Bob Wachter @Bob_Wachter Twitter profile

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Bob Wachter

@Bob_Wachter

2 years

I’ve been tweeting about Covid for nearly 2 years. But this week it became personal when my 28-year-old younger son got it. With his permission, I’ll describe his experience & how I approached his situation, given the realities of life and the rapidly changing evidence.(1/25)

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Bob Wachter

@Bob_Wachter

4 years

The more I think about it, the more concerned I am about 25th Amendment issues & Trump's mental status. We know he was "lethargic" & we know he's been hypoxic (low oxygen). We now know he's on a medication (dexamethasone) that causes confusion or altered thinking at times (1/3)

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Bob Wachter

@Bob_Wachter

4 years

When I saw "Secret Service" trending & read first tweet on Trump's joy ride around Walter Reed, I thought, "This has got to be a joke." But nope, it's real. So massively irresponsible. And another reason to question whether he is capable of making sound decisions at this time.

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Bob Wachter

@Bob_Wachter

3 years

We've received more useful guidance from @CDCgov in the past week than the prior 52 combined. And more coming on schools, what the vaccinated can and can't do, etc. Nice to see that this national treasure was hibernating and not destroyed. @CDCDirector

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Bob Wachter

@Bob_Wachter

4 years

Well, my goal on @maddow @msnbc wasn't to "rattle" Rachel. But I did, when she asked about possibility that Trump's decision-making is impaired due to steroids/Covid, & I walked her through why the answer is yes – and that the patient may not realize it. Will post video when up.

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Bob Wachter

@Bob_Wachter

2 years

A) "Everyone will be exposed to Omicron" B) "Everyone will get Omicron" They're different. (A) promotes appropriate caution till surge ends: boost, N95, outdoor>indoor. (B) promotes counterproductive behavior as hospitals are overwhelmed. Biggest difference: A is true. B is not.

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Bob Wachter

@Bob_Wachter

3 years

Dear Media: As you report cases of Covid in vaccinated people (happens: vaccine is 95%, not 100%, effective) and people who died soon after vaccination (happens: coincidence), please ALSO report on the >3000 people dying of Covid each day who would've been saved by vaccination.

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Bob Wachter

@Bob_Wachter

2 years

Biden administration needs to fight this decision, even if is was gearing up to make the same call in a couple of weeks. Accepting a precedent that says that @CDCgov or other agencies don't have the authority to enact mandates during a public health emergency is enormously scary.

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Bob Wachter

@Bob_Wachter

3 years

My younger son, who is autistic, went out tonite to hear music with friends. When I picked him up, he was smiling. "This is great," he said. "Nobody knows how to socialize anymore."

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Bob Wachter

@Bob_Wachter

2 years

Anybody who says "I hate Twitter" has never tried to keep up with a pandemic in which crucial new data is released every few hours, data that often requires sophisticated interpretation by domain experts in areas ranging from virology to epidemiology to supply chain to sociology.

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Bob Wachter

@Bob_Wachter

4 years

"Don't be afraid of Covid." Are you kidding me? After 210,000 deaths in the U.S. & 1 million deaths worldwide? This either shows a breathtakingly callous, inhumane & counterproductive attitude, or he has altered mental status – in which case the 25th Amendment should be invoked.

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Bob Wachter

@Bob_Wachter

2 years

My son should do OK, but the illness & the anxiety it causes are miserable. Resigning ourselves to getting Omicron doesn’t seem right, especially since the surge may be short-lived. I still think it’s an experience best avoided – for you and your loved ones – if you can. (25/end)

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Bob Wachter

@Bob_Wachter

2 years

I’m not doing indoor dining, and I still wear a mask in crowded indoor spaces. While most in US have chosen to be less careful, in this 🧵 I’ll review the logic & math behind my decisions, hoping that some of you will find them useful in navigating today’s Covid landscape. (1/25)

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Bob Wachter

@Bob_Wachter

3 years

How awesome that William received his vaccine before I did. The vaccine rollout is a window into the culture and priorities of an organization.

