Hunter, ER doc, believer in democracy. I’m here to rant, combat medical misinfo, and get social therapy. Posts aren’t medical advice. This is the only platform I am currently on. If you find “me” elsewhere, it isn’t me.
If you have COVID vaccine questions, I’m always happy to try to answer. Let’s all share good info, facts, and science, and keep ourselves and each other safe!
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Published at
2023-03-27T16:57:41+02:00 Event JSON
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Last Notes npub12c9dvk6zgvkk0caykg983nua99fa4h3344ctw302kexczn448nhqm95uuj McNadoMD Every single time you mention Joe Manchin, it is obligatory to include that his daughter drove the cost of epinephrine autoinjectors (Epi Pens) up by 600% for no reason other than profit, which left children to die from completely treatable anaphylaxis. npub12c9dvk6zgvkk0caykg983nua99fa4h3344ctw302kexczn448nhqm95uuj McNadoMD Biden pulling his ads down is fucking stupid. Does anyone for a second think Trump would stop his relentless campaign to undermine democracy if Biden were injured, ill, or dead? Fuck off. npub12c9dvk6zgvkk0caykg983nua99fa4h3344ctw302kexczn448nhqm95uuj McNadoMD First case of mumps, huh, neat. npub12c9dvk6zgvkk0caykg983nua99fa4h3344ctw302kexczn448nhqm95uuj McNadoMD Reminder that Donald Trump, who is a felon, admitted this week to authorities in NY that he is in possession of a firearm, and yet ATF has not a goddamn thing to say about it. npub12c9dvk6zgvkk0caykg983nua99fa4h3344ctw302kexczn448nhqm95uuj McNadoMD Why is anonymity in social media important? During the worst of the COVID hellscape in 2020-22, I used a large Twitter following to amplify the absolute fucking disaster we were experiencing in hospitals. I called out the bullshit statements by state and local officials, and was able to use anecdotes from their backyard to do it. npub12c9dvk6zgvkk0caykg983nua99fa4h3344ctw302kexczn448nhqm95uuj McNadoMD People living near the dog food plant here are suing it for smelling like dog food. Dudes, your house was cheap for a reason. That plant has been around longer than most Denver residents have lived in Colorado. npub12c9dvk6zgvkk0caykg983nua99fa4h3344ctw302kexczn448nhqm95uuj McNadoMD For the record, per BBC’s reporting a few months ago, there were only two verifiable dead babies from the Oct 7th attacks in Israel, and neither was burned. The attack by IDF in Rafah that incinerated a refugee encampment has killed at least that many, and there are verified photos of babies that were burned horrifically. npub12c9dvk6zgvkk0caykg983nua99fa4h3344ctw302kexczn448nhqm95uuj McNadoMD Remember folks, before Dobbs, Republicans claimed abortion was too unsafe to be performed in a clinic, but now in Florida they think C-sections can be. It was never about safety. npub12c9dvk6zgvkk0caykg983nua99fa4h3344ctw302kexczn448nhqm95uuj McNadoMD Florida allowing clinics to perform C-sections outside of the hospital is a horrendous handout to private equity on the backs of women and babies. npub12c9dvk6zgvkk0caykg983nua99fa4h3344ctw302kexczn448nhqm95uuj McNadoMD The current SCOTUS continues to do what they’ve been doing since Dobbs. They make one decision that is pretty middle of the road “yep, that’s the right call”, and then the next five or six big decisions are all deeply unpopular, and wildly partisan. They think people don’t see the systematic erosion of democracy, separation of church and state, and equality. They are so fucking removed from actual society that they think this will all blow over. npub12c9dvk6zgvkk0caykg983nua99fa4h3344ctw302kexczn448nhqm95uuj McNadoMD So a gun owner gets killed in his own home by a cop raiding the wrong apartment, and yet the NRA doesn’t have a thing to say about it. Huh. npub12c9dvk6zgvkk0caykg983nua99fa4h3344ctw302kexczn448nhqm95uuj McNadoMD I don’t give a fuck what FDA is gearing up for with respect to fowl fever. What I