Megan Ranney MD MPH 🌻
@meganranney
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I fix problems and promote health 🔸️Dean @YaleSPH 🔸️ER doc 🔸️ Cofounder @researchaffirm #ThisIsOurLane 🔸️she/hers
New Haven, CT
Joined January 2011
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We all owe South Africa a thank you and an apology.
JUST IN: Omicron COVID variant was in Europe before South African scientists detected and flagged it to the world
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This week alone:
1. A boy shot for ringing the wrong doorbell
2. A girl shot for pulling in the wrong driveway
3. A girl shot for going up to the wrong car
4. A girl shot for rolling a ball into the wrong yard
The common denominator is NOT the kids. 🤷♀️
AGAIN: Kinsley White, 6, was shot by a North Carolina neighbor who was upset that a basketball rolled into his yard. The gunman also shot her parents and other family members. White was released from the hospital overnight.
#ncpol
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Last night in my ER: zero critically ill
#covid19
patients. Thanks, vaccines. 🎉
What a difference from last year.
May it last.
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If anyone tells you they will fix physician burnout with yoga & wellness apps they are lying.
It will be fixed when we create a system that makes it easier to do the right thing for the patient.
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OMG OMG this gives me heart palpitations.
Folks. DON'T DO IT. This is going to light a million new fires and devastate families across the country.
DO NOT DO INDOORS THANKSGIVING with people who aren't part of your immediate household. I'm begging you.
Poll: 38 percent of Americans plan to have Thanksgiving dinner with 10 or more people
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Nope. Your decisions directly affect mine, and my unvaccinated child’s, and my elderly parents’. Because when you get infected & spread this virus, you put the rest of us at risk too.
Signed, your friendly ER doc
My decision not to get vaccinated does not affect anyone else’s health. Full stop.
The
#ScaredVaccinated
are dividing our communities and the country.
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Does
@fox
@SteveKrak
really think I pay someone to arrange my bookshelf?! 🤦🏻♀️C'mon guys, that's weak sauce.
Ps, I've read them all.
Pps, I'm a medical doctor, not a "pundit".
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In the last 7 days:
💉Almost 600,000 people vaccinated in the US in 1 week; 0 deaths; 1 observed in the hospital & released out of an abundance of caution after an allergic reaction
🦠Versus > 120k hospitalized (many of whom will have
#LongCovid
) & 20k deaths from
#covid19
🤔
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I'm tearing up right now while talking with a group of fellow emergency docs about our (in)ability to care for patients coming through the doors right now.
It hurts us in our soul when we can't provide quick, empathetic care. We know the system is broken. We can't fix it alone.
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Today, a cashier WAS KILLED because she asked someone to wear a mask.
This is the confluence of our country’s worst instincts - misinformation, firearms, & unbridled anger.
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So where does that leave us?
1) Keep doing & funding science.
2) Insist that state & federal gov'ts increase testing so you can go back to work
3) Fund
#Publichealth
infrastructure
4) Until then... maintain masks & social distancing to keep yourself *and your community* safe
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I am very rarely angered - it isn’t in my nature.
But I am livid at the “experts” - particularly those in the medical profession - who claim WITHOUT EVIDENCE that our kids in high surge states don’t need to mask. Thereby putting kids, schools, & communities at risk.
A thread.
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Things like:
- disproportionate representation in essential service jobs (unable to practice social distancing)
- historic economic & housing issues (which make social distancing difficult)
- bias in the
#healthcare
system (which hurts care, hurts trust, & worsens outcomes)
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I & my colleagues have worn masks 8-16 hours a day for months on end. We have not died, developed pneumonia, or developed the mythical "CO2 poisoning" as a result.
And, in fact, we even ASK for masks!
#GetMePPE
If docs & nurses can wear a mask, SO CAN YOU.😷
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This is the face of the amazing emergency physician Dr Tamara ONeal, at work today, before she was murdered.
Tonight, hold her, her family, & our colleagues at
#MercyHospital
#UIC
in your hearts.
