NEW: Prosp study in 225 pts w/ “mild” #COVID19 & future surgery or other procedures. People w/ viral RNA detection in tissue or🩸5.2 times more likely to dev #longCOVID symptoms (OR 5.2, 95% CI 2.6–10.1, p<0·0001). Higher copy #, higher odds. #MedTwitter
thelancet.com/journals/lanin… Months after a positive #COVID19 test, viral RNA was found in 10 diff types of tissue, incl the liver, kidney, stomach, intestine, brain, blood vessel, lung, breast, skin, & thyroid + blood cells, which could explain the wide range of reported #longCovid symptoms. #MedTwitter /2

I’ve received 4 major media requests in the 2h since #KateMiddleton announced her #cancer diagnosis. I have declined them all. She has not revealed what type or stage of cancer she has, & any dr, including oncologists such as myself, appearing on the news would be speculating. /1 I’ve been asked questions on live broadcasts before that we had agreed were off-limits. I know if I agreed here, I’d be asked to speculate on the type of cancer, type of treatment, how long it might last, what the side effects might be, what her prognosis is. I won’t do it. /2

Devastating study in NEJM. Prospective study of 257 patients having carotid artery surgery: micro/nanoplastics (MNP) in 58% of atheromas & those w/ MNP present had 4.5x ⬆️ risk of stroke, heart attack, & death at mean of 34 mos follow-up. #MedTwitter nejm.org/doi/full/10.10… Add this to the list of health concerns about micro/nanoplastics (MNP) in food. For example, this recent thread I wrote expressing concern about how we're seeing more young-onset colon cancer. Unfortunately MNP are already in soil, water, foods, etc. This is a big problem.

https://twitter.com/tmprowell/status/1744722775204602072

#MedTwitter, This is an important 🧵 from a bereaved husband’s perspective as a caregiver. I’ve been an oncologist for >20y; all of my patients by definition have a serious illness. So I hadn’t thought much about the power of affirming it. When the #COVID19 #pandemic began… 1/

https://twitter.com/greg_travis/status/1748019838105100483

& we all did more outpatient care via 📱, I had the good fortune of overhearing bits of how my husband (an infectious diseases dr) speaks to his patients. I don’t know them or their diagnoses of course, but I know it’s not all cancer, which everyone agrees is real & serious. /2

Sen @BernieSanders opens Senate HELP Committee mtg on #LongCovid stating that 16M in the US are currently living w/ #LongCOVID, a syndrome w/ brain fog, memory loss, language problems, fatigue, & more. “Long COVID can affect anyone…It poses a severe threat to #publichealth.” A former endurance athlete Angela Vasquez shares her story of becoming severely disabled after an otherwise mild #COVID19 infection in 2020. She now requires 12 prescription meds. Notes that people w/ #longCovid may be too ill to navigate the disability system. #HELPLongCovid

Wading into this water bottle debate as a cancer doctor. There has been a striking increase in #coloncancer in people under age 50. When you see an abrupt change like this by generation, it always raises concern for an environmental cause. #MedTwitter cancer.gov/news-events/ca… We don’t know why this is happening, but I think it’s logical to ask what may be spending time sitting in the colon, i.e., things we eat or drink. This rise in #coloncancer is occurring in #Millenials & younger #GenX. Look at the birth years & ages in the screenshot. #crcsm /2

🧵 LOTS of folks with #COVID19 in my text messages this week for the first time in months, & many of my #MedTwitter friends are saying the same. This has happened before every recognized 🇺🇸 surge. Be careful, esp if you are higher risk. All, please 😷 & test if you feel sick. 1/ Some insurers (incl Medicaid) are still covering #COVID19 home rapid tests. If you have rapid tests at home that have expired, check this list before discarding them. Many have had their expiration dates extended: . /2 #MedTwitterfda.gov/medical-device…

In May 2019, Dr. @rschilsky & I co-chaired the #AAADV19 Workshop Plenary Session "Decentralized #ClinicalTrials: The Future is Now." An incredible group of panelists from academia, industry, govt, & patient #advocacy 👇discussed the rationale, challenges, & opportunities of DCTs. No one knew yet that the #COVID19 #pandemic was just around the corner. In Mar 2020, FDA released a guidance on conduct of #clinicaltrials during the pandemic: fda.gov/media/136238/d…, & colleagues wrote about the impact on #OncTwitter trials: ncbi.nlm.nih.gov/pmc/articles/P…. /2

Students from 🏠 with annual income <$50K were half as likely to be accepted to med school as students with 🏠 annual income >$200K. We all knew this was a problem, but the magnitude is shocking. We all have a role in addressing this, #MedTwitter… /1

https://twitter.com/MytienTNguyen/status/1656766277384302592

Students from lower income 🏠 are at an educational disadvantage that begins well before college. A concrete intervention: volunteer to tutor students. I did this multiple times per month the whole time all 3 of my kids were in elem school. files.eric.ed.gov/fulltext/EJ898… /2

A study from #Brazil finds 1 in 4 adults who had mild #COVID19 demonstrated cognitive deficits. The average age of study participants was 38. See what happened when they were asked to copy a diagram. We are not prepared for this. #MedTwitter #LongCovid brainfacts.org/diseases-and-d… Many people are replying “I wouldn’t have been able to copy that drawing accurately even before #COVID19.” This is true. On avg, 5-8% of population are unable to reproduce this. What concerned researchers was that in this study of ppl w/ mild COVID, 25% of them could not.

A survey of 20K people found the most productive people:
👉Set objectives & priorities before beginning to read, write, or plan day
👉Insist on short, focused mtgs & clear, efficient comms
👉Develop consistent strategy to handle 🌊 of msgs/tasks
hbr.org/2019/03/what-m… 2/ A couple interesting observations. Americans work more hours than much of the world but are not more productive. I suspect this is because 🇺🇸 culture values “workaholics,”
so we push through with diminishing returns.