care about is what HHS and DHS are doing with the National Strategic Stockpile. npub12c9dvk6zgvkk0caykg983nua99fa4h3344ctw302kexczn448nhqm95uuj McNadoMD @npub1jdw…awld and now small physician practices are going out of business because they can’t get paid. npub12c9dvk6zgvkk0caykg983nua99fa4h3344ctw302kexczn448nhqm95uuj McNadoMD Brain worms, or more specifically, beef and pork tape worms (taenia saginata and taenia solium) are not rare in the US. We find the calcified cysts from these on brain CT scans all the time, particularly in communities with large populations of South and Central American immigrants. They don’t make people into racist, antivaccine, profiteering, grifters. npub12c9dvk6zgvkk0caykg983nua99fa4h3344ctw302kexczn448nhqm95uuj McNadoMD Guys, Republicans around the US used late 2020-2022 to take local, state, and federal governments to court to undermine public health response. They called COVID a hoax. They said the vaccine was deadly. They encouraged crazy people who came into hospitals with guns looking for the hoax. npub12c9dvk6zgvkk0caykg983nua99fa4h3344ctw302kexczn448nhqm95uuj McNadoMD Nope, nah. Senator Tim Scott didn’t “dodge” or “not commit” to accepting the 2024 election results. What he DID say is that Trump would be the 47th president “at the end of the day”, and doubled down on that statement when asked to clarify. npub12c9dvk6zgvkk0caykg983nua99fa4h3344ctw302kexczn448nhqm95uuj McNadoMD @npub1dgz…4q3g very much joking in that hahahahahaha — actually fuck ‘em, burn it all down because it is all garbage way. npub12c9dvk6zgvkk0caykg983nua99fa4h3344ctw302kexczn448nhqm95uuj McNadoMD Seems to me that we should take a page out of IDF’s book, and since there are allegations of Hamas setting up shop at universities, we should bulldoze the buildings, stop food shipments at the campus border, and prevent the administration from leaving while we systemically destroy the entire campus. You know, because if anyone is Hamas there it means everyone is. npub12c9dvk6zgvkk0caykg983nua99fa4h3344ctw302kexczn448nhqm95uuj McNadoMD @npub19fc…ay3c all I know is I watched a video this morning showing cops dragging a young woman to the edge of concrete stairs and then logrolling her off the edge and letting her roll down the stairs. No excuse for that. npub12c9dvk6zgvkk0caykg983nua99fa4h3344ctw302kexczn448nhqm95uuj McNadoMD Video of officers with NYPD throwing protestors down concrete steps are emerging this morning. If a protestor threw a cop down concrete steps, they would be charged with felony assault or attempted murder, guaranteed. I’m not here to debate the optics of occupying the admin building at Columbia (I do think it is stupid). I’m here to say that officers responding in a blatantly unsafe fashion once again points to the “cops are there to protect property, not people” stereotype. npub12c9dvk6zgvkk0caykg983nua99fa4h3344ctw302kexczn448nhqm95uuj McNadoMD I can’t tell you what will happen or not, but I can level-set for you a bit. Here’s what a guy who was in the shit during the worst of COVID is doing about bird flu: npub12c9dvk6zgvkk0caykg983nua99fa4h3344ctw302kexczn448nhqm95uuj McNadoMD Funny how no college admins, governors, or chiefs of police were calling for cops to sweep up the demonstrators when the demonstrators were carrying literal fucking swastikas. npub12c9dvk6zgvkk0caykg983nua99fa4h3344ctw302kexczn448nhqm95uuj McNadoMD Just a reminder that on Jan 6, 2021, police let a mob of right wing whackos gather at the capitol with the openly stated intention to effect violence on elected officials. npub12c9dvk6zgvkk0caykg983nua99fa4h3344ctw302kexczn448nhqm95uuj McNadoMD Here’s some of what was in my medic kit during the 2020 protests in Denver: npub12c9dvk6zgvkk0caykg983nua99fa4h3344ctw302kexczn448nhqm95uuj McNadoMD Great reporting by @npub1hgr…2e7r on the likely illegal repression of a protest at UT this week. npub12c9dvk6zgvkk0caykg983nua99fa4h3344ctw302kexczn448nhqm95uuj