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Mike Hoerger, PhD MSCR MBA Profile picture
Mike Hoerger, PhD MSCR MBA
@michael_hoerger
Founding Director of Louisiana's #HealthPsych PhD program. Expert in weighing medical evidence. Posts on pandemic mitigation, psycho-oncology, health strategy
Brian Branagan Profile picture ARP Profile picture james.pamela Profile picture David O'Brien Profile picture 5 subscribed
Jun 1 • 14 tweets • 9 min read
In JAMA Oncology today, the "debate" continues.

Should hospitals do MORE or less to help people with #cancer avoid severe outcomes from COV1D?

I'll take you through each article! 🔁

1/ twitter.com/i/web/status/1… Graphic of 4 articles in JA... Dr. @drlennardlee and colleagues found that people with #cancer had diminished vaccine antibody response, leading to breakthrough infections and hospitalizations.

2/
jamanetwork.com/journals/jamao… Selected graphs. Diminished...
May 17 • 7 tweets • 4 min read
#ASHRAE has released draft guidelines for how to reduce the spread of #airborne infectious illness (like COV1D) in schools, hospitals, and other places.

It's open for public comment until May 26. This thread will give you background info and how to comment.
🧵
1/ ASHRAE Standard 241P Advis... Joey Fox linked to the #ASHRAE indoor air cleaning draft guidance and also provided a helpful summary thread.


2/
Apr 19 • 10 tweets • 2 min read
Public Comments at the #CDC ACIP happening live now.

Absolutely heartbreaking. The first person, near in tears, talking of the lack of precautions for newborns. Now, a mother in 3rd trimester talking about lack of eligibility for recent booster.

video.ibm.com/channel/VWBXKB… 3rd speaker: Had to miss some work with mRNA vaccines. No issue with Novavax. Asking for greater flexibility on the frequency of vaccination and allowing anyone to get Novavax as a booster
Apr 17 • 10 tweets • 7 min read
As more #hospitals drop universal #masking requirements, I see many patients, family members, and medical staff who are rightly concerned.

🧵This thread has my best advice for protecting yourself from #COVID in high-risk settings.

1/10 Images from various threads... Big Picture - Top 10 Tips if you're new to thinking about the importance of #mask quality, size, and fit in high-risk settings

2/10
Jan 17 • 11 tweets • 8 min read
"Surviving the COVID-19 #Pandemic: Things I Have Learned (So Far)"

A pandemic mitigation primer geared toward my students.

Full video (40 mins):
vimeo.com/showcase/10115…

Refs in the PPT notes:
psychmike.com/Hoerger_pandem…

Video segments in thread🧵 Picture of video segments 1. Introduction

COVID cases and deaths were surging in New Orleans right when I launched a project working with people who are seriously ill.

Thus, I began studying COVID mitigation.
vimeo.com/789390581
Dec 23, 2022 • 15 tweets • 11 min read
In an Invited Editorial in @JAMAOnc today, my colleagues & I call for health systems to develop “Comprehensive #Pandemic Support Programs” for their most vulnerable patients.

These are our Top 10 Tips!

THREAD 🧵
jamanetwork.com/journals/jamao… JAMA Oncology article, "Variability in COVID-19 Vaccine Tip #1: Health systems should explain to all patients that #COVIDisAirborne and is best avoided through multi-layered mitigation. Swiss Cheese model of COVID mitigation
Dec 17, 2022 • 21 tweets • 10 min read
THREAD: 19 Tips for a DIY mask fit test to reduce your risk of #COVID19.

H/t @amandalhu & @__philipn__

What did I miss? Assorted fit-testing pictures Fit-testing Tip #1: Keep it Simple.

Get a nebulizer (usually $30-40) & some 3M FT-32 Bitrex solution ($24). The FT-32 fit-test solution (right) goes in the nebulizer. J
Dec 15, 2022 • 5 tweets • 4 min read
Our #pandemic global strategy:
"If I paint a rosy picture, will you promise not to cry?"

ascopubs.org/doi/full/10.12…
1/5 Image Written a decade ago, the article was about how clinicians too often falsely reassured patients w/terminal #cancer that treatment was working just fine.

There are many parallels b/w cancer cancer, the pandemic, & climate change.

Mortality salience elicits #denial.
2/5 ImageImage
Dec 2, 2022 • 4 tweets • 1 min read
If you're advocating for more cautious and compassionate COVID policies or generally "doing the right thing," please keep pushing.

I've had three extremely validating interactions in the past week I wish to share (details disguised).... #1 - A vulnerable family member had a cable guy come to her home. The cable guy refused to mask, so she refused to let him in and called to complain to the cable company. One of those big, hated cable companies.

Know what they did? Fired him on the spot. 🔥
Nov 15, 2022 • 8 tweets • 3 min read
I've yet to see a well-designed study showing that #COVID #RapidTests are no longer efficacious.

This one is no exception. Why?
5 reasons.

clinicalmicrobiologyandinfection.com/article/S1198-… Image 1. They compare same-day PCR against self-administered/interpreted rapid tests.

For most ppl, that's not reality. It's RAT today or PCR result in 1-3 days (or do both).