UCSF Health

@UCSFHospitals

3 years

Senior custodian William Wyatt was the first frontline #HealthcareHero at UCSF to receive a #COVID19 vaccine yesterday. William has been cleaning dirty linens in hospital rooms during the pandemic. #UCSFHeroes

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Bob Wachter

@Bob_Wachter

3 years

Dear @nytimes photo editor: Huge fan here. But when you post pic of a guy grimacing while getting his vaccine (when shot actually feels like a pin prick), at least consider fact that 1000s may see this as reason to not get vaccinated. Some will die from that decision. Thanks.

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Bob Wachter

@Bob_Wachter

4 years

Visiting my 90 year-old dad, who is sadly nearing the end, and 84 year-old mom in Florida. Dad is pretty clear-eyed about his future and says he is "ready to go." But he has one thing he still wants to accomplish. "I want to stay alive long enough to vote." So proud of him.

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Bob Wachter

@Bob_Wachter

4 years

One more medical nuance: dexamethasone, a powerful steroid, can cause confusion – w/ obvious implications here. As an anti-inflammatory, it can also lower fevers & aches; pts sometimes feel better, even if their underlying illness isn't any better or their risk any lower...(1/2)

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Bob Wachter

@Bob_Wachter

4 years

Impressions of today's Walter Reed presser: a) Conley's mea culpa: “I was trying to reflect the upbeat attitude of the team. Didn’t want to give any information that would steer the course of his illness.” Trump's fingerprints. But even so, today was only slightly better. (1/8)

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Bob Wachter

@Bob_Wachter

4 years

We must be reassured that he'll have an independent (and not by Dr. Conley; sorry, but he's done nothing to earn our trust in the past two days) of fitness for duty, carried out at least daily for next several days. Congress/Cabinet should insist on it... and do so stat. (3/3)

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Bob Wachter

@Bob_Wachter

2 years

What to do now? 1) If not vaxxed, get vaxxed 2) If not boosted & >4-5 mths out, get boosted 3) Get prepared mentally to act more cautiously if Omicron proves to be more infectious, immune-evasive, or both 4) Follow the news & science – will be much clearer in 2-3 wks 5) That's it

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Bob Wachter

@Bob_Wachter

4 years

Bottom line: it seems like Trump is stable, but remains at high risk, given transient hypoxemia, some findings on chest imaging. The happy talk and evasions are clearly at Trump's direction, putting the docs in a terrible position. No way he's ready for discharge tomorrow. (8/8)

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Bob Wachter

@Bob_Wachter

2 years

Covid ( @UCSF ) Chronicles, Day 838 The die is now cast: BA.5 is destined to be our dominant virus. In today’s 🧵I discuss the implications on the course of the pandemic, and how to think about responding. (I use “BA.5” & not “BA.4/5” since BA.5 is poised to outrun BA.4.). (1/25)

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Bob Wachter

@Bob_Wachter

10 months

Until this week, I remained a NoVid, which I chalked up to being fairly cautious, fully vaxxed & a bit lucky. This week my luck ran out. My case is a cautionary tale, particularly for the “just a cold” folks. Mine definitely was not...I literally have scars to show for it. (1/22)

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Bob Wachter

@Bob_Wachter

3 years

We have to push ourselves to avoid becoming desensitized to Covid's toll. In 2005, Hurricane Katrina killed 1500 people in New Orleans. It was a tragedy & a political scandal. Covid has now killed more Americans (396,000) than the entire population of New Orleans (390,000).

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Bob Wachter

@Bob_Wachter

3 years

Covid ( @UCSF ) Chronicles, Day 453 1/ I know everybody’s sick of playing 3-dimensional Covid chess. Sorry, but the Delta variant forces us back to the chess board. Ergo, this 🧵. If you’re fully vaxxed, I wouldn’t be too worried, especially if you’re in a highly vaxxed region.