McNadoMD I have taken care of a few sexual assault victims over the years in the ER. Anyone who thinks that raped women should have to carry the rapist’s baby to term is a horrible human being with no ability to understand the feelings of others. npub12c9dvk6zgvkk0caykg983nua99fa4h3344ctw302kexczn448nhqm95uuj McNadoMD When a kid dies in my ER, there are multiple debriefs, and we usually see some of our staff really hurting for days afterwards. It’s a rare thing, it is awful, and everyone from the prehospital providers to the ER registration staff are affected. npub12c9dvk6zgvkk0caykg983nua99fa4h3344ctw302kexczn448nhqm95uuj McNadoMD Does anyone really believe that the women living as men in war and beyond over the centuries were not discovered? Sure, maybe there are some exceptions, but it seems more likely that their friends and colleagues probably figured it out eventually and didn’t give a damn because trans panic wasn’t a thing. npub12c9dvk6zgvkk0caykg983nua99fa4h3344ctw302kexczn448nhqm95uuj McNadoMD If you feel the need to carry a handgun, as an ER doc who has seen too many shot up legs (and as a guy who has from time to time carried), some friendly advice: npub12c9dvk6zgvkk0caykg983nua99fa4h3344ctw302kexczn448nhqm95uuj McNadoMD Anthem Blue Cross is now systematically downbilling every level 5 chart my ER physicians group sends them. Our billing people then appeal, and have to appeal multiple times, and eventually months later they accept the appeal on most of them. npub12c9dvk6zgvkk0caykg983nua99fa4h3344ctw302kexczn448nhqm95uuj McNadoMD If World Central Kitchen staff in marked vehicles, delivering aid that they *just* picked up from a ship, are killed by IDF, I think it is fair to say the sea route for aid is a fucking joke. npub12c9dvk6zgvkk0caykg983nua99fa4h3344ctw302kexczn448nhqm95uuj McNadoMD Oregon lawmakers fail to learn from a century of failed policy and re-criminalize drug possession. npub12c9dvk6zgvkk0caykg983nua99fa4h3344ctw302kexczn448nhqm95uuj McNadoMD If companies had to pay people $10,000 every time they lost a person’s social securitt number, it wouldn’t happen. The problem is there is nearly no cost to these large data breaches. npub12c9dvk6zgvkk0caykg983nua99fa4h3344ctw302kexczn448nhqm95uuj McNadoMD The safety of medications is precisely not within the purview of the Supreme Court of the United States. It is decided by FDA, an arm of the Executive branch. SCOTUS has no business debating or considering the safety of mifepristone — that was decided by FDA decades ago. If you hear safety, studies, adverse events, or any other discussion of clinical data in front of SCOTUS, it is someone playing politics to cover for abysmal judicial activism. We know it’s safe. npub12c9dvk6zgvkk0caykg983nua99fa4h3344ctw302kexczn448nhqm95uuj McNadoMD Trump out here threatening a bloodbath if he loses in November, while the news mostly ignores. Hey assholes at NBC and NYT — maybe instead of a million bullshit articles on Biden’s age, run something on Trump threatening violence again. npub12c9dvk6zgvkk0caykg983nua99fa4h3344ctw302kexczn448nhqm95uuj McNadoMD Republicans are against a new policy that is intended to block judge shopping, or filing cases in a district unrelated to the case but where the judge is considered favorable to the case. That’s right — Republicans want the system rigged from the start. They explicitly are against a neutral justice system. The Republicans are a fucking joke. npub12c9dvk6zgvkk0caykg983nua99fa4h3344ctw302kexczn448nhqm95uuj McNadoMD For context, one of my jobs is an EMS medical director where I work on the ambulance. A frequent area of friction in the last year is law enforcement officers being unwilling to interact with people having mental health crises, leaving me and my medics the option of entering unsafe scenes, or leaving the call without trying to help. Both options suck. Historically the problem was officers