BC HEALTH
Saved by @Alex1Powell

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

 2) ““Everyone wants to describe the day that the light switch flipped—It didn’t happen that way—more of like a hand grasping something, and it slowly closes, closes, closes, closes until you realize that, middle of the summer, it has a complete grasp on everything at the CDC”
3) “Mr. McGowan and Ms. Campbell, both 34, say they tried to protect their colleagues against political meddling from WH and HHS but was largely stifled by the Trump administration.
4) “The White House insisted on reviewing — and often softening — the C.D.C.’s closely guarded coronavirus guidance documents, the most prominent public expression of its latest research and scientific consensus on the spread of the virus.”
5) “The documents were vetted not only by the White House’s coronavirus task force but by what felt to the agency’s employees like an endless loop of political appointees across Washington.
Mr. McGowan recalled a White House fixated on the economic implications of public health.
6) “He and Dr. Robert R. Redfield, the C.D.C. director, negotiated w/ Russell T. Vought, the White House budget director, over social distancing guidelines for restaurants, as Mr. Vought argued that specific spacing recommendations would be too onerous for businesses to enforce”
7) ““It is not the C.D.C.’s role to determine the economic viability of a guidance document,” Mr. McGowan said.
They compromised anyway, recommending social distancing without a reference to the typical six-foot measurement.
8) “Over the summer, political appointees at the health department repeatedly asked C.D.C. officials to revise, delay and even scuttle drafts of @CDCMMWR they thought could be viewed, by implication, as criticism of President Trump.”
9) ““It wasn’t until something was in the M.M.W.R. that was in contradiction to what message the White House and H.H.S. were trying to put forward that they became scrutinized,” Ms. Campbell said.

“What’s not legitimate is to overrule science,” he said.
10) “Often, Mr. McGowan and Ms. Campbell mediated between Dr. Redfield and agency scientists when the WH’s requests and dictates would arrive: edits from Mr. Vought & Kellyanne Conway on choirs and communion in faith communities, or suggestions from Ivanka Trump, on schools.
11) “Every time that science clashed w/ messaging, messaging won”. Episodes of meddling sometimes turned absurd. In the spring, CDC published an app that allowed Americans to screen themselves for symptoms. But WH built its own, then demanded CDC wipe its app off its website”!
12) “Top CDC officials devised workarounds. Instead of posting new guidance for schools and election officials in the spring, they published “updates” to previous guidance that skipped formal review from Washington. That prompted officials in Dc to insist on reviewing updates.”
13) “especially unnerved last winter when officials in Washington told the C.D.C. that regular telephone briefings with another senior scientist, Dr. Nancy Messonnier, were no longer needed because Mr. Trump had his own daily briefings.”

(Sidebar: Dr Messonier is my hero)
14) “Dr. Messonnier angered the White House in late February when she issued a public warning that the virus was about to change Americans’ lives.
15) “There’s not a single thing that she said that didn’t come true,” Mr. McGowan said. “Is it more important to have her telling the world and the American public what to be prepared for, or is it just to say, ‘All is well?’”

“They need to be allowed to lead.”
16) BOTTOMLINE: CDC being censored and muzzled is one of the greatest travesties of this pandemic. And its tarnish reputation one of the worst stains of Trump WH.

➡️ 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

Eric Feigl-Ding
Eric Feigl-Ding
@DrEricDing
⚠️TWO DIFFERENT #COVID19 PANDEMICS—Many think with cases dropping that pandemic is nearly over. But truth is, there are now 2 different #SARSCoV2 pandemics diverging—old strain is waning, while the more contagious #B117 strain is dominating. We will be soon slammed very hard. 🧵


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
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Eric Feigl-Ding
Eric Feigl-Ding
@DrEricDing
Stupid—Oregon church has huge 74+ person #COVID19 outbreak after dozens of maskless churchgoers stood onstage singing & clapping inside a packed indoor venue for Easter Sunday service. The Peoples Church, is vowing to do continue church service on Sunday.

2) Now, the Oregon Health Authority says that at least 74 people associated with the church have tested positive for the coronavirus — one of the state’s largest workplace outbreaks.

3) “In a statement, the church’s leaders attributed the outbreak to a recent rise in covid-19 cases in Marion County, Ore.

Murray said the church, which has held in-person services throughout the pandemic, intends to continue with in-person ceremonies on Sunday.