And tomorrow, pledge to fight for women like her. Because
#ThisIsOurLane
.
#Enough
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Tell me which "elite bubble" that might be? The one where scientists worked tirelessly to create&ensure safety of vaccines in record time? Where healthcare workers went without PPE? Where 300k+ Americans died?
Or: the bubble where you went to the front of the line for a vaccine?
Dr. Fauci lied about masks in March
Dr. Fauci has been distorting the level of vaccination needed for herd immunity
It isn’t just him
Many in elite bubbles believe the American public doesn’t know “what’s good for them” so they need to be tricked into “doing the right thing”
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4. Relatedly, we don't know what works to treat
#COVID19
.
Remdesivir may decrease hospitalizations.
Proning may decrease intubations.
Hydroxycholoroquine WORSENS outcomes.
Plasma from recovered pts: Maybe.
That's all we've got, folks. Still waiting on 100s of ongoing trials.
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I’ve taken care of people with “indigestion” who had heart attacks
People with “pink eye” who had vision-threatening infections
Ppl with a “tension headache” who had brain bleed
This policy is horrible. Patients shouldn’t be forced to decide if they’re having an “emergency”😬
ACEP strongly condemns UnitedHealthcare’s dangerous new policy to retroactively deny emergency care claims.
Reckless policies like this will leave millions fearful of seeking medical care just as we’re getting hold of the pandemic. Full statement:
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I'm an ER doctor. I've seen a therapist and have been on anti-depressants.
It's normal to need help.
I’m an ER doctor. I’ve seen a therapist and have been on antidepressants. Our system considers this a red flag, instead of a positive signal that I’m taking the best care of myself possible. This needs to change.
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I think I will make a career for myself out of calling out misleading headlines.
THIS IS NOT A FAILURE OF THE VACCINE. He tests positive because... he was already infected.
Kentucky's GOP auditor tests positive for COVID-19 one day after first vaccine dose
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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? 🧵
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Inherent to
#COVID19
- as in every epidemic - are issues of class, race, and equity.
I cannot be more clear: although we are all at risk, historical injustices result in INCREASED risk for Black communities.
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Please tell me I am not the only person who paces around the house from 10:45pm-11:10pm so I can close my last circle? 🤷♀️
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Let me tell you about the kids I've saved - and those I couldn't - before you tell me that the method doesn't matter.
#ThisIsOurLane
Dana Loesch says that pediatricians are “irresponsible” for pointing out the link between firearms and adolescent suicide
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I'm honored & excited to share: After almost 20 years here at
@BrownUniversity
@Brown_SPH
@BrownMedicine
I'm becoming a Yalie!
Grateful for the place that made me who I am. Excited to make the world better with new colleagues & students.
Here's to the future of
#PublicHealth
.
Dr. Megan L. Ranney (
@meganranney
), an internationally recognized public health leader, investigator, advocate, and clinician-scientist, will become dean of the Yale School of Public Health on July 1, President Peter Salovey announced today.
More:
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8. And we of course don't yet know when/whether we'll have a safe and effective vaccine.
(But PLEASE FOR THE LOVE OF GOD once we have one, GET VACCINATED!)
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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.
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A reminder: If we want to keep schools open, we have to do the work to keep kids and teachers and staff healthy.
Masks.
Vaccines.
Ventilation.
Tests.
Reducing community transmission, & prioritizing kids and teachers for once.
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Ok, let's look at the facts surrounding this joy ride:
1. He is still infectious
2. CDC guidelines require isolation for a minimum of 10 days after a + test, no matter who you are
3. Almost a dozen secret service agents have already been infected
4. The car is a closed space
President Trump, wearing a mask, rides by his supporters outside Walter Reed while in the back of a Suburban.
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5. We are not totally sure about the efficacy of those home-made masks.
We know that masks work, period. But what kind of fabric masks work, for whom, at what distance? Still TBD.
(Wear them! But don't feel immune.)