being overly agressive. Mental health is a tough, complex problem in emergency services. npub12c9dvk6zgvkk0caykg983nua99fa4h3344ctw302kexczn448nhqm95uuj McNadoMD Did you know that before the Affordable Care Act (Obamacare), mental health services were often not paid for by insurance? The ACA/Obamacare requires insurance companies to pay for mental health services (depression medication, office visits, certain hospitalizations, some therapy). Around 20% of Americans use these services. If the Republicans win in November, any of us using those services can expect to immediately be paying out of pocket (if we can afford it). npub12c9dvk6zgvkk0caykg983nua99fa4h3344ctw302kexczn448nhqm95uuj McNadoMD Once insurance in the US officially and legally can exclude whatever they want again, they’ll use data from your car, phone, smartfridge, home alarm system, and Amazon to undermine coverage. You want them to cover injuries from a car accident? Nope. Your car says you always speed. You get autoimmune hepatitis and your body kills your liver — too bad, Cigna knows you buy alcohol every week and claims that’s the real reason. There will be no running from it. npub12c9dvk6zgvkk0caykg983nua99fa4h3344ctw302kexczn448nhqm95uuj McNadoMD So how does that play out? Reupubs abolish Obamacare protections. Big Insurance (TM) with CEOs making over $20million/yr immediately cancel all policies and reissue policies without coverage for all pre-existing conditions, including many you may not even know you have. You go get to get a mammogram, and it isn’t covered because 23&me told United you are at high risk of breast cancer. Your ER visit for irregular hearbeat isn’t covered because Garmin told BCBS you’ve had it for years. npub12c9dvk6zgvkk0caykg983nua99fa4h3344ctw302kexczn448nhqm95uuj McNadoMD Here’s a thing to consider: under the ACA (“Obamacare”) insurance cannot exclude pre-existing conditions. A GOP-led Congress and Presidency will destroy that. This is a problem for you and me because: npub12c9dvk6zgvkk0caykg983nua99fa4h3344ctw302kexczn448nhqm95uuj McNadoMD My takeaway from the SOTU tonight is this: a guy with a speech impediment delivered an hour+ long speech with a handful of stumbles. npub12c9dvk6zgvkk0caykg983nua99fa4h3344ctw302kexczn448nhqm95uuj McNadoMD This shit? This shit right here is the reason folks have a hard time letting anything Israel does just slide anymore. “Hey, we are under intense international scrutiny for our treatment of Palestinians. Let’s go approve more “settlements” that will require ethnic cleansing of Palestinians from the area of the planned settlement.” What’s the justification? Fuck. npub12c9dvk6zgvkk0caykg983nua99fa4h3344ctw302kexczn448nhqm95uuj McNadoMD I don’t entirely disagree with SCOTUS today on the question of who gets to disqualify candidates for federal office, but the glaring contrast between their feelings on this issue of federalism vs abortion or gun rights is something they’re going to have to figure out if they want to retain any semblance of legitimacy. Oh, and the conservatives’ flagrant separation of powers power grab in their decision is horse shit. npub12c9dvk6zgvkk0caykg983nua99fa4h3344ctw302kexczn448nhqm95uuj McNadoMD Republicans don’t care about pregnant women (or their fetus): Texas sued the Feds, arguing a 2022 law that protects pregnant women in the workforce is unconstitutional. For now, at least, Texas has won, removing protections for pregnant women. npub12c9dvk6zgvkk0caykg983nua99fa4h3344ctw302kexczn448nhqm95uuj McNadoMD Just to be perfectly clear: #COVID-19 #COVID can be spread by people who have no symptoms, and usually for at least a week after any initial symptoms. The fact is, if you have COVID-19, you should consider yourself contagious for 10-14 days from the first day you had any symptoms, regardless of how quickly you recovered. It is wise to mask up in public or stay at home during that