Wow. On board JetBlue. Attendant just announced that the courts struck down CDC’s 2 week extension of the mask mandate today and JetBlue now dropped its mask requirement. The attendant added he is taking his off.
(Meanwhile: double digit increases in cases in the northeast.)
I'm grateful and honored to be asked to serve and to contribute to ending this pandemic. We have runaway spread right now. But I am confident we can get the virus under control, save lives and livelihoods, and bring people back together again.
Pulling out of WHO is a disaster for the lives and health of all people, including Americans. I can’t imagine a worse thing to do in the midst of a pandemic and ongoing work to fight back TB, HIV, polio, and other health threats. America First does not work for global disease.
This is what is possible. Masks, Distancing, Testing, and Tracing work. But we need a leader who pulls people together to take the problem seriously, instead of sabotaging those who do.
It is hard not to be emotional in this moment.
We have had a president who fomented division and chaos, attacked doctors and science in the midst of the worst public health crisis in a century, and damaged our democracy.
But we have turned him out and given decency a chance.
Such a great article: “Households that got cash instead of standard aid packages saved 60% more, consumed 32% more, & expanded productive assets like livestock by 76% more...Recipients' diets improved & so did their kid’s height, weight, and...survival"
A 6 yr old Oregon boy whose parents refused vaccination got the first pediatric case of tetanus in the state in 30 years. Produced lockjaw requiring a tracheostomy and 5 wks on a ventilator. (And the parents still won’t give him any vaccinations.)
It appears we are a week or so behind Italy. A ban on flights from Europe isn’t going to change that. More decisive federal action — massive testing and social distancing — appears to be necessary to “flatten the curve.”
Important results: Remember the 2 MO hairstylists who saw 140 clients over 8 days while infected with COVID but everyone had worn masks? Contact tracers found ZERO secondary infections. More evidence that masks work.
Just got out of the OR to read this piece about Trump’s new lawsuit to bring back pre-ex condition exclusions. If it won, all four of my patients would be denied coverage on the individual market for the very reasons I did surgery for them. Insane.
Masks work? YES. This is appalling. Atlas offers no explanation for the increasing mountain of evidence in support, and instead offers only a bizarre and incoherent paper. I don't know why the administration wants to die on this hill.
What the tax bill does to graduate students alone — the seed of our economic future — should be reason enough to stop this disaster. And then there is what it does to healthcare for millions. I am baffled by the GOP complicity in inflicting damage on this scale.
It will be great news if dexamethasone, a cheap steroid, really does cut deaths by 1/3 in ventilated patients with COVID19, but after all the retractions and walk backs, it is unacceptable to tout study results by press release without releasing the paper.
BREAKING: The incomparable
@Atul_Gawande
just confirmed to be
@USAID
Assistant Administrator for Global Health! We can’t wait to work with him in tackling
#Covid_19
, getting vaccine shots in arms around the world, strengthening local health systems & preventing future pandemics.
This report is stunning. Political appointees are interfering in the publication process of MMWR, the CDC’s longtime, hallmark public health journal, to insure alignment with the President’s preferred narrative. They should have no role in scientific publications. None.
Such a disturbing study. "What we found in this study is that people with talent that come from disadvantaged households don’t do as well as people with very little talent from advantaged households.” You knew it. But here is some hard data...
"Now my oxygen level is 50, and the guard at the Balrampur hospital is not letting me enter.”
Such a disturbing picture of COVID overwhelming Indian hospitals. This journalist, finding no help, live tweeted his declining oxygen levels until he died.
What's happening in Brazil is horrifying. The coronavirus is spreading rapidly, overwhelming the health care system, and proving especially deadly for the medical workers on the front lines. More nurses dead than in any other country.
This outbreak is vital to understand. It shows what we still face if younger folks go unvaccinated.
47% of health care workers refused vax, while only 10% of residents did.
Result: 1 unvax'd HCW with COVID led to 20 HCWs & 26 residents infected, of whom 3 died (1 vaccinated).
An unvaccinated health care worker at a Kentucky nursing home set off a Covid-19 outbreak among many staff and residents who were already vaccinated, according to a new study.
The JNJ vaccine results indicate we miraculously have at least 3 safe, highly effective vaccines.
