Internist & oncologist serving ppl w/ cancer @ #bcsm clinic, #MedEd, #Regulatory & #COVID19. #ASCO20 Ed Chair. @HCWvsHunger. #NavyWife. Equity activist. Go high
7 added to My Authors
May 18 • 4 tweets • 4 min read
So I wasn’t that worried a few hrs ago. This dials it up a little.
For anyone who has ever played the collaborative board game #Pandemic, you may know how it goes when there’s uncontrolled spread of one pathogen throughout 🌎 & then outbreak of a new one in mult countries. 😖
The current #monkeypox outbreak now includes cases in #UK, #Spain, #Portugal, #Canada, #US…from what I’m reading, this sounds like person-to-person transmission, which historically was thought to be rare, & evidence of community spread. Wow. #MedTwitter
We have either rapid re-infection, or rebound #Covid19 after Paxlovid, in my own 🏡 . Vaxxed & boosted. Symptoms & rapid test pos 5/2, 5d of Pax 5/4-5/8, all symptoms gone, neg rapid test x 2 5/8 & 5/9.
5/16 new symptoms & RAT instantly pos (📸). Our #MedTwitter 🏡 is weary.
By the way, the right answer is not “So Paxlovid doesn’t work.” It works very well to ⬇️ risk of severe illness, which matters a lot. And right answer is not “so let’s just give 10d.” Right answer is we need data to understand this phenomenon & direct rational antiviral use.
May 9 • 4 tweets • 3 min read
Per @NoNutTraveler, “the @united pilot came back, & he & the flight attendant began asking me if we had Epi-Pens. I said, of course we do. To which the flight attendant gaily said: ‘Well then, we can serve anything because he can just use the pen.’” NO! /1 allergicliving.com/2022/05/09/i-w…
This represents a fundamental misunderstanding of anaphylaxis, including #peanutallergy. In fact, this fallacy—if you’ve got an Epipen, exposures aren’t a concern—was the topic of a past corrective ad that FDA required the maker of Epipen to air. /2 mmm-online.com/home/channel/o…
May 7 • 4 tweets • 3 min read
Lots of chatter in my feed & my DMs this AM about Paxlovid & “rebound.” Let’s be mindful of the diff ways this term is getting used & interpreted, #MedTwitter. Some are referring to return of symptoms after feeling better, others to triggering more severe symptoms… /1
Others are using “rebound” to mean going from rapid test neg (not contagious) back to positive (contagious) again; still others are using it to mean increased short-term risk of new infection w/ same #Covidvariant. People are suggesting alt dosing, duration. Stop, stop, stop. /2
May 7 • 4 tweets • 3 min read
Here are 2 family members, similar ages/#MedTwitter history, #vaxxed & #boosted, dev symptoms & tested pos same day, got Paxlovid same day. Day 4 tests below. Why are we still using a 'one size fits all' strategy to exit isolation when rapid tests are readily available, @CDCgov ?
I doubt policy will change (note: shortening isolation to 5d was done to minimize societal impact from loss of essential workers to isolation in Jan #Omicron wave), so you should choose to rapid test to exit isolation. A positive = contagious, no matter how many days it's been.
Apr 28 • 4 tweets • 3 min read
There's another 🌊 of #COVID19, y'all. I have gotten more texts since Mon asking questions about monoclonal antibodies, about Paxlovid, about rapid tests, & on & on than I have in the whole month preceding. Be aware. All these folks tested at home & are uncounted in tallies.
This is anecdotal, but a pattern recently: people staying pos longer on rapid test. Here's an older pt, 4 doses Moderna #COVID19#vaccine, mono Ab on d1, feels 100% now, & still quickly/strongly pos (ie very contagious) on d10. Had he not retested, he might be infecting others.
Apr 27 • 5 tweets • 3 min read
Invited to a destination wedding earlier in Apr. Awesome place that holds a special place in my ❤️(Vail). Lots of people I miss. All #vaxxed. Many boosted. No masks required. No rapid tests. Declined. One positive couple next AM. Groom & all but 4 guests got #COVID19. #pandemic
In care you’re wondering who did NOT get infected, the common elements were 4 doses of #COVID19 vaccine OR known/suspected past infection + 3 doses of vaccine, with last dose being recent.
Apr 22 • 9 tweets • 7 min read
Well, it was fun while it lasted. And remember that official case counts are just the tip of the iceberg. Most people are being diagnosed via rapid testing at home & never appear in these totals at all. If you aren’t #Boosted, now’s the time. #MaskUp#COVID19
Let me add that my major reason for concern at this point is less about deaths in the short-term. Though we continue to lose a couple thousand Americans per wk to #COVID19, & it wasn’t mild for any of them, deaths are much lower than they’ve been in a long time. /2
Apr 21 • 5 tweets • 4 min read
I am a dr who has dedicated her career to people w/ #cancer.
I am the grateful daughter of a #lymphoma survivor.
I have #asthma.
Why wouldn't I #wearamask if it might prevent an illness, death, or #longcovid disability?
If you find masks uncomfortable, I can suggest some to try.
(And then I'm going to talk to you for the ENTIRE flight & all the way down the terminal to baggage claim & ground transportation about masks, so be ready if you're in the seat next to me & do this. Might be better just to #WearAMask.😂)
.@Delta@united@americanair @southwest, can y'all break it down for us why seatbelts, why bags "fully under seat," why seat backs & tray tables "full upright & locked position for landing"? We can't choose to risk ourselves & others at risk on the plane...or something? #maskup🤷♀️
You know, it's a hassle to have to contort myself to get my bag out from under the seat when we arrive. And I often have to make slides on my flights. I like to use every minute to work on them from boarding to exiting. Also it's a lot easier to do that with the tray table down.