time. npub12c9dvk6zgvkk0caykg983nua99fa4h3344ctw302kexczn448nhqm95uuj McNadoMD Jesus christ, if I had realized I could just not file or pay taxes for seve years… npub12c9dvk6zgvkk0caykg983nua99fa4h3344ctw302kexczn448nhqm95uuj McNadoMD For the record, I have, and continue to, write the White House to implore the Biden administration to pick a clear direction on Gaza. This mealy-mouthed horseshit is just enabling both Israel and Hamas to be terrible. He needs to come out and tell (not suggest) Israel to stop killing civilians, and he needs to tell Hamas that they are done. Then he needs to back those statements up with immediate policy change. Waiting for hostage negotiations to complete is not an option anymore. npub12c9dvk6zgvkk0caykg983nua99fa4h3344ctw302kexczn448nhqm95uuj McNadoMD What I would say to Arab Americans arguing against supporting Biden in the fall is this: if Trump wins (which is a likely outcome), he will ban any immigration from majority muslim countries again. He will round up and deport anyone who is not yet a citizen, regardless of their asylum claims, supporting family, or history. He will probably deport some citizens “by accident” (as he did when he was last president). npub12c9dvk6zgvkk0caykg983nua99fa4h3344ctw302kexczn448nhqm95uuj McNadoMD @npub1lzz…jhl3 They are forced to choose between admitting they are scientifically illiterate, or admitting they wrote laws so draconian that even their own voters can’t stomach it. npub12c9dvk6zgvkk0caykg983nua99fa4h3344ctw302kexczn448nhqm95uuj McNadoMD I have deleted a previous post as some folks found it offensive. My point was not that we should not have compassion for women in red states who have been screwed by GOP policies. My point is that many of the people screwed by those policies voted for them, and are now affecting access to care in states where people did not vote for those policies. In fact, if the GOP wins the senate and presidency this fall, we will lose access nationwide. npub12c9dvk6zgvkk0caykg983nua99fa4h3344ctw302kexczn448nhqm95uuj McNadoMD Here’s the thing — people vote against their interests all the time. In the case of white women in red states, they have voted for policies that ban their own healthcare. I suspect it is a mix of ignorance, being duped, and the usual “that doesn’t happen to people like me” attitude. So yeah, it infuriates me that women are being harmed, but also, feeling the effects of policies that for years were raining down on the less fortunate is how people learn to be less of an asshole on election day. npub12c9dvk6zgvkk0caykg983nua99fa4h3344ctw302kexczn448nhqm95uuj McNadoMD Maybe instead of taxpayers paying to clean up “abandoned” oil wells, we should be charging oil companies a fee on all new wells that is sufficient to cover both the new well and the existing mess they have created. npub12c9dvk6zgvkk0caykg983nua99fa4h3344ctw302kexczn448nhqm95uuj McNadoMD Just remember folks, there are women in Alabama who are $30,000 deep into the IVF process, and have been on risky drugs for months at a time, who were scheduled for implantation, and just got told “fuck you, our lawyers say we can’t do anything with your embryos. Oh, and we aren’t sure if you can take them and go elsewhere either. Sorry”. npub12c9dvk6zgvkk0caykg983nua99fa4h3344ctw302kexczn448nhqm95uuj McNadoMD Anthem’s CEO made $19 million in 2021. The CEO of Cigna made over $20 million. npub12c9dvk6zgvkk0caykg983nua99fa4h3344ctw302kexczn448nhqm95uuj McNadoMD Spent 20 minutes on the phone in the ER today getting a standard of care blood thinner approved for a patient because Cigna requires prior auth for all standard of care options. npub12c9dvk6zgvkk0caykg983nua99fa4h3344ctw302kexczn448nhqm95uuj McNadoMD Are you unhappy with the state of affairs in the US and are a US citizen? Check your voter registration. Voting is where your voice is heard. npub12c9dvk6zgvkk0caykg983nua99fa4h3344ctw302kexczn448nhqm95uuj McNadoMD If these reports are