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Family Medicine MD. Love family, outdoors, friends and sports. Get VAXXED
Reno, NV
Joined April 2018
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This is SIGNIFICANT. 25% reduction in Long COVID. 47% reduction in post acute DEATH. 24% reduction in hospitalization. Results seen in vaccinated and previously infected. Not a cure but very helpful. Also, not that 90% reduction nonsense advertised on TV
Paxlovid can prevent #LongCovid
The latest from our team in @JAMAInternalMed
by @Biostayan @TaeyoungChoi93 @zalaly
A thread
jamanetwork.com/journals/jam…
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Yup, As I said over and over again. Severity may be close to the flu. Frequency of infection no where close. Welcome to our new reality. Clean air anyone?
A reminder that Covid is not like Flu - not least because it doesn't go away for 9 months of the year.
Graph from today's UKHSA surveillance report
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❤️🔥Thread. Every infection carries risk when taking into account that people can't die twice. That is not to say immunity doesn't help. It's just that the protection can be short lived in the high risk and very likely is not permanent in the low risk. Clear air anyone?
Dead people can't die twice.
I decided to try to visually represent the concept of "hybrid immunity" to try to show why it's a misleading concept that has the overall effect of hiding the bodies and the magnitude of the damage covid infections leave behind. Here's what I mean🧵
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GAS peds DEATHS in UK keep rising. As of 3/16 40 peds deaths from GAS in England alone, likely close to 50 for all of the UK. Based on YEARS of CDC data an avg year based on pop. size would be 6-7. Max ever previously recorded 27. It's not just "Immune debt" folks.
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Maybe when the NIH says it we should listen? It’s the degree of immune suppression and duration post infection that are in question not if it happens. Immunity debt is not the sole driver of waves of other infections diseases. Vaccination helps but isn’t a cure. Clean air anyone?
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20% persistently absent from school DUE TO ILLNESS. Where is the urgency of normal on this? Why is this OK? Just saw a patient in his 30s, healthy 2 prior COVID infections in which he had hardly any symptoms. Third infection, now out of work for over a week and still sick.....
This will continue as long as we keep infecting children repeatedly with Covid, and it will probably get worse, not better.
theguardian.com/education/20…
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Anyone else find it disturbing that many in the US are advocating for raising the retirement age? What about this chart makes anyone think there is going to be a big jump in life expectancy in the future? Flat from 2010 on even prior to the pandemic. Universal health care anyone?
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That immune dysfunction can occur post infection is undeniable IMO. It's the %, severity, and duration that are widely divergent from person to person and infection to infection. If you don't think it can occur you are being willfully ignorant. Clean air anyone????
note how the authors underline the correlation between covid19 infection and severe streptococcal infection in children (GAS)
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EXCELLENT Breakdown! Makes Immunity debt very hard to believe as the sole driver of the past two winters of SEVERE RSV in Denmark. 50% more hospitalizations then would be expected after ONE missed season. Especially in the elderly who should have some immunity from past infection
Essentially, the catch-up occurred in 21/22. The high number of hospital admissions in 22/23 means that around 9,000 people have been hospitalized for RSV over the past 3 years, instead of 6,000 in a normal 3-year period.
Here I've broken the 3-year average down by age.
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Face of COVID deaths now. Just had a patient die directly from COVID for the first time in awhile. In their 80s, healthy other than HTN. Fully vaxed/boosted but over 90 days ago. Mild symptoms, got PAX. 4 days later found dead in the shower. Maybe a coincidence probably not. 🧵
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Also recently had a few patients new onset severe heart failure. No prior heart disease, clear coronaries on cath. Dilated cardiomyopathy on ECHO. Recent URI symptoms prior to CHF. None tested for COVID as they didn't seek care. Similar case 👇 🧵2
today.com/health/coronavirus…
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Good news BUT Metformin was stared within FOUR days of symptom onset. Getting treatment started within that time frame in the USA is very difficult especially with the pull back of testing (Look at Paxlovid rates). Likelihood of actual clinical use is going to be very limited.
Very good news
Metformin significantly helped prevent #LongCovid in a placebo-controlled randomized trial, a 42% relative reduction
papers.ssrn.com/sol3/papers.… by @BramanteCarolyn
and colleagues
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Well Shit. Rapid loss of protection against severe disease with bivalent booster in Finish study. Look at Finland 3 week CFR death rate last two Omicron waves. 1st wave CFR 0.59%, 2nd wave 1.5%. 2.5X increase likely due to decrease testing but clearly NO attenuation in disease.🧵
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Thus, what we've had for past TEN months in US is likely as good as it gets. We can expect 100-200,000 direct COVID deaths per year with a total of 200-400,000 EXCESS deaths per year. 90% of those will be post COVID infection (known or unknown). 🧵2
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Link to Finish Study. CLEAN AIR ANYONE!!!!! medrxiv.org/content/10.1101/…
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Honest answer. Right now we have settled into a pattern with a virus that kills those hospitalized within 30 days at a rate 1.5X that of flu and infects around FIVE times more frequently. That doesn’t count long COVID which post immunity is less than it was but not zero.
I don’t know. It’s a new virus/vaccine and we are all learning about it in real time.
I do know that often it medicine we have to make decisions with imperfect info, and repeatedly exposing unvaccinated kids is a decision.
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