NEW—CDC was truly suffocated by Trump WH at every turn. Kyle McGowan, a former chief of staff at CDC, and his deputy, Amanda Campbell, witnessed WH dismissal of science, WH’s slow suffocation of CDC’s voice, meddling in messages & siphoning of CDC budget.
https://t.co/HeuNbUggiw

Mr. McGowan recalled a White House fixated on the economic implications of public health.
They compromised anyway, recommending social distancing without a reference to the typical six-foot measurement.
“What’s not legitimate is to overrule science,” he said.
(Sidebar: Dr Messonier is my hero)
“They need to be allowed to lead.”
➡️ all this is incredible painful to me cuz of what I also went thru in Jan trying to warn:
https://t.co/I5G7PL6boG
More from Eric Feigl-Ding
2) That said, the new UK mutated strain is a more transmissible (contagious) variant. Keep transmissibility and illness severity separate. They are two different things. Don’t get them confused.
3) The new UK variant severity study is included in today’s WHO report, to be released soon this afternoon according to WHO sources. Waiting for it to drop. I’ll keep folks posted on the details.
4) Update: here is UK Technical report on #SARSCoV2 variant of concern (B.1.1.7) in 🇬🇧 with prelim findings from their case-control study of no increased severity for the new variant that I reported yesterday.
5) Also keep in a mind that a virus that spreads faster (more contagious) yields much worse total outcomes than a virus that is just merely more severe.
All things equal, a new mutated variant that is more contagious & no more severe is worse. And that is what we now have.
Why a SARS-CoV-2 variant that's 50% more transmissible would in general be a much bigger problem than a variant that's 50% more deadly. A short thread... 1/
— Adam Kucharski (@AdamJKucharski) December 28, 2020

2) Here is what is really going to happen... most countries are having a gentle case decline with R(e) currently around 0.9. But this is deceiving. The #B117 is still relatively rare so far, so the R is being influenced mostly by the old common variant. But not for long...

3) Here is what is going to happen... currently R is ~0.9 in many places, but with the more infectious #B117, the R will jump 50% approximately. And it is inevitable (all CDC and Danish models say this) that B117 will take over as the reigning dominant variant soon...

4) and when that happens, what worked before to keep the pandemic contained at R of 0.9 will no longer work. Here is the model for Alberta, 🇨🇦 by @GosiaGasperoPhD. The B117 dotted red line will soon dominate and drive a new surge in latter half of March and April.

5) And Denmark 🇩🇰 CDC has found the same thing. I GQR works now for keeping R around 0.9 or even 0.8, will absolutely not work anymore once #B117 variant takes over. Forget about it. We will be hit hard. But there is a way—if we suppress R to 0.7 or less.
https://t.co/gOq0put4H5

HHS @SecBecerra has tested positive for COVID-19 again, the agency just announced. Last time he tested positive was May 18, after attending the G-7 Summit.
— Ariel Cohen (@ArielCohen37) June 13, 2022
2) #BA5 and #BA4 are worrisome. They are surging and they have high reinfection potential. Your past BA1/BA2 doesn’t substantially protect you from #Ba5/4
\U0001f4c8Surging #BA5 & #BA4 variants in both US & England. It\u2019s looking like #Ba5 is the new fastest strain\u2014which has ~10x increased in England in 1 month. Also notice that older #Omicron #B11529/#BA1 are already near *extinct*. I worry the \u201cnew\u201d Omicron BA1 bivalent vaccine is behind. pic.twitter.com/kLNH0gzPk3
— Eric Feigl-Ding (@DrEricDing) June 9, 2022
3) Excess deaths—the new #BA4 & #BA5 variants of the coronavirus are currently the **fastest growing** strains in the US & UK. ➡️They are exponentially replacing all other past strains. Learn from South Africa’s early warning signs and their excess deaths. #CovidIsNotOver #COVID
To anyone pointing to South Africa to suggest the impact of the omicron wave has been 'mild' or that the BA.4/5 haven't had much impact, I'd urge you to look at excess deaths. 29,500 excess deaths since Jan (omicron wave) & a peak of 1,844 excess deaths/wk during BA.4/5 wave.\U0001f9f5 pic.twitter.com/r7kLzmD5dG
— Dr. Deepti Gurdasani (@dgurdasani1) June 11, 2022
4) Is it a Paxlovid rebound for Becerra, as some are asking? Unclear—Paxlovid rebound usually only happens at day 10-14 that we know of and have data. The FDA says it’s 1-2% rebound but I counted 12% from this Pfizer graph submitted to FDA.
4) Look at these 97 Paxlovid patients here with viral RNA load data over time. Of 97, i conservatively counted at least 12 of 97 (12%) with viral load rebound after day 10. Even more if you count rebound after day 5. Thus, FDA\u2019s 1-2% doesn\u2019t match up here. https://t.co/bNoqj5W3Sk pic.twitter.com/B3Kh0Lc1A4
— Eric Feigl-Ding (@DrEricDing) May 5, 2022
5) and yes, #ba5 / #BA4 are very problematic. they are 2x more resistant than even BA2 for neutralizing the virus compared to those who had breakthrough reinfections from older Omicron.
Unfortunately neutralization experiments found that BA.4/5 is 2x more resistant than BA.2 to the blood obtained from vaccinated individuals who had a breakthrough infection with BA.1 or BA.2. 4/ pic.twitter.com/MEOPXuqTgg
— Dr. Jeff Gilchrist (@jeffgilchrist) June 13, 2022
Great animated lecture on #LongCovid by @Dr2NisreenAlwan, animated by @VickiGSP using info from UK @IndependentSage experts.

2) Furthermore, 1 in 8 of those who were discharged subsequently die. And many suffer long term ailments like heart disease, liver, kidney, diabetes, and more. This doesn’t even include less clinical critical cognitive effects. #LongCovid is real.