accurate Israel’s army: npub12c9dvk6zgvkk0caykg983nua99fa4h3344ctw302kexczn448nhqm95uuj McNadoMD BBC has verified video from within Nasser hospital in Gaza, showing staff having to evacuate patients in hospital beds, and carried in blankets, through smoke and dust, while gunfire rattles through the building. IDF has, yet again, raided a hospital. Staff there are reporting IDF shooting at least one patient. npub12c9dvk6zgvkk0caykg983nua99fa4h3344ctw302kexczn448nhqm95uuj McNadoMD Why did CDC change isolation recommendations? A few things, but I suspect the main driver is that nobody was following them anyway. npub12c9dvk6zgvkk0caykg983nua99fa4h3344ctw302kexczn448nhqm95uuj McNadoMD US conservatives are “live and let live” unless you: npub12c9dvk6zgvkk0caykg983nua99fa4h3344ctw302kexczn448nhqm95uuj McNadoMD @npub1yyt…t6x9 @npub1ztt…tvss @npub14mp…zp26 it is my personal and professional opinion that detergent pods should never be kept in a home with kids. They can be lethal if swallowed, the contents can kill or maim if the pod is bitten and the contents inhaled, and when kids squeeze them and the highly caustic detergent gets in their eyes, it can cause ulcers on the eye requiring corneal transplant. They have infinite risk with no tangible benefit over regular detergent. npub12c9dvk6zgvkk0caykg983nua99fa4h3344ctw302kexczn448nhqm95uuj McNadoMD When Russia retreated from Bucha and was driven out of that corner of Ukraine, Ukrainian troops, as well as citizens from multiple other countries serving with Ukraine, posted photos, videos, and testimony showing dead civilians, booby-trapped daycares and kitchens, looted homes, and surviving women and children who had suffered severe sexual violence. A Russian invading force leaves behind nothing but horrific inhumanity. That’s who the GOP is supporting. npub12c9dvk6zgvkk0caykg983nua99fa4h3344ctw302kexczn448nhqm95uuj McNadoMD @npub14mp…zp26 why pods remain legal is beyond me. You only have to see one kid need a corneal transplant to realize how stupid these things are. npub12c9dvk6zgvkk0caykg983nua99fa4h3344ctw302kexczn448nhqm95uuj McNadoMD I’m glad Denver is doing the right thing and trying to support migrants, but I do want to know why DPD isn’t investigating the bus operators for human trafficking. Texas gets federal dollars to deal with migrants. Colorado, and Denver, do not. Texas is paying bus companies to ship people up here. Maybe look at how that is being done, who is paying for it, and get them to pony up or fuck off. npub12c9dvk6zgvkk0caykg983nua99fa4h3344ctw302kexczn448nhqm95uuj McNadoMD So, uh, folks, Biden is 4 years older than Trump. He bicycles regularly, and regularly jogs across the stage at events. Trump is obese, never exercises (by his own report), and isn’t known for his ability to walk steadily. If you’re voting for Trump because Biden is old, you’re an idiot. npub12c9dvk6zgvkk0caykg983nua99fa4h3344ctw302kexczn448nhqm95uuj McNadoMD The days of maintaining small outposts in hostile terrority are over. Ukraine successfully pioneered the use of small, cheap drones, and Russia and Iran learned quickly from them. It is essentially impossible to completely defend from these. Probably good long-term from the standpoint of ending stupid imperial moves by superpowers. npub12c9dvk6zgvkk0caykg983nua99fa4h3344ctw302kexczn448nhqm95uuj McNadoMD @npub1nlu…auac @npub1kpw…xzz4 while some cases of inaccurate reporting may have occurred, there was not any significant effect of that on the numbers overall. COVID aid was not related to cases or deaths. Hospitals did not make any more money treating COVID than anything else, and indeed many hospitals went broke during the pandemic due to need for extra staffing, expensive PPE, and inability to run lucrative elective surgical cases. npub12c9dvk6zgvkk0caykg983nua99fa4h3344ctw302kexczn448nhqm95uuj McNadoMD @npub1nlu…auac @npub1kpw…xzz4 in the US at least, the mortality data were