Headlines focus on the 66% overall efficacy. But the big deal is that the single-dose vax was 100% effective against severe disease after day 49, and 85% effective by day 28.
Bit by bit, the FDA & CDC's strengths have been pecked away to insure fealty to the President instead of the people. The damage will take years to undo. For those who devoted our lives to serving the health of those people, I cannot express how difficult seeing this is.
I can't remember a single incident in my nearly eight years running the CDC or 20 years working there when any entity forced the agency to change its guidance. We can't let politics get in the way of science.
India was on a trajectory to have the worst COVID epidemic in the world. But with far less resources for combatting COVID than US or Europe, it has turned the tide — with a determined focus on masks.
I have become a target for ads from sellers of these evil valved masks. The valve provides “breathability” when you exhale by releasing your breath and its contagion-carrying respiratory droplets. The masks protects no one. They need to be banned.
Warning for COVID scientists: An impostor is asking scientists for an interview using the email atulgawande65
@gmail
.com (not mine) and signature “Atul Gawande, Staff Writer, The New Yorker.”
These are fake. Do not respond. I use a address for work. 1/4
Today, my health system took a big step: Notified staff that they're adopting the model described here, with face masks at all times & a health check each shift for even mild ill symptoms. Effective Wednesday. Kudos to
@PartnersNews
@BrighamWomens
@MassGeneralNews
“We can learn from the experiences of our colleagues across the planet,”
@Atul_Gawande
writes, of Singapore’s and Hong Kong’s success in containing the spread of the coronavirus. “The pandemic is global; its lessons are, too.”
We have gone big to vaccinate the US. We need to undertake exactly such an effort abroad: an all-out response for an all-in global vaccination campaign.
We have the production know-how, the logistics expertise, and the ability to rally the world.
The assurances
@SenatorCollins
was promised for her Yes vote are fading fast. Still a chance for her to stop this disaster on the final vote on the conference committee bill yet to come.
This survey finds that 90+% of parents of color fear school reopening. Most distressing additional finding: 44% fear that without school, their children will not have enough to eat at home. Only 9% of white parents have that fear.
Huge news for the global COVID fight.
Covaxin is an inactivated virus vaccine.
Effectiveness is 93% vs severe disease; 65% vs symptomatic Delta infection.
Can be stored in a fridge. Cost in India is $4.
And output will reach 70M+/month by Jan.
I’m honored to be nominated to lead global health development at
@USAID
, including for COVID. With more COVID deaths worldwide in the first half of 2021 than in all of 2020, I’m grateful for the chance to help end this crisis and to re-strengthen public health systems worldwide.
3 things I was wildly wrong about: 1) the # of rally goers (6,200 v 19K); 2) the % who don’t care or believe COVID is a danger to their family (<10% wore masks); 3) I hadn’t even conceived that the President might actively sabotage testing, accelerate US deaths, and brag about it
New Mich. hospital data: Of people admitted with COVID, 70% were alive and home 60 days later.
Of those who'd been working, 40% either lost their job or were still too sick to work.
It's not just the deaths; it's the health and economic damage.
Big news on the Ebola vaccine from Congo: "the evidence the WHO has been gathering in North Kivu — where nearly 64,000 doses have been administered — point to the vaccine being 'highly, highly efficacious.'"
@statnews
How great is it that our biggest clickbait of the week is Meghan and Harry, and our biggest worry seems to be whether monarchy is doomed rather than whether democracy is doomed or another 100,000 people will die this month?
We are ringing the alarm bell, folks. The US is 10-14 days behind Italy. We're not doing enough to change that trajectory.
They had 368 deaths yesterday. For a nation of 60 million, it was enough to raise their all-cause mortality rate 20%.
We can avoid that.
#StayHome
My latest
@NewYorker
piece, in gestation for a couple years now, as you’ll see. Something to read about other than the election, at least. It is on the state of health care information technology. In other words: .
As Coronavirus puts us into uncharted waters, tonight I have joined w 15 health leaders to publish an open letter in
@USATODAY
with an urgent, lifesaving message:
Everyone who can,
#StayHome
.
Here's what it means for you, officials, and health workers
“As a doctor, I feel I have a duty to inform the public of what I have learned as I have observed these wounds and cared for these patients. It’s clear to me that AR-15 or other high-velocity weapons... have no place in a civilian’s gun cabinet.” Must read.