A fairer comparison would be a RAT today versus a PCR yesterday (since you'd have to wait for results).
Nov 14, 2022 • 9 tweets • 6 min read
Cloth masks could be customized to look amazing. BUT they offered weak protection (poor filtration, many gaps).

What if you could safely customize an N95 or #BetterMask with a small logo, decal, or other decoration?

THREAD 🧵

1/ 3M N95 with monotone cancer ribbon (or interpret as another H/T 🎩 to @amandalhu for recommending rub-on “dry transfers.”

Follow her & see her amazing thread of several examples. Very fun, especially for kids. Many pre-designed options.


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Nov 13, 2022 • 13 tweets • 8 min read
New article in @JAMANetworkOpen provides critical data on the long-term trajectory of COVID-19 symptoms.

Lots of bad news. 😕
Very bad news for ppl w/cancer or bad acute case of COVID. 😬
Also, a few rays of hope. 🌞
#LongCOVID #COVIDcancer

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jamanetwork.com/journals/jaman… Title and graph, journal ar... 66% of adults had at least 1 symptom during the acute phase (first 2 months) of diagnosis of #COVID-19.

I’ve highlighted the symptoms experienced by at least 10%. Note that some of the less common symptoms are quite debilitating though (e.g., 9% w/lung pain).

2/12 Symptom table. Acute sympto...
Oct 28, 2022 • 5 tweets • 3 min read
I made a new graphic representing my current gist-level representation of the #SwissCheese Model of #COVID mitigation.

In your mind, how do you organize the categories differently? Is there something else you prioritize?
1/5 Swiss Cheese model of COVID... My mental model of COVID mitigation differs from others in that it gives more weight to secondary and tertiary prevention.

The less the Western world focuses on the first 8 slices of cheese, the more we will need to focus on the final 2-3 slices.
2/5 Secondary and tertiary prev...
Sep 26, 2022 • 11 tweets • 12 min read
Empowered communities want free #N95 masks!

Our new pre-print shows that people are excited to use N95s during COVID surges when given them for free w/helpful information on their evidence & how to use them.
1/
 psyarxiv.com/f76vw Study abstract: People want...Project banner: Free N95 Qu...Aegle N95, given away in th... You might remember when we posted about the study back in December!

I hope you find the results useful. We tried to make the figures relatable, even if you're not reading science articles every day. Please let me know if you have questions!
2/
Sep 25, 2022 • 9 tweets • 6 min read
Know someone having a baby soon? CONGRATULATIONS! 🍼🍼🍼

As hospitals drop universal COVID protections, these are my top 7 tips for protecting unmaskable un-vaxable newborns from #nosocomial (hospital-acquired) COVID.

What did I miss?

THREAD of Top 7 Tips 🧵 Tip #1 – Determine your #mask rules. Some parents require staff to #N95. Compliance would vary by region/hospital. Prep for what you’ll say if staff don’t comply.

With our newborn twins, we supplied medical staff w/free N95s & tests. Nobody wanted N95s; 1 took a #RAT. 🤣
Sep 13, 2022 • 4 tweets • 2 min read
Such a proliferation of useless #COVID "treatments," now nasal irrigation.

If a virus kills millions of people, a useful treatment would be published in a journal with impact factor >20, not 1.7.

journals.sagepub.com/doi/full/10.11… The study gave people nasal irrigation and compared it to CDC data on hospitalization and death rates.

Not everything must be an RCT, but the purpose of an RCT is to compare two equivalent groups so that the observed differences can be attributed to the treatment.
Sep 13, 2022 • 4 tweets • 2 min read
Do you know any #parents looking for better #masks for their kids this fall?

Check out all the helpful comments on this Tweet.

Best for many: @flo_mask & 3M Vflex 9105s
Popular: WellBefore, Powecom, Lutema, Vitacore

1/3 The child #MentalHealth clinic I was helping out ended up purchasing the WellBefore masks. Useful in this context b/c they needed disposables in plenty of different sizes.

The clinic runs somewhere between 12-18 ACH to help w/ imperfect mask fit.
2/3
Jul 19, 2022 • 12 tweets • 9 min read
Top 10 tips everyone should know about wearing #N95 & #elastomeric masks.

What did I miss?

THREAD! Image Tip #1: Masks buy time. Context matters too: Ventilation (HVAC/outdoor air), filtration (HEPA), & ⬇️ people buy more time.

The longer you’ll be someplace or the worse the context, the better the mask you’ll need.

In a “typical” setting, you might expect this (per @akm5376): Image
Jul 14, 2022 • 10 tweets • 10 min read
Kids <2 yrs old can’t mask.
Kids <6 months can’t vax.

Many parents are using strollers w/rain covers to try to get some protection during essential activities.

Does adding a #PAPR or #HEPA device help?

I tried 6 models: engrxiv.org/preprint/view/…

#PAPRbuggy #HEPAbuggy
1/10 Image First off, thanks @RealSexyCyborg for the original design. Thanks to @ccwake1, @gjmf, @drgregkelly for ideas too. Happy to acknowledge!

My goal was to test 6 models & help relate them to non-engineers.

2/10