not falsified despite reports to the contrary. Indeed, two papers by the same authors looking at mortality suggested a ~20-30% undercount during the early pandemic (higher early on, lower later on). This was most likely due to poor test availability, out of hospital deaths, and shoddy reporting early on. npub12c9dvk6zgvkk0caykg983nua99fa4h3344ctw302kexczn448nhqm95uuj McNadoMD @npub1kpw…xzz4 @npub1lr0…pa6s Dude. You are not reading the same paper. You are so tied up on being right that you are confused. Again, READ the source I am citing which is NOT that Nature paper. Fuck… npub12c9dvk6zgvkk0caykg983nua99fa4h3344ctw302kexczn448nhqm95uuj McNadoMD @npub1kpw…xzz4 @npub1lr0…pa6s here’s the text of the study cited by the CDC abstract. Go find that part for me in it, I’ll wait. npub12c9dvk6zgvkk0caykg983nua99fa4h3344ctw302kexczn448nhqm95uuj McNadoMD @npub1kpw…xzz4 @npub1lr0…pa6s the analysis SPECIFICALLY states that multiple data sources were not exclusively hospitalized or severe cases. Jesus christ man, I’m arguing with a “well acshuallllly” guy from hell here. npub12c9dvk6zgvkk0caykg983nua99fa4h3344ctw302kexczn448nhqm95uuj McNadoMD @npub1kpw…xzz4 @npub1lr0…pa6s the study cited included in it’s meta-analysis multiple studies of non-hospitalized patients. Again, did you read it? npub12c9dvk6zgvkk0caykg983nua99fa4h3344ctw302kexczn448nhqm95uuj McNadoMD @npub1kpw…xzz4 @npub1lr0…pa6s literally what they said is “…80% of the patients with COVID-19 have long term symptoms”. Explain to me what it is you are getting from this that is different than what the authors repeatedly conclude. npub12c9dvk6zgvkk0caykg983nua99fa4h3344ctw302kexczn448nhqm95uuj McNadoMD @npub1kpw…xzz4 @npub1lr0…pa6s not sure if you missed that citation in the CDC paper or are concluding something different than the authors, but it is right there, in the cited paper, repeatedly… npub12c9dvk6zgvkk0caykg983nua99fa4h3344ctw302kexczn448nhqm95uuj McNadoMD @npub1kpw…xzz4 @npub1lr0…pa6s is it? Here’s the study (linked below). It’s a meta-analysis from earlier in the pandemic, which looked at studies that included hospitalized and ambulatory patients. The study concludes jn multiple places that 80% of people with COVID will experience one or more long-term symptoms. Do I think that’s representative? No. Is it what the study says, yes. npub12c9dvk6zgvkk0caykg983nua99fa4h3344ctw302kexczn448nhqm95uuj McNadoMD @npub1kpw…xzz4 I never (and have never) said that the 80% number is representative. What I said, and is the case, is that estimates run that high in some studies. The higher bounds tens to be in much higher risk populations, in studies from early waves, and in studies with high risk of selection bias. Similarly, low bound estimates in the single digits are likely underestimates. npub12c9dvk6zgvkk0caykg983nua99fa4h3344ctw302kexczn448nhqm95uuj McNadoMD @npub1kpw…xzz4 I think you have an opinion that COVID isn’t a big deal, when in fact, for some folks, it’s a problem. We have a poor understanding of the long term sequelae of it, but as I initially and repeatedly have noted, post COVID symptoms are not rare, and even at a conservative estimate of 10%, are a concern. Palpitations are a common ER complain, and we see folks after COVID with this not infrequently, some of whom are told not to worry, when in fact they haven’t had adequate workup. npub12c9dvk6zgvkk0caykg983nua99fa4h3344ctw302kexczn448nhqm95uuj McNadoMD @npub1kpw…xzz4 the CDC study I posted specifically cites a range from 10-80% for PCS, and the Nature review also shows a range up to 70% (the higher estimates are for people who were hospitalized, which is obviously not the same as ambulatory cases). Literally right there in the papers I cited, one of which is a recent and broad review in Nature… npub12c9dvk6zgvkk0caykg983nua99fa4h3344ctw302kexczn448nhqm95uuj McNadoMD @npub1kpw…xzz4 while the prevalence is not well established, the estimates of long COVID range