A trauma surgeon who was on duty last week, taking care of Parkland victims, describes -- in graphic detail -- what bullets from an AR-15 do to the human body.
Difficult to read. Important to read.
Testing showed DNA in the bone marrow transplant patient’s blood was replaced by his donor’s. No surprise there. But over time cells all over his body had donor DNA. The DNA in his semen had been ENTIRELY replaced by his donor’s.
I agree with Europe: Wearing medical-grade masks will be important to slow the spread of the B.1.1.7 strain. We have consistent evidence that single-layer cloth masks are not as effective as surgical masks, and N95 or KN95 masks are even better.
Fabulous trial reduced loneliness, depression, and anxiety in Meals on Wheels participants who live alone over four weeks.
How? College volunteers w 2 hrs training simply called a roster of 6-9 folks 2-5X/week (elders' choice) to ask how they are.
Palliative care is absolutely NOT synonymous w end of life care. It is the field devoted to providing people with serious life-limiting Illness with expert care that serves their goals for quality of life, not just quantity of life. These are not either/or.
Recently,
@BrighamWomens
had a COVID-19 outbreak among 20+ patients & staff. We rapidly traced and tested all contacts and advised quarantine. We deployed PCR testing in <24 hours for ~9,000 staff. We ID’d 52 total cases associated w the cluster and are containing the outbreak.
>50% of passengers and crew dropped their masks, including many passengers who appeared age 70+.
With weekly cases in Boston at ~300/100K, and 3-5X that unconfirmed, our packed plane of ~250 likely has at least 1 case.
Kept my mask on. Just don’t want to get sick.
CDC calls out face masks with valves -- they do not stop spread of coronavirus because the valve lets exhaled air out. Airlines are banning them. Others should, too.
Pfizer's move is indefensible. Yes, squeeze every dose we can. But cutting deliveries from 40M to 33M vials for the same price cannot be justified. Especially when many places lack the special "low dead space" syringes needed to get the "extra" dose.
Having a 3rd vaccine with such strong early results (incl 1 regimen w 90% efficacy) is stunning.
AZ/Oxford vax:
- Regimen 1 (1/2 dose then, 1 mo later, full dose): 90%
- Regimen 2 (2 full doses): 62%
- Refrigerator storage
- Just $2.50 per dose
Now let's get thru winter alive
SCOOP: Tennessee Department of Health halts all vaccine outreach to kids – not just for COVID-19, but all diseases – amid pressure from GOP. Staff ordered to remove the agency logo from any documents providing vaccine info to the public, per internal dox.
The problem with vaccine waning 4-6 months later was 1st recognized in Israel in July, confirmed by more than 10 reports, and occurs with all vaccines. Protection is fully restored (or even exceeded) by 3rd (booster) shots.
Also clear: a 50% vaccination rate for HCWs in such settings is not acceptable.
This case tells me that requiring COVID vaccination, just like flu vaccination, for working with vulnerable patients is going to be necessary.
One of
@edyong209
’s best. The exhaustion of health care workers treating COVID is mounting. And the hardest part is the “societal fatigue” of seeing case after case & beds filling up, only to hear so many say it isn’t real or they’re fear mongering.
Massachusetts reached 75% of adults with at least one COVID vaccine dose -- and yesterday joined half a dozen other states, Israel, England, Scotland, and Northern Ireland in having its first day with ZERO COVID deaths since the spring 2020.
The vaccines work.
“Indians have embraced masks thanks to a combination of factors, including a healthy fear of the virus among the public, a unified voice from authorities, billions of automated phone messages and hundreds of thousands of masking-violation tickets.” This is the result.
Super interesting research. The answer is at least partly that elephants’ cells have an astounding twenty copies of p53, a cancer repair gene. Ours have just one.
My commencement address at UCLA Med School yesterday in
@newyorker
, in which I tell the story of treating a prisoner and sorting out what we mean when we say we are all created equal.
Seeing Dorothy Oliver bring vaccines to her town and persuade people to take them, in this short film, is extraordinary and beautiful. She does it with love. And love works.
A stunning 94% of Panola, Alabama, is vaccinated because of her.