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I wish Laura would shadow me in my ER. Any day, any hour. Then decide about what’s the “lie”.
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My
#covid19
#vaccine
dose
#1
is in the books! Hurt less than a flu shot. 21 days until I'm protected 💓🙏🏻
#bareyourarms
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2. We know that to decrease transmission & deaths, we need a a combo of (a) Social distancing (b) Testing (c) Isolation & Contact Tracing of Sick People (d) Adequate PPE.
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6. We don't yet know how long immunity lasts. Once you get it once, will you be immune for a month? A year? A lifetime? Will this be like the common cold, or like smallpox? We're hoping for the latter.
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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
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Almost a week ago, I was honored to receive one of a very few
@cdcgov
grants to study the
#publichealth
approach to firearm injury prevention.
I've been waiting to tweet about it, because I wanted to create the best possible tweet.
But that will never happen. So instead:
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So my plea from the frontlines. Let's not forget:
1) THIS IS NOT NORMAL.
2) We can still prevent it: masks & other basic measures do work
3) Hope is on the way. Don't give up now.
#ThisIsOurShot
4) Human lives matter.
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I worked the last 2 evenings in the
#COVID19
pods of our ER.
What struck me - more than at any other point during the pandemic - was the resignation that I heard.
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13 years ago, I started here as Assistant Prof. 1 marriage, 2 kids, lots of mentees & grants & papers later - having finally made some small differences in the world professionally & personally - I am so very honored to now be a full Professor
@Brown_Emergency
@BrownMedicine
💕
Congratulations to our outstanding faculty on their 2021 promotions! Please congratulate them when you see them!
@Brown_Emergency
@meganranney
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3. We don't fully understand why & how it causes a wide variety of clinical syndromes. For example, although we have growing clinical knowledge, the new multi-inflammatory syndrome observed in kids is very much a black box.
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So what???? It's a 2-shot vaccination. The EUA was not for a single dose - because that's not what the data supported.
The 2nd dose matters
California nurse tests positive over a week after receiving Pfizer COVID-19 vaccine: ABC
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In emergency medicine, we rarely call “uncle”. But
#DeltaVariant
is getting us there.
Now, 16 directors of emergency depts in Memphis have written a letter saying “we are at the breaking point. Please, mandate that everyone
#maskup
, to help us save room for emergencies.”
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2. And if we can increase (b), (c), and (d) .... then (a)
#SocialDistancing
is not so necessary.
WITHOUT these standard
#publichealth
measures, we'll see new hot-spots emerge, watch infections & deaths balloon, & will be right back where we were in mid-March in the US.
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I'm going to get harassed for saying this but every woman should know how to do a cric, or at least how to jet ventilate. It's part of being an incredible nurturer and caregiver.
I’m going to get harassed for saying this but every woman should know how to cook and bake for her loved ones. It’s part of being an incredible nurturer and caregiver.
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3. We also know that if you're close to someone who's infected, inside, for a period of time, you too have a high risk of infection.
And... 1 selfish person, who goes out & about when ill, can get a lot of other people really sick :(
Once again, 1-2 infections lead to a large number of new infections & deaths.
#covid19
is real and - unless we test, trace, & isolate - will continue to spread.
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New study!!
#covid19
itself hurts fertility (in the 1st 60 days after infection).
The vaccines, on the other hand, don’t affect fertility of women or men. Period.
Pass it on.
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I just got off shift in the ER.
This news broke while I was working.
My co-workers and I kept talking about it.
My nurse friends: “I worry that it could have been any of us. Especially the last 2 years.”
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Here's the thing.
We are all going to run out of beds - but also docs, nurses, respiratory techs, radiology techs, PAs, NPs, lab techs, etc.
There simply isn't enough capacity in the system.
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4. Lastly, we know that underlying social & economic inequalities worsen disease.
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My greatest achievement on my ER shift tonight: A few folks agreed to finally get their
#covid19
vaccine! 💉🌟
Honest fears, allayed & explained. Real logistical problems, fixed. One patient: “Doc, thanks for just talking to me.”