from 10-80%, with most studies I’ve seen landing somewhere around 30%. Arrhythmias are a commonly cited concern, and prevalence there again is variable, but 10-20% is a pretty reasonable slice of the published literature. The intro to this Nature review pretty well sums up the concerns… npub12c9dvk6zgvkk0caykg983nua99fa4h3344ctw302kexczn448nhqm95uuj McNadoMD @npub1kpw…xzz4 up to 30% of people who get COVID get some form of post-COVID syndrome. Estimates vary widely on the number who experience cardiovascular complications, but there are entire clinics dedicated the problem, so it isn’t exactly a rare presentation to healthcare. I agree that there is overhyping of some of the risk, but overall, I would argue that in fact the risks associated with infection have been downplayed quite a bit. npub12c9dvk6zgvkk0caykg983nua99fa4h3344ctw302kexczn448nhqm95uuj McNadoMD @npub1kpw…xzz4 I said palpitations are common (10-20% of folks with post-COVID syndromes have them). A-fib is one of the many causes of this, and I would argue is not all that rare compared to many things we consider quite serious in Emergency Medicine, particularly since a-fib has a significant stroke risk associated with it. We can quibble over what exact cutoff makes something a concern I suppose, but to what end? npub12c9dvk6zgvkk0caykg983nua99fa4h3344ctw302kexczn448nhqm95uuj McNadoMD I saw a post today discussing palpitations after COVID. Folks, what I tell my patients is: if you get palpitations in the weeks to months after COVID, call your doc and get seen. Here’s why — palpitations after COVID are common, and one prevalent cause is atrial fibrillation. This is often detected by a wearable event recorder such as a Holter monitor, because a 1-time ECG (as if often done in the ER) is worthless if you aren’t in a-fib at the time. A-fib dramatically increases stroke risk. npub12c9dvk6zgvkk0caykg983nua99fa4h3344ctw302kexczn448nhqm95uuj McNadoMD This is not just about abortion anymore. This about undermining your right to emergency medical care. Once the Republicans undermine EMTALA, hospitals can go back to refusing care for people who can’t pay, or are the wrong religion, or whatever. npub12c9dvk6zgvkk0caykg983nua99fa4h3344ctw302kexczn448nhqm95uuj McNadoMD Just remember, in the system Trump and Guiliani want, people in their situation would have their jet shot down after a failed insurrection. npub12c9dvk6zgvkk0caykg983nua99fa4h3344ctw302kexczn448nhqm95uuj McNadoMD @npub1jsz…42fk @npub189n…satx I mask for every patient every shift, but the two reasons most of the rest of the ER staff don’t are: npub12c9dvk6zgvkk0caykg983nua99fa4h3344ctw302kexczn448nhqm95uuj McNadoMD @npub1ht0…dyc3 lemme tell you how angry I was when I discovered I couldn’t just buy MS Office anymore. Did I spend an inordinate amount of time hunting down a CD? Yes I did. npub12c9dvk6zgvkk0caykg983nua99fa4h3344ctw302kexczn448nhqm95uuj McNadoMD It’s not like the other 8 members of SCOTUS were unaware of Thomas accepting gifts and schmoozing with political operatives. Yeah, it’s bad, but they’ve been tolerating it all along. Someone should probably ask Roberts why he never put a stop to it. npub12c9dvk6zgvkk0caykg983nua99fa4h3344ctw302kexczn448nhqm95uuj McNadoMD @npub1fpr…lyph I wear an N-95 for all patients, both for my protection, but more because I have a kid in daycare and don’t want to bring COVID from him to someone with cancer or other immunocompromise. Most (all?) hospitals here are mask-optional, which in practice means nobody other than a few docs are wearing masks. npub12c9dvk6zgvkk0caykg983nua99fa4h3344ctw302kexczn448nhqm95uuj McNadoMD The attack on Ukrainian grain storage was not directed at Ukraine. It was an attack on the world’s food supply. It has no military or strategic value beyond starving millions of civilians, most of them on another continent. Russia is setting up a global famine to punish the West for supporting Ukraine.