"My life depends on it. I need you to make your vote match your principles, Senator." A man who says he was recently diagnosed with ALS debates the GOP tax bill with Senator Jeff Flake on a plane
With cases rising, and superspreader events like the Gridiron dinner, I thought CDC’s 2 wk wait to see if hospitalizations climb was sensible. Moreover, it seemed far from an abuse of public health authority. Different courts 2nd guessing seems mainly likely to confuse matters.
NEWS: System uses hydrogen peroxide to sterilize 80,000 N95 masks per day and will serve hospitals across the entire Boston area. Approved by
@US_FDA
just a week ago. More shipping to other high need cities ahead of viral peak. Thank you
@Battelle
.
Study from Israel finds rapid vax effect: After 14d from first shot, infection rates fell 33% among 200K 60+ year-olds vaccinated vs 200K not.
Of 1.7M vaccinated, just 1,127, or 0.06%, reported side effects, such as weakness, headaches, dizziness, fever, or site pain/swelling.
Israeli vaccine data suggests Covid-19 infection rates among a group of vaccine recipients began to decrease two weeks after they received the first shot of the Pfizer-BioNTech vaccine, offering important insights to other countries
This is the President admitting on national TV to putting his need to not look bad above American lives. He acknowledges what we’ve seen—active obstruction of testing in a pandemic which claimed 120K lives so far. If I did this for 10 people at my hospital, it’d be a crime.
Trump: When you do testing to that extent, you’re going to find more people. You’re going to find more cases. So I said to my people slow the testing down please.
It is beyond outrageous for the President to attack the HHS Inspector General for issuing a report that documents the PPE and test shortages hospitals are facing—many have just days of mask supplies. This is moral bankruptcy. Lives are on the line.
Dr Bernard Lown, Nobel Prize winner and hospital patient at 96, in revolt: "Healing is replaced with treating, caring is supplanted by managing." Should he be allowed to eat? Has anyone asked him? The magnificent story from the intern on his medical team.
Why covering your face is a good idea — not because it blocks germs but because it blocks you from touching your face. *DO NOT USE MEDICAL MASKS. Health care workers need the supply.* Cloth face coverings, even bandanas, are fine.
What a scoop. In April, HHS and the USPS were set to mail five face masks to every US residence. Imagine the impact--lives saved, jobs recovered--that would have had on the pandemic if the Administration hadn't called this announcement off.
The mounting smear campaign against Fauci is as deceitful as it is frightening. It is an effort to destroy his credibility for daring to present the distressing but inconvenient reality of the danger of the pandemic and the necessity for the federal govt to act.
#IStandWithFauci
The insanity of this piece aside, theres no better proof of the incompetence & dishonesty of Navarro than his new op-ed in USA Today. He makes sweeping statements with links to prove his point - and HIS links *disprove* what is saying. Yes, he's lying../1
The light at the end of the tunnel just got even brighter. We may now have multiple, very effective vaccines distributing widely in spring and summer. Now we must pull together to get everyone we can through that tunnel alive and with jobs intact.
Many lessons here. Most notable to me: 1. PARTIAL SOLUTIONS DON'T WORK. Italy locked down only high risk areas ("red zones"), but it only facilitated spread as people fled lockdown areas. "Italy followed the spread rather than prevented it." Exactly what the US is doing.
This horrific story. The administration stripped these 545 children from their parents and deported most of the parents to Central America. And now they can't find them. My heart is breaking.
Today, hospitals from every state joined together to ask--to plead--for everyone to
#MaskUp
.
COVID has hit healthcare workers hard. But we remain committed to be there for you.
Show your appreciation. Socially distance. Wear a mask.
Great piece on lessons learned globally. You don’t need continual lockdowns. You need robust testing and isolation; public health guidance pushing mask wearing and avoidance of closed, crowded spaces; strict border measures. Still can be done.
@devisridhar
Kentucky is literally reintroducing literacy tests for people to get coverage if they fail their work requirement. Literacy tests. (And hey, never mind that lack of literacy may have been a reflection of undiagnosed medical issues and a reason they don’t have a job.)
Let’s start here in reviewing the new program.
There’s a “literacy” provision.
If you don’t work enough hours and lose coverage, you can get to see a doctor again if you can pass a state literacy course about health or money. 😕2/