A little respect goes a long way.
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I’ve spent nearly 20 years walking the halls of this building. Bittersweet to leave my shift for what is likely the last time.
Thanks for helping to make me who I am,
@BrownEMRes
@RIHospital
- I will miss you. 🩺.
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When was the last time you stopped to think about what hospital housekeeping staff really do?
They clean up the blood.
The vomit.
The influenza, measles, &
#COVID19
rooms.
They sanitize the tragedy, so the rest of us can go on "saving lives".
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Life is unexpectedly fleeting.
Take a moment and appreciate it. And hug those you love.
❤️, your friendly ER doc
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I don't normally swear on twitter. But when I do.... (click on the image).
#6feetback
HT
@DrHowieMell
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Let me be CRYSTAL clear: we do NOT have adequate PPE. Not in hospitals, or nursing homes, or clinics.
Nor are we lying, nor are we seeking publicity. We just want to be able to do our damn jobs.
#GetMePPE
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The ball dropped, and I started bawling.
I guess I hadn't let myself really admit how horrific 2020 was.
Here's to a year of vaccines, leadership, & hope. Thanks for ringing it in with humor & kindness, and for creating space for overdue grief,
@andersoncooper
@Andy
#CNNNYE
.
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7. We don't know how long people are infectious.
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For the last decade+, I have been one of the vocal voices in our country calling to address
#gunviolence
as a
#publichealth
problem.
***Gun deaths are no different from
#COVID19
: when we politicize human suffering, we all lose.****
A thread: 🧵
#BoulderStrong
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Let's be crystal clear: According to our country's and every country's
#publichealth
guidelines - VP Pence should be *quarantining* right now, no matter what his
#covid19
tests show.
For him to show up in person at campaign events or the VP debate would be, simply, wrong.
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1. We know the virus' genome.
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Someone asked me today how I stay positive.
Answer: I don’t.
But: I refuse to give up.
And I refuse to let others give up.
Which means that, together, slowly, persistently, we can create hope.
Over & over again.
#keepgoing
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in case anyone was wondering: WE SHOULD BE TESTING ASYMPTOMATIC PEOPLE.
Fauci tells
@drsanjaygupta
he was under anesthesia when task force met to discuss changing testing guidance. “I am concerned about the interpretation of these recs & worried it will give people the incorrect assumption asymptomatic spread is not of great concern. In fact it is.”
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TBH most of us took pay cuts.
#Breaking
: Donald Trump just attacked American Doctors and said they are fabricating the Covid-19 death count for money.
There’s no bottom.
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I find it ridiculous when people accuse me of various perceived faults about kids &
#covid19
.
Folks, one can hold ALL of these things as true:
1. Covid is not benign, even for kids
2. Children can spread SARS CoV2
3. Covid is preventable, with vaccines and masks
*And*
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Today, the first time, CDC says "Fully vaccinated persons who meet criteria will no longer be required to quarantine following an exposure to someone with
#COVID19
."
THIS IS HUGE. A thread (with a NEW GIF PER REQUEST)
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An observation: Right now is not easy, no matter who you are. The last 16 months were tough. And the sadness, anger, & fatigue are finally oozing to the surface.
So please, let’s default to having grace for each other.
We sure could all use it.
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I'm hearing from lots of medical colleagues right now "I'm so tired."
We're disheartened. The virulence is the same. We knew we weren't REALLY through it...but had hope against hope that
#COVID19
would be different this fall.
Hold nurses, docs, techs in your heart. They need it
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A reminder to clinicians of all stripes:
Patients’ symptoms are not “just anxiety” unless you have ruled out all the dangerous stuff. 🧠🫁🫀🦠
And even then - anxiety is a real diagnosis, too.
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Of course it didn't ! Testing detects the disease *after* you get it - & helps prevent spread to others. It doesn't protect you from getting it on the first place. You need masks and physical distancing to be protected.