4) Who saw this coming? Countless scientists. If only airborne-denialists didn’t muzzle the airborne aerosols science.
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Eric Feigl-Ding
Eric Feigl-Ding
@DrEricDing
JUST ONE PERSON—UK 🇬🇧 scientists think one immunocompromised person who cleared virus slowly & only partially wiped out an infection, leaving behind genetically-hardier viruses that rebound & learn how to survive better. That’s likely how #B117 started. 🧵 https://t.co/bMMjM8Hiuz


2) The leading hypothesis is that the new variant evolved within just one person, chronically infected with the virus for so long it was able to evolve into a new, more infectious form.

same thing happened in Boston in another immunocompromised person that was sick for 155 days.

3) What happened in Boston with one 45 year old man who was highly infectious for 155 days straight before he died... is exactly what scientists think happened in Kent, England that gave rise to #B117.


4) Doctors were shocked to find virus has evolved many different forms inside of this one immunocompromised man. 20 new mutations in one virus, akin to the #B117. This is possibly how #B1351 in South Africa 🇿🇦 and #P1 in Brazil 🇧🇷 also evolved.


5) “On its own, the appearance of a new variant in genomic databases doesn’t tell us much. “That’s just one genome amongst thousands every week. It wouldn’t necessarily stick out,” says Oliver Pybus, a professor of evolution and infectious disease at Oxford.
SCIENCE
Eric Feigl-Ding
Eric Feigl-Ding
@DrEricDing
Breaking—UK scientists just reported a case-control study that the mutated UK 🇬🇧B.1.1.7 variant is not associated w/ more severe #COVID19— “found no significant differences in hospital admissions and case fatality at 28 days, & occurrence of reinfections”, says @mvankerkhove

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.
COVID
Eric Feigl-Ding
Eric Feigl-Ding
@DrEricDing
Wow. 1 in 3 hospitalized with #COVID19 gets readmitted to the hospital within a few months after discharge. ~48,000 UK patients.

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.
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@AlexMcNeil14
Masks. A short thread. In June last year my GP advised me that wearing a mask even for a short space of time would be harmful for me on two fronts. One - I have painful rosacea on my face. It’s a horrible condition and it’s lifelong. I can at times look scary!

Putting on a mask simply makes it worse. Two - I have hypertension. Manageable and controlled. GP also advises that mask wearing even for short periods can raise cortisol levels and make them dangerous to me.

On that basis and given the dreadful treatment us non-maskers have to suffer and to appease the abusers I have three times asked my GP to issue me with a letter relating to my conditions.

On each occasion she has said that there is no need. Whilst she won’t admit it straight up, all conversations suggest she’s been told not to. I happen to agree that no-one should need to reveal their medical history to anyone other than medical professionals responsible for me.

I’ve researched mask wearing in relation to what they are supposed to be used for ref *Covid* - I’m no thicko - I prepare risk assessments (and I’m qualified to do so) every day (or did) - and the evidence *for* is weak. Very weak.
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matthew remski
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A staple of anti-lockdown conspiracism in yoga/wellness is that public health measures are oppressive, authoritarian, and stifling what it means to be human. Masks suppress identity and speech. Vaccines assault the sovereign body. Influencers must rise up against tyranny! /1

Ironically, pandemic management in economies where yoga/wellness is lucrative has been a neoliberal, choose-your-own-adventure mess in which centre-right governments barter with public health to enact a patchwork of half-measures that punish the poor and marginalized. /2

The goal is not universal health rights, or protecting medical systems, or saving as many lives as possible. The goal is to return to business-as-usual, using public health as a pit stop on a productivity race off a cliff. The ice caps aren’t melting fast enough, I guess. /3

Right-leaning governments, like influencers, have assessed the COVID threat with the magical bias of limitless optimism. Then they work to normalize COVID casualties as a new cost of doing business. *This* is what alt-healthers and Qamoms call “socialist”, or “communist”. /4

Centre-right governments and wellness influencers share a goal: get back to the optimism of making productivity heroic and consumption virtuous, without any reflection on structural issues of injustice, or what universal health care funding and standards would look like. /5
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Tamar Haspel
Tamar Haspel
@TamarHaspel
Let’s talk about ORGANIC.

Robert Paarlberg’s new book on the food system is out today, and here’s an excerpt.

He’s not a fan of organic, and he makes some good points but misses others.

Here we go.

Organic's biggest shortcoming is that you need more land to grow the same amount of food.

The yield penalty happens in almost every crop, in almost every study.

The gap could narrow with more research/varieties, but it won’t go away.

This has big, bad climate implications.

The second issue I have with organic, which Paarlberg shares, is that its basic criterion is naturalness.