🔥IMPORTANT! #MedTwitter & all workers: the @FTC is proposing to make noncompete clauses illegal. Employers would be prohibited from establishing them & forced to rescind existing ones, incl notifying past employees of the change! 👏👏 @MedicineForward nytimes.com/2023/01/05/bus… ~ 1/5 of US workers are currently under non-compete clauses. They harm workers in many sectors, incl #MedTwitter, e.g., by preventing them from taking a better position w/ another company unless they’re willing to move or travel a long way to work. 2/

🧵This is a VERY brief thread about #HCWvsHunger tonight because this week has been out of control, & I still have to pack to fly to Texas for #SABCS22 on 12/5, which is TOMORROW! A longer thread will follow because I know everyone comes to Twitter for long form, lol.

1/ The last few months worried me. The economy. The numerically & emotionally depleted #MedTwitter colleagues. The very fate of this platform, which has big problems, & also has been an undeniable source of reliable info to the public during this #pandemic & community for us all.

🧵 I did 10 parent teacher conferences yesterday where my kids have an A in the class & I had nothing to discuss. I used the time to tell #TeacherTwitter a few things:
👉I know you risked your own health & life, & your family’s, to come to work in a #pandemic. #ThankYou

/1 👉I know you spent 1.5 yrs teaching our kids virtually, navigating unfamiliar technology, staring at a little dot on your monitor instead of a class full of kids, not knowing if the kids with cameras off were there, wondering about the ones who never connect. #ThankYou

/2

Learned so much in this evening's @AACI_Cancer@ webinar on physician use of social media! Dr. @fumikochino highlighted sev successful research collaborations that began via #SoMe & said that Twitter has helped a lot with the "hustle" all #MedTwitter junior faculty face.

https://twitter.com/fumikochino/status/1592216627374067714

Dr. @SyedAAhmad5, who began tweeting during the #pandemic, highlighted opportunities to expand reach of #MedEd via #SoMe. For example, he taught this to #MedStudentTwitter, then realized there was no reason the learning needed to be confined to his operating room. cc @AACI_Cancer

#HoCoMd #Election2022 - I am supporting @DanNewberger & @JackyMcCoyBOE in the non-partisan race for @HCPSS Board of Ed. I have spent a lot of time reading about all of the candidates. McCoy & Newberger, endorsed by @MomsDemand, are committed to ending #GunViolence in our schools. .@JackyMcCoyBOE has been a teacher for decades & is endorsed by our local educators. She has dyslexia & achieved a graduate level-degree so understands what supports make it possible for students with learning differences to be academically successful.
/2

So the kids at our local high school are now referring to “Homecoming fever,” a cough/fever that is hitting tons of the student body since the dance on Saturday.

I’m so tired of perpetual sickness. I know you are too.

#GetBoosted & 😷 & #WashYourHands

#Pandemic #HoCoMD Update: hearing from LOTS more parents on another platform that their kids have fever & cough post #Hoco2022. Sev have tested + for #Influenza A. If your kids aged 6m & up haven’t had a #FluShot, get it done. We don’t need more home/school/work disruption. 😷 + #WashHands.

This trend of #COVID19 followed soon after by #rhinovirus or #enterovirus (& we have it in our 🏠 , test-confirmed) is 👎👎. The 🫁 are taking a beating. Beware, especially folks w/ #asthma & other lung diseases. Masks on. 👀 recent CDC alert: emergency.cdc.gov/han/2022/han00…. #MedTwitter If you are age 12+, it’s been at least 2 mos since your last dose of #COVID19 #vaccine or any # of #booster dose, & you haven’t gotten your updated #Omicron bivalent #boostershot, get it! Likewise anyone 6m old & up who hasn’t had a #FluShot this fall, go get one. Same day is👌.

Part 2 of ACP-Medicine Forward series on solutions to #FixPriorAuth happening now w/ amazing lineup! @gabrieldane, co-founder w/ @EricTopol of @MedicineForward, kicks off the mtg w/ comments about urgency of #MedTwitter #advocacy & activism to protect dr-patient relationship.

https://twitter.com/ACPinternists/status/1576905413013946368

Dr. @ShikhaJainMD is orienting audience to the amt of time #MedTwitter spends doing prior auth & peer-to-peer calls, in many cases w/ insurance company "peers" w/ no training in the specialty. Some could not even pronounce the tumor type or drug name. #DenialOfCare #FixPriorAuth

FDA has extended emergency auth of Novavax #vaccine to age 12-17y. Given as 2 doses 3w apart, it was 78% effective in preventing confirmed symptomatic #COVID19 7d after dose 2. It is a protein-based vaccine like many familiar vaccines in use for decades, e.g. tetanus. #MedTwitter Those under 18 are much less likely to be fully #vaccinated against #COVID19 than adults in the US, even though we now have vaccines authorized & recommended for kids as young as 6 mos. We'll see fewer kids missing school this fall/winter the more we #GetVaccinated now.

I’m more cautious than @Bob_Wachter when it comes to #WearAMask indoors (basically always w/ ppl from outside my 🏡 except briefly when I have to eat). I share his🧵 because this approach is sound: choose deliberately knowing current trends & weighing risk vs benefits. I differ…

https://twitter.com/Bob_Wachter/status/1554702870213103619

On one point: I don’t agree that “the tools now exist” means everyone has the tools. We know that #COVID19 treatments are being underutilized in low-income & minoritized groups. We know that the high-quality N95 😷 that Dr. Wachter concedes are tough to wear all day every day…