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Bob Wachter

@Bob_Wachter

4 years

g/ Finally, most tellingly: when T was hypoxic, they tried to put him on O2. "He was adamant he didn't need oxygen." In my 35 years of practice, I've never seen a pt refuse oxygen. It's crazy, & illustrates who is running the show, which may well be scariest thing I heard. (7/8)

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Bob Wachter

@Bob_Wachter

4 years

All physicians have seen many confused pts who don't know it – they lose insight. Moreover, we have T's narcissism, tendency to spin, & mistrust of others. Added together: the least qualified person in the world to determine if he's capable of carrying out his duties is him (2/3)

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Bob Wachter

@Bob_Wachter

2 years

This thing has rapidly become the world’s exasperating good news/bad news story. If your head isn’t spinning, you’re not paying attention. A 🧵on my take on both the good news & the bad, with an emphasis on the things that have changed in the past few days... or minutes.(1/25)

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Bob Wachter

@Bob_Wachter

2 years

Remember "TX & FL have done nearly as well as CA while staying 'open' " narrative? Let's look: CA deaths/100K=194 TX deaths/100K=262 FL deaths/100K=291 Dead Texans who'd be alive if TX matched CA death rate:19,741 Dead Floridians...:20,827 To me, "nearly as well" ≠ 40,000 lives.

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Bob Wachter

@Bob_Wachter

1 year

While I'm as bothered by Musk's actions & tweets as anyone, I still haven't found a forum to deliver accurate scientific information to the public that matches Twitter. But I have decided I'll never buy a Tesla. If many people make that choice, it should send a powerful message.

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Bob Wachter

@Bob_Wachter

2 years

My latest tweets have mostly been bad news, which saddens me, particularly during holiday season. Today I’ll take you to my Happy Place, with some thoughts on why we could be in good shape – and maybe even great shape – in 6-8 weeks. A 🧵(1/24)

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Bob Wachter

@Bob_Wachter

3 years

For months, I've made point that – as a fully vaxxed person – I still don't want to get Covid. Big reasons: 1) we aren't sure that breakthru Delta cases can't be transmitted; & 2) I'm not certain that a mild Delta breakthrough case can't lead to Long Covid. Yesterday... (1/2)

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Bob Wachter

@Bob_Wachter

2 years

The latest Omicron variant (BA.2.12.1) is the most infectious yet, & it’s snagging tons of people who have avoided Covid for > 2 years. It’s hitting close to home for me, so tonight’s 🧵is about that…with a few poll questions to see how your thinking lines up with mine. (1/23)

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Bob Wachter

@Bob_Wachter

2 years

After several days of watching commercials for cryptocurrency on the Olympics, I've made a decision: At age 64, my life expectancy is about twenty years. I’m going to see if I can make it to the finish line learning precisely nothing about what crypto is and does. Am I wrong?

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Bob Wachter

@Bob_Wachter

2 years

My son's now 5d since symptoms. He's better (now mild sore throat, no fever). Binax is below. I study this for a living & am confused by CDC recs. Work (with mask) would've been OK if we didn't test, but since we did, he should stay home 5 more days? Huh?

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Bob Wachter

@Bob_Wachter

3 years

Well, the blessed email came late last night and I snagged the first appointment this morning. Thanks to all the scientists and the study volunteers who made this miracle possible. I’ll let you know how it goes; so far so good.

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Bob Wachter

@Bob_Wachter

3 years

It's a mask, people. It's not chemotherapy.

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Bob Wachter

@Bob_Wachter

4 years

I thought this show was jumping the shark, but have to say that the Biden call happening while Trump is golfing and we learn of a new cluster of White House Covid cases from an election eve mask-less gathering is a pretty satisfying ending.

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Bob Wachter

@Bob_Wachter

3 years

U.S. is now considering idea of a single vaccination shot, delaying shot #2 until months later. Last wