Just got my 4th shot at CVS. No staff masking. The woman who gave the shot put on a surgical mask *after* bringing over the immunization kit. Seven feet away, a woman was requesting free COVID tests “because my husband is unwell; I think he has COVID.” She, at least, was masked!
Osterholm: "we're actually seeing a population that, in many cases, is becoming less immune, not more. Because as time goes on, we know that the duration of protection from both vaccine and previous infection wanes." Also a practical lesson: don't unmask in elevators.
A very important paper is out in Nature on the role of pathological coagulation in Long COVID. Spike protein causes thromboinflamation by binding to fibrinogen, the soluble blood protein that converts to fibrin, the central component of blood clots. That inflammation in turn
Ugggh. 40 hr ago we had to take our younger kid to the ER at Hasbro Children’s to get a lacerated eyebrow glued shut. 3 hr in the waiting area, crowded, dubious ventilation. My wife wore her Envo Mask but the little one isn’t great at masking yet. 3 hr ago he started vomiting.
@jklmd123
Hilarious, isn't it, that the powers that be are vaunting everyone's personal freedom to make decisions, while depriving us of the information that we would need to exercise such freedom.
Very interesting. The Omicron variant has been known for less than 2 months and in South Africa there are already people getting *reinfected* with it. It *may* turn out that pursuing herd immunity through mass infection with an immune-evasive virus that attacks the immune system
SARS1 caused vascular necrosis of the femoral head years later. Infants now recently starting to experience hip pain and limping. Watch the intel from the front lines, as
@brownecfm
reminds us!
More infants attending x-ray for hip pain and limping, last few days. All recent "cold symptoms", along with rest of family. X-rays normal.
Wondering whether "cold" is Covid and remembering the paper on 20yr follow-ups in SARS-CoV-1; one of the sequelae was femoral head AVN.
@JessGrose
A 9/11’s worth of deaths every *week* since July from COVID in the U.S.; a Twin Tower’s worth yesterday alone, yet people are acting as if nothing were happening. And almost every one of those deaths would be preventable if everyone slapped on an N95 and wore it properly for a
6yo home from day camp. He reports, “People don’t know what my mask is.” Although most of the camp is outside, he wears his Flo Mask indoors. One kid apparently thought that he was missing part of his face. I suggested that he tell them he’ll from another planet & can’t breathe
causes not only blood-vessel damage but also neuronal damage, including the death of brain cells. Therapies targeting fibrinogen and microclots, such as nattokinase, should be very useful!
@merry123459
@albertabella17
When masks come off in indoor spaces, anecdotal reports show that Omicron approaches a 100% attack rate, regardless of vax status. That means 1 person can infect everyone in the room, if the LFT doesn’t detect them. This happened to all 10 at a dinner party in London last wk.
@Captaincoby00
Of course. For the same reason I wear one when removing drywall: to avoid breathing in crap that may ruin my health. It's not a difficult calculation.
Wow. Just wow. The Surgeon General's pathetic substitute for public health, the "war on loneliness," is starting to look like a coordinated absurdist exercise, "post-pandemic":
Jha tries to split hairs by telling people that immune *dysregulation* is somehow not immune *damage*. But the assertion is nonsensical. The immune system is a *system*. To dysregulate a system is to knock it out of kilter. When that occurs, the system is by definition damaged.
There's a lot of bad information out there about how covid damages the immune system
It really doesn’t
But you know what does?
Measles
And thanks to the antivaxers
We are seeing measles outbreaks again
Encourage people to get their kids vaccinated
It’s really important
@thecovidslayer
Ugh. I'm sorry. I can't fathom this mindset. It's like, the zombies are still surrounding the house, but I'm bored, and we've been here all night, I wanna go to 7-Eleven.
@JessGrose
fortnight. The feeling you aren’t giving a name to is the shame at the cowardice of mass capitulation and the fear of the mass harm that’s impending from the long-term effects of repeated infection. Especially the gratuitous injury to children.
Dx: concussion/brain injury highly unlikely (patient is alert, unimpaired; nay, chirpy); GI virus highly likely; COVID possible (GI symptoms with Omicron relatively common in pediatric patients). Rx: antinauseant, wipe down surfaces but don’t waste your time with hand sanitizer;
@annect64
@NjbBari3
Brain infiltration, damage to the olfactory bulb, cognitive decline, erosion of gray matter, murdered astrocytes, damage to the cerebellum causing dysautonomia, proliferation of Lewy bodies, spongiform encephalopathy possibly leading to prion disease, please pass the cranberries
@1goodtern
I allow some agnosticism by saying it’s either COVID or something you’ve caught because COVID has trashed your immune system. (I’m very popular at parties.)
We know that COVID must be hitting the American NE hard now, because the Human Yankee Candle Index,
@ashishkjha
, has started tweeting again that the pandemic is over, that COVID is no big deal, and that the increasingly irrelevant annual vaccines are the antidote to all worries.
@BaileyDevine20
Unremediated lead paint. This is the clearest parallel to the level of societal harm that we’re talking about. Mass harm to children in cities across the U.S., barely addressed, and allowed to continue for decades.
@boggleknits
Yeah, Noro remains a strong possibility. Because of the head injury he’s back in the ER now, at the advice of the general practice, on a Friday night; if it’s Noro we have no easy way of preventing him from infecting others. Emergency departments are poorly thought out.
@alexgdodds
Yah, a lot of people are acting like just cuz you can apparently catch it via anal sex, you can only catch it by anal sex. It has all the makings, so far as I can tell, of a perfect day-care plague.
I’ve *had* hand-foot-mouth, complete with rash, as an adult. Caught it from
@MLS_Dave
Buried near the bottom of the piece: “Makenzie Boyle, a 28-year-old human resources administrator in San Francisco, went to the emergency room when she was infected with Covid for the first time in December 2020 and was diagnosed with pneumonia. A year later, Boyle was diagnosed
@dshoskes
@UnitedAirlines
Their Twitter handle is apparently now
@United
. If they aren’t going to take passenger safety seriously by at least strongly encouraging good masks, I’ll not fly with them.
For a visceral understanding of the significance of the paper, skip straight to Fig. 1f, which "Human plasma" vs "Human plasma + spike." Not many micrographs actually make me queasy, but this one does.
@myrabatchelder
Look, most of the country is ignoring BA.1, and it's currently filling the hospitals and spreading through the schools. Who's anticipating and preparing for the next wave 3–4 wk out? Not my neighborhood.
@EdmontonThug
I was on my own, so as a courtesy I phoned them, navigated their tedious phone tree, & advised them that I was still alive before driving off. The woman had voiced concern that I might pass out in my car—which is *much* less likely than catching B2.12.1 in the waiting area.
@greg_travis
@zerocovid4kids
I dunno—I’d sure be tempted to leave them a pile of recent journal articles from Science, Nature, JAMA, the Lancet, and NEJM, with a condescending note about the need for physicians to educate themselves continuously… AND the cake. But admittedly it’s more work to go that route.
@KellyScaletta
@thrive_win
you are lucky, they may improve with time.
Finally, at all costs avoid catching COVID again. Wear an N95 in indoor public spaces. We may have a sterilizing intranasal vaccine within a year.
I have not reviewed in detail Alberta's Rapid Evidence Report on PPE, dated 13 Sept., but I have a few impressions to share. They are informed by my training in the history & sociology of science & medicine, as well as my undergrad background in phil at U of Calgary.
@CPita3
/2
@MLS_Dave
Repeated infections are generally mild, but they exact a “psychological” toll. The pieces of this narrative don’t quite line up, do they? Maybe that’s why the author is called the “breaking health” reporter. Too many people have already had their health broken.
@vbagate
Speaking as an historian of medicine & a parent: Everyone ought to be very worried. The only reasons people aren’t are fatigue, incomprehension, & failure of imagination. Just think, e.g., how well daycares are prepared to interdict MPX from spreading via changing tables.
@MLS_Dave
“with diabetes, which her doctor said was an effect of Covid — research has shown a link between the two conditions.
“Boyle’s third infection, though mild, exacerbated lingering symptoms from her first illness, such as fatigue and swelling in her extremities. Then after her fifth
@MLS_Dave
“infection in June, she developed chronic kidney disease and chest pain that hasn’t gone away, she said. (Studies have indicated that Covid can directly infect kidney cells, and consequently contribute to kidney disease.)” So the premise of the article remains,
I would like to second this, but in all caps: WHEN A WEIRD NEW HEALTH ISSUE ARISES GLOBALLY AFTER THE WEST'S COORDINATED DECISION TO ALLOW MASS INFECTION OF THEIR COUNTRIES' POPULATIONS WITH A NOVEL, EXTREMELY PATHOGENIC VIRUS, IT'S THE HEIGHT OF INTELLECTUAL DISHONESTY /2
When a weird new health issue arises globally after the West’s coordinated decision to allow mass infection of their countries’ populations with a novel, extremely pathogenic virus, it’s the height of intellectual dishonesty not to consider that novel virus as the prime suspect.
@jrisherWalks
The link to it directly is useless because it bounces you to the greenwashed map. From the top of its page, you have to choose the link to “community transmission levels.”
The paper is now out in
@Nature
after I tweeted on this oral presentation
@ISTH
2023 by
@AkassoglouLab
. Fibrin/fibrinogen may be a therapeutic target in СОVΙD neuropathology. Link in next tweet.
@TheRMH
Great to see a whole roomful of newly trained healthcare workers who know what kind of mask to wear during an airborne pandemic! This savvy behavior will inspire confidence from patients.
In short,
#COVIDisAirborne
. AND (this is still part of the scandal) we possess simple, easily available technologies for preventing SARS2's inhalation: masks that stop aerosols, including N95s and up. /5
@DaniellaCarlisi
Not planning to do any flying anytime soon, but I would be tempted to give the 50-min. ans., with copious bibliography from medical and scientific journals.
@DaniellaCarlisi
I have no compunction about carrying a dozen or so articles in my carry-on, to slap down for punctuation, on my neighbor's tray table. I'd stick to NEJM, JAMA, the Lancet, Nature & its spinoffs, & Science, and maybe that piece from Annals of Internal Med., I think it was, on ...
@MelpomeneMel
Wow. I sure hope you’re wrong! Better take pictures & document whatever it is as best you can. What does your state department of health tell you? Maybe notify the Airbnb guests and see if *they*’re eligible?
@alexmeshkin
, do your have anything to suggest about her getting tested?
In a nutshell, the scandal is this: scientists and physicians have known for decades that pathogens can travel as aerosols, not droplets; have known since 2006 that SARS1 did so; & have had solid case-based evidence of such transmission for SARS2 since at least Mar 2020. /4
@PHealthGnome
I am not aware of any evidence that COVID aerosols behave differently from measles aerosols. Is there any? And what’s the theoretical basis for this claim? Argument from authority will not suffice here.
@KellyScaletta
@thrive_win
Search on here for nicotine & LC or long COVID & you’ll find a ton of comments—appears to help for some but not others. Meanwhile get detailed blood work if you can. Look for lymphopenia & specific wbc counts that are out of whack. Also check thyroid & iron metabolism (ferritin
@TheAmirImani
Also, wearing coats is causing terrible psychological harm to children. There is no real research to support this, but it’s really really a serious problem.
With few exceptions , Ontario officials at every level have fought tooth and nail to resist mitigations against COVID & other airborne pathogens in hospitals & schools. Meanwhile, though, a quick Aranet4 reading is all you need to show that the provincial legislature is taking
@TRyanGregory
For me it was horrible. I was assailed by venomous antimaskers calling me a demon and child abuser because I replied to someone that my kids wear masks to protect them from the brain-eating, immune-suppressing, organ-trashing bat virus. I've taken my account private.
@medexit
@fitterhappierAJ
No; it wouldn’t. It’s too late for that, if that would ever have been possible. We need as much vaccination as possible, high-quality masking, first-rate ventilation, rapid testing, contact tracing, isolation protocols, the whole 9 yards. With O the vaxxes will leak like crazy.
@CamNichelle
@AlexanderDent6
Your “top doctors” are not the buffoons speaking for the provincial government; they’re the docs in the trenches & the ones fighting the official disinfo, eugenics, & droplet idiocy. Your real top docs advocate for respirators, airborne mitigations, & testing. And safe schools.
@clipartbug
Personally I would cancel and reschedule elsewhere and explain why in writing. Not sure whether it would help in your case, but you might consider a cancer screening by poop-by-mail or whatever it’s officially called.
There's lots of questionable material coming out of this acct but here's 1 tweet that I'm finding hard to tolerate and may be giving me a rash. 2009 study with n=27. Concl.: "new respirator designs may be necessary to improve tolerability." Such designs are now available! 1/
@Timodc
@mattplotner
Except that these “fans” are people who read science & medical journals, pay attention to the constraints of physical reality, & have the gumption to realize that an airborne vascular disease that trashes immune systems & brains can be easily interdicted by physics. Step aside.