Think of it as a pregnancy test, instead of condoms.
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The cognitive dissonance astounds me:
* Docs, nurses, & teachers are hailed as "heroes" for showing up for our communities during
#covid19
🇺🇸
* Yet docs, nurses, & teachers are also insulted as "selfish" & "frauds" when we ask for basic protections & good science? 🤔🤯
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A short list of things we currently need in hospitals and outpatient clinics, in addition to N95 masks:
* Face shields
* Surgical masks
* Disposable gowns
* Test swabs
* HEPA filters
* Gloves
* Hand sanitizer
Praying that the supply chain comes through.
#COVID19
#healthcare
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RETRACTED!!!! (But should never have been published. This was poor science, to say the least.)
To be super clear: THERE IS ZERO EVIDENCE THAT MASKS HARM KIDS (or adults), and in fact there is good evidence that they do not.
@trishgreenhalgh
@kprather88
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I have lots of thoughts on the pausing of the J&J vaccine.
The biggest is that I’m glad that we do good science and post-vaccine monitoring. The 2nd is that even if real, this association is very small. More below:
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“But in general, what’s standing in the way of normal life is Covid, not Covid prevention.”
Preach
@michelleinbklyn
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OH MY GOD THANK YOU
@Twitter
---- I promise to use the blue check wisely.
#publichealth
and
#science
shall overcome, for
#COVID19
and in the future.
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This matters WAY more than boosters for the 18-49 set.
NEW: Pfizer is ready to ask the FDA for authorization to use its Covid-19 vaccine in children 5-11 “within days,” Pfizer CEO Albert Bourla told ABC.
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It’s ok to be tired, my friends.
It has been a very long couple of years.
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My thoughts on the
#mentalhealth
effects of dexamethasone - as shared with
@wolfblitzer
tonight:
This med may be necessary for sick
#covid19
patients, but it is not benign. Steroid induced psychosis and mania are real, and common.
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Who else thinks that Fauci looks younger? That weight we all felt lifted, was real.
@weijia
Dr. Fauci seems to be enjoying his return to White House briefings:
“One of the new things in this administration is, if you don’t know the answer, don’t guess. Just say you don’t know the answer.”
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Imagine if every country did this.
NEW—As of today, unvaccinated people can no longer board airplanes ✈️ or ride (long distance) trains 🚊 in Canada.
@AirCanada
&
@WestJet
also state they will ask every passenger to show proof of vaccination. Exempted people must show recent negative test.
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(....that's essentially it, folks. That's what we KNOW about the virus, its transmission, and its prevention.)
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This is my state right now.
To all the people (who I don't tag, bc they don't deserve the notoriety) who accused me of "fear mongering" - I hope you don't get sick, from
#covid19
or anything else, because WE HAVE NOWHERE TO TREAT YOU.
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Hi. ICYMI: This is not a "slip & fall". This is not a minor concussion. This is MAJOR head trauma.
My condolences to Saget's friends & family. I hope that they get answers as to what really happened.
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I have spent the last hour standing next to my 2 kids while they do their distance learning days, troubleshooting various tech platforms.
The teachers are doing an incredible job.
But I have now lost an hour of my workday.
*i am watching the gender gap grow in real time*
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My parents got their 2nd dose of
#COVID19
#vaccine
today. Which means: Two weeks until we can have Sunday dinner. Two weeks until they can hug their grandkids. Two weeks. My heart hurts with anticipation.
What's first on YOUR list once you're fully immunized?💉🦠🍀
#ThisIsOurShot
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More: this is good news because -
* he has survived 🙏🙏
* his heart rate & blood pressure are ok if his vital signs are stable
* it is NORMAL to sedate & intubate a patient after something like this - to protect them from stress, & to give us docs time to determine next steps
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My kids both went to school today.
They're both vaccinated. They both masked - except lunch. And realistically, they'll be exposed to
#omicron
. But the vaccines protect them - and if they do get infected, I will be able to care for them at home.
This is different from 2020.
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