Apr 19 • 10 tweets • 6 min read
The more I think about airlines abruptly allowing mask removal w/o warning—mid-flight for many—the angrier I get. People who are #immunocompromised had no choice not to travel or to upgrade their protection at that point. Some will go on to die. As an oncologist, I am enraged.
If you haven’t had #cancer or been a caregiver to someone with it, you don’t know how much people endure. I’m a breast oncologist. Our patients have breasts amputated, lose their fertility, go bald, risk nerve damage, infection, & more from chemo, because they want to live.
Mar 4 • 4 tweets • 3 min read
Trying hard to stay in my lane on #UkraineUnderAttack. I’m a physician, not a foreign policy expert. But per AP, Russian attacks have just caused a fire at Europe’s largest nuclear power plant, & elev radiation levels are being detected in the region. That is a big deal.
🧵As a scientist & physician, when our #pandemic predictions are off, I think it's important to circle back & analyze why. In late Dec 2021, I tweeted a🧵predicting widespread disruption of everything from health care & pharmacies to grocery stores & schools in Jan/Feb '22. 1/x
The reason for my prediction was the pattern of a huge spike in #COVID19 cases the prior winter (driven in part by holiday travel) & the fact that #omicron was considerably more contagious than prior #COVIDvariants & more able to evade immunity from vaccines or prior infxn. 2/x
Jan 28 • 23 tweets • 12 min read
🧵 I’m not sure what I’m about to say has been made clear to ppl w/o a science or #MedTwitter background. It may be a genuine source of confusion (ie good faith questions), so here goes. Many are saying “If #Omicron makes a given person less sick (which appears to be true)…” /1
“Shouldn’t we just go ahead & get it over with? You know, masks off & almost everyone gets infected & then we’ll be done with it?” I get why someone might think or ask that. It makes sense. But it’s not the right thing to do, & here’s why. /2
Jan 26 • 4 tweets • 4 min read
🧵My #UrgencyOfNormal includes:
👉People w/ #cancer needing urgent chemo getting a hosp bed without a wk+ wait & a desperate plea by their dr on Twitter
👉My #immunocompromised patients not wondering if kids brought home #COVID19 that can kill them (#vaccineswork less in them)
(P.S. You might think these are someone else's problems, but >1 in 3 Americans get #cancer in their lifetime, so reply w/ care...this could well become you or yours)
👉Timely medical care in our local ERs
👉The same teacher, not a parade of subs, because of #COVID19 illness
Jan 23 • 6 tweets • 3 min read
Shout out to participants in #clinicaltrials. I’m enrolled in an NIH RADx-supported trial that requires me to do #COVID19 rapid tests & PCR every other day within a time window, & then drive a pkg to a FedEx every other day by 3p. This is the 4th study I’ve joined in my life…
The studies I’ve been in have ranged from pregnancy outcomes yrs ago to #COVID19 diagnostics. I keep joining them because I believe #ScienceWillWin, but also because it’s important to be reminded what a genuine hassle it is to be in a study. /2
Jan 8 • 23 tweets • 7 min read
🧵 Parents of teens looking for N95/KN95/KF94 masks that your teens will wear without complaint, I feel your pain. We are 2 drs w/ 3 teens. We obviously believe in high-quality masks, & we’ve struggled to find masks that fit well & are comfy enough for kids to wear all day. 1/x
Let me start by saying we have no relationship with any mask company, no one gave us any free masks, & no one asked us to review or recommend any mask. Our views don’t represent any employers. Tweeting here as parents & your kids may be different. 2/x
Jan 2 • 5 tweets • 3 min read
In case no one has told you, the odds your kids will be at school in person in 2-3 wks in the US approach zero in most areas, no matter what your BOE or Governor decide about opening. There won’t be enough people well to run buses, lunches, clean, or teach. Plan now as a family.
I do think we’ll see a rapid peak of #omicron cases by some point in January & then a fall, but enough critical staff will be sick that it will be logistically impossible to keep most schools open during Jan. Our own county @hcpss had a 90 driver shortfall to start the school yr.
Jan 2 • 4 tweets • 7 min read
This is horrifying. I expected this to happen at some point in Jan or Feb with #Omicron. I didn't expect it happen on January 1. 💔
Listen, important. Most adults in #Maryland are #vaccinated. Fewer kids are. MANY haven't yet gotten a #boostershot (only 70M in entire US pop of 331M #boosted). A booster will ⬇️ risk of hospitalization by 88% & starts protecting you in 7d with major protection in 14d. GO DO IT!
The sensible thing to do is: 1. Delay reopening or go virtual now & do a school-based campaign to get as many as possible 12+ (& 5+ who are #immunocompromised) #boosted next wk: google.com/amp/s/www.nyti…. That will decrease breakthrough cases & odds of severe illness in community.
Dec 30, 2021 • 5 tweets • 2 min read
Please don't panic about what this tweet means. I say this as a doctor in a #pandemic, as well as a daughter who lost a parent this year: please make sure your will is current & your loved ones know where it is & that your wishes on end-of-life care are known to your family.
It is an enormous & avoidable source of stress when people become seriously ill or die without them. You can create a simple will online, often for free (consumerreports.org/estate-plannin…).