Natural doesn’t mean safe, or even safer. A farming standard based on it forces farmers to sometimes use more dangerous, less effective tools.

On human health, there’s scant evidence that pesticide residues on conventional produce are harmful to consumers (though it’s possible farmworkers could be at risk).

What I don’t want is for folks who can’t afford organic to worry about feeding their kids conventional produce.

On the plus side, Paarlberg acknowledges that the organic standard has some real advantages for animal welfare.

This is why I buy organic animal products.

Many in the organic world would like more regs ensuring animals have decent lives.
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Sumanta Pal
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It's Monday AM post-@ASCO #GU21 & clinic starts in a couple of hours! Lots to process - I'll try to tackle optimal 1L tx for #kidneycancer. I'll make a case for cabo/nivo, leaning on the beautiful (& timely) tables below from @lalaniMD, @SoaresAndrey & @brian_rini (1/15)


What about IO/IO? We have long f/u w #CM214 data w nivo/ipi, no doubt (@AlbigesL et al in @myESMO Open). And treatment-free interval discussed by McDermott @BIDMChealth is no doubt impt. But we've known data not as impressive for favorable risk (2/15)


And furthermore, as @ERPlimackMD points out in another tweet, impt to look at primary PD rates (seen in @lalaniMD's table) - nivo/ipi at 19%!!! CR rate used to be something we highlighted w nivo/ipi, but now comparable across studies (3/15)


Okay now to the really tough stuff - comparing TKI/IO regimens. Something interesting I will add to @brian_rini @uromigos table above is the HR for PFS by INVESTIGATOR review. If the diff in HR for PFS by IND review caught your eye, this is even more striking (4/15)


I think INV-assessed PFS is impt, but if you're a skeptic, forget that argument. Turn instead to #QOL with axi/pembro. Kudos to @brian_rini @tompowles1 @ERPlimackMD et al for advocating for QOL in KN-426. @crisbergerot et al have taughts us the importance of these metrics. (5/15)
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Chris Yiu
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@clry2
I think that, in the face of an ongoing global health emergency and a pressing need to reopen safely, some form of health pass is a reasonable option to consider. But debate is a good thing, so here are some brief thoughts on various concerns I've heard about them... [thread]

"A health pass discriminates against people who have refused the vaccine." No. A health pass should also support proof of test result for people who haven't been vaccinated, and exemptions for people who cannot be vaccinated (get vaccinated if you can though, for heaven's sake).

"A health pass is an invasion of privacy." No. A health pass should be privacy preserving, allowing you to prove your status to third parties without giving away personal data or letting them track you without your permission.

"A health pass is unfair to people without smartphones." No. A health pass should accommodate people without a smartphone, e.g. with a printable option as a fall-back (though for most of us, carrying a digital pass on our phone will be much more convenient).

"A health pass will become obsolete as the virus mutates." No. A health pass should actually give us more insight and flexibility to adjust our response as our knowledge of the virus, and the ways we test / treat / vaccinate for it, increases.
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I get asked for writing tips a lot. Of all the ones I’ve given, here are a few of the ones that seem to hold true and remain somewhat universal or at least mostly unobjectionable:

#amwriting #writingtips

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Speech Delay is most common in children nowadays

In ancient times, our grandparents used to follow typical natural way of caring the needs of a child. All they used were more of natural products than chemical based for the growth of child.


One of major step followed was to feed Gurbach Jadd/ Vasa Kommu/ Acorus Calamus for initiating good speech ability in a child. This stem was needed to babies on Tuesdays and Sundays in mother's milk.

Vasa is feed to baby after the 1st bath on 12th day in week. Weekly only thrice it is fed and named as :

Budhwar - Budhi Vasa
Mangalwar - Vaak Vasa
Ravi Vaar - Aayush Vasa

This stem is burnt and rubbed against the grinding stone in mother's milk or warm water to get a paste


The procedure to make it is in the link

https://t.co/uo4sGp7mUm

It should not be given daily to the child. Other main benefits are

1. It clears the phlegm in child's throat caused due to continuous milk intake. It clears the tracts and breathing is effortless.
2. Digestion

For children who haven't got their speech and is delayed than usual should feed this vasa on these days in week atleast for 6months. Don't get carried away with this dialogue
"Some gain speech little late"
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4/ Todays massive venture-backed advertising, sales, and user acquisition playbook has morphed into one that champions growth at any cost.

This is creating a big bill that will soon come due...

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Ignore people playing status games. They gain status by attacking people playing wealth creation games.

You’re not going to get rich renting out your time. You must own equity - a piece of a business - to gain your financial freedom.
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