of us in healthcare "heroes." But we've got nothing on these folks.

@PJRosz @EMSimGal @AliRaja_MD @DrTsion @ERdisasterdoc .... *thank you*
Read 4 tweets
25 May
@AlexBerenson Thank you for highlighting that my tweets are consistent. As I said, I've been calling for testing, PPE, and public health messaging.

And nb we know that rises in hospitalizations occur 3-5 weeks after infections.
@AlexBerenson And I hope to God that science catches up so we can act based on data rather than conjecture.
@AlexBerenson In the meantime, I appreciate your commitment to not throwing political shade, but rather engaging in conversations based on what we do know, and what we don't know. And pushing forward to get more data and science, quickly.
Read 3 tweets
24 May
Here's a short list of things we do and don't yet know about #COVID19.
1. We don't yet know the true case fatality rate. (E.g.: if you catch it, how likely are you to die?)

Scientists agree that the CDC's #s are likely underestimates; but it's AT LEAST 4x more deadly than the flu, if infected; & will infect far more ppl.

jamanetwork.com/journals/jamai…
2. We don't yet know *exactly* how it's transmitted. Definitely by droplets. But maybe aerosols? Maybe fomites?

----> For now: best practice in the non-healthcare setting is mask, distance, and hand-washing

cdc.gov/media/releases…
Read 17 tweets
21 May
I am so appreciative of @RepBlaine Q during the hearing today about "deaths of despair" & patients dying due to lack of care during #COVID19. His concerns about these people, informing his push for re-opening, is tangible.

I am also so appreciative of his focus on data & science
Here's the thing: It doesn't have to be either/or.

We MUST re-open.

We MUST take care of our vulnerable.

AND: we MUST do so in a way that has adequate PPE & testing & science.

Or else reopening is useless - no one will show up.
I'd be happy to talk any time about how we can support our workers and communities BOTH in getting back to work, AND in staying safe.

Staying "shut down" is not an option.
But neither is going back to early March.

I wish it were different. But this is where we are.
Read 3 tweets
21 May
So honored to get to talk to the House today about the perspectives of frontline emergency docs, nurses, techs, & more. About our need for PPE. About our exhaustion & frustration in the face of #COVID19.

I also urge us to listen to the stories of the other speakers:
Ms Talisa Hardin of @UChicago - talking about her experience as a nurse in an ICU in Chicago. Not enough PPE. Nurses out sick.
Mr. Eric Colts, a bus driver from Detroit, and a friend of Mr Hargrove who died after calling out the lack of PPE.

Talking about how buses serve an essential public function, but also are enclosed petri dishes for infection.

nbcnews.com/news/us-news/d…
Read 11 tweets
20 May
@DigMedEvidence @BenRosnerMD_PhD @JHabboushe Great citation of @Ted_Melnick work by @JHabboushe -- a stellar example of integration of #informatics & #digitalhealth to improve treatment of patients with opioid use dx.
@DigMedEvidence @BenRosnerMD_PhD @JHabboushe @Ted_Melnick And yes.... i use @mdcalc every shift 🙏🏽
@DigMedEvidence @BenRosnerMD_PhD @JHabboushe @Ted_Melnick @mdcalc Very cool data from Dr Blaufeux of @NorthwellHealth on use of automated EHR workflows to improve care & health outcomes for emergency dept patients.

(Hey @MichaelJDowling.... let's talk about this for #violence prevention!)
Read 6 tweets