3) How common is #LongCovid overall? UK estimates 1 in 5 at 5 weeks and 1 in 10 have symptoms have even 12 weeks after initial #COVID19 diagnosis.
Lecture again by @Dr2NisreenAlwan

4) Let these numbers sink in... 1 in 10 at 12 weeks still have symptoms!

5) Here is the original study of the above lecture from few weeks ago. We need to prepare our healthcare system long term for the impact of millions with #LongCovid. This is gonna be larger than Gulf War Syndrome or long term health of 9/11 first responders.
LONG COVID\u201430% of hospital recovered #COVID19 patients end up back in hospital in <5 months; up to 12% die of complications. \u201cwe really need to prepare for #LongCovid. It\u2019s a mammoth task to follow up w/ these patients, but monitoring needs to be arranged\u201dhttps://t.co/h0y8WUn8sQ pic.twitter.com/Pk8GhQc9J5
— Eric Feigl-Ding (@DrEricDing) January 18, 2021
More from Health
This may help for those considering MS/PhD in Public Health
1. The Erasmus Mundus Joint Master Degree in Public Health in Disasters
https://t.co/1Z5qpstsSu
2. Afya Bora Global Health
3. Carl Duisberg Scholarships
https://t.co/HnNXdbWBxy
4. Commonwealth Scholarships for Developing Countries
https://t.co/3fWGf5b2OH
5. Fellowships in Public Health & Tropical
6. Fellowships to Promote Mental Health Journalism
https://t.co/MVV9PFsBJ1
7. 2021-22 Jeroen Ensink Memorial Fund
8. Paul S. Lietman Global Travel Grant for Residents & Fellows
https://t.co/qK76R495QT
9. Global Health Internships and Funding
https://t.co/FD9Gh2wXvO
10. Kofi Annan Global Health Leadership
11. MA in European Public Health
https://t.co/5x0Vr7b1j8
12. MSc in Public Health Scholarships - Maastricht University,
Why do B12 and folate deficiencies lead to HUGE red blood cells?
And, if the issue is DNA synthesis, why are red blood cells (which don't have DNA) the key cell line affected?
For answers, we'll have to go back a few billion years.

2/
RNA came first. Then, ~3-4 billion years ago, DNA emerged.
Among their differences:
🔹RNA contains uracil
🔹DNA contains thymine
But why does DNA contains thymine (T) instead of uracil (U)?
https://t.co/XlxT6cLLXg

3/
🔑Cytosine (C) can undergo spontaneous deamination to uracil (U).
In the RNA world, this meant that U could appear intensionally or unintentionally. This is clearly problematic. How can you repair RNA when you can't tell if something is an error?
https://t.co/bIZGviHBUc

4/
DNA's use of T instead of U means that spontaneous C → U deamination can be corrected without worry that an intentional U is being removed.
DNA requires greater stability than RNA so the transition to a thymine-based structure was beneficial.
https://t.co/bIZGviHBUc

5/
Let's return to megaloblastic anemia secondary to B12 or folate deficiency.
When either is severely deficient deoxythymidine monophosphate (dTMP*) production is hindered. With less dTMP, DNA synthesis is abnormal.
[*Note: thymine is the base in dTMP]
https://t.co/AnDUtKkbZh

hospital and ICU utilization has been and remains low this year.
it's terribly curious that so few of these monitoring tools provide historical baselines.
getting them is like pulling teeth.
It took a Freedom of Information request but @Covid19DataUK acquired 2017-2019 averages for England hospitalizations.
— Yinon Weiss (@yinonw) December 31, 2020
2020 had 18% fewer hospitalizations than prior years.
All around the world, using hospital data without context of prior years is just a fear generating lie. pic.twitter.com/DJDpqhIQuw
we might think of this as an oversight until you see stuff like this:
this woman was arrested for filming and sharing the fact that their are empty hospitals in the UK.
that's full blown soviet. what possible honest purpose does that
this is the action of a police state and a propaganda ministry, not a well intentioned government and a public heath agency.
"we cannot let people see the truth for fear they might base their actions on real facts" is not much of a mantra for just governance.

90% full ICU sounds scary until you realize that 90-100% full is normal in flu season.
staffed ICU beds are expensive to leave empty. it's like flying with 15% of the plane empty. hospitals don't do that.
and all US hospitals are mandated to be able to flex to 120% ICU.
the US is currently at historically low ICU utilization for this time of year.
61% is "you're all going to go out of business" territory as is 66% full hospital use.
can you blame them for mining CARES act money? they'll die without it.

Imagine you go to the doctor and get tested for a rare disease (only 1 in 10,000 people get it.)
The test is 99% effective in detecting both sick and healthy people.
Your test comes back positive.
Are you really sick? Explain below 👇
The most complete answer from every reply so far is from Dr. Lena. Thanks for taking the time and going through
Really doesn\u2019t fit well in a tweet. pic.twitter.com/xN0pAyniFS
— Dr. Lena Sugar \U0001f3f3\ufe0f\u200d\U0001f308\U0001f1ea\U0001f1fa\U0001f1ef\U0001f1f5 (@_jvs) February 18, 2021
You can get the answer using Bayes' theorem, but let's try to come up with it in a different —maybe more intuitive— way.
👇

Here is what we know:
- Out of 10,000 people, 1 is sick
- Out of 100 sick people, 99 test positive
- Out of 100 healthy people, 99 test negative
Assuming 1 million people take the test (including you):
- 100 of them are sick
- 999,900 of them are healthy
👇
Let's now test both groups, starting with the 100 people sick:
▫️ 99 of them will be diagnosed (correctly) as sick (99%)
▫️ 1 of them is going to be diagnosed (incorrectly) as healthy (1%)
👇