@NateSilver538
A jaw-droppingling specious argument. The chief way to restrict the spread of SARS-CoV2 is to reduce the number of superspreader events. Airplanes can be sites of such events, & when they are, they seed the virus far & wide. N95s or better curtail such transmission chains.
@AgelessObserver
@sameo416
Cape Cod & want to know the risks of a shark attack, you’d look at rates of shark sightings & attacks, not how many intensive-care beds were available. The fact that the highest level on the green map is terra cotta should also be a tip that the goal is to hoodwink, not inform.
@notnaughtknot
@4d3d3d3d3
My son, at 2, saw my PhD adviser’s car, before the boy could name colors. He only saw the car once, but recalled correctly, several months later, that the car was red. (I do not believe tat the color of the car had ever been a subject of conversation.)
The 3yo was the weak link. His masking game leaves quite a bit to be desired. Looks like all 4 of us have got it now. The 7yo just gave an ambiguous result, followed immediately by a negative, but he’s symptomatic and we don’t believe he’s not got the virus.
@kelcsimpkins
And it’s bloody typical of the healthcare response that the patient is wearing an Aura and the HCW is wearing a surgical mask over a beard.
@KellyScaletta
@thrive_win
& transferrin). COVID can lead to autoimmune hypothyroidism (where your immune system trashes the thyroid gland). Look at CD4/CD8 ratios. They can be way off, even while the total of all white blood cells is OK. And rest assured much as you can!! Chart your symptoms. If
@Sbharris11
Nope. It doesn't. Boosters largely wane by 90 days, and the only ones available so far have included the extinct Wuhan strain. Some studies are showing *negative* efficacy against recent variants, because of immune imprinting (original antigenic sin).
@bridget857
@HelenBranswell
Not so unknown anymore. The literature is accumulating at a rate that, for scientific literature, is breathtaking. Forget about the acute illness, which has a relatively small chance of killing you immediately. The medium-term damage is just a train-wreck. I'd rather put off
But the professional community known as IPAC (Infection Prevention and Control) has been sl-o-o-o--o-w to accept these realities. The AB report, while not denying the reality of airborne transmission, claims the evidence remains insufficient to warrant adopting N95s widely. /6
@DrTedros
@WHO
@AfricaCDC
Years of denial, culminating in fresh obfuscations. Yet COVID remains airborne! It’s simple and easy to understand:
#COVIDIsAirborne
! You’re drumming yourselves out of the scientific community with your folderol.
@KatePri14608408
Sorry to hear that this happened. I would strongly suspect the restrooms/outhouses as likely sites of transmission. COVID aerosols will hang in the air, potentially for hours, especially in confined spaces. "Outdoor" events have to have toilets, and the toilets always have doors.
@Laurie_Garrett
What else would you expect? Omicron’s speed at infecting people has little or nothing to do with how quickly it kills them. The question is, is it killing them in the same ways? Perhaps it spreads quickly but kills more slowly than other variants. We have no way of knowing yet.
@AlisaValdesRod1
in understanding the disease course. And it holds out the tantalizing possibility that indeed Paxlovid might be a game-changer for you—& others. You need a research-minded doc who will say to him/herself, “Hey, I might be able to help this person *&* get an article out of it.”
@danaparish
It’s reasonable to suspect post-acute COVID sequelaein these cases, especially since Ontario has been retrograde about N95 use, but it must be remembered that Toronto physicians, like those elsewhere, have been subjected to enormous workplace stress in the last three years also.
How do people catch the delta variant? According to the experts in a Sept. 14 UBC Webinar, contamination happens when people "let down their guard" and "pick their noses." Nosepicking is going on at a ferocious "15-25x/hour"!). Yup, we know this happens because "there is data."
@Obnoxiouss01
@OliverJia1014
Cigarettes & alcohol only. Housing is expensive in Japan. Most were middle-aged men, living orderly lives, to all appearances. This was in the mid-90s.
I'm getting the distinct impression that the viral shit is hitting the fan right now in Melbourne-area schools. When to throw the circuit breaker and pull the kiddo for a couple weeks??
Thomas Kuhn and others have observed that scientific paradigms don't usually flip because individuals experience epiphanies, but because the old guard dies off. But we've got to keep trying to persuade, because the current emergency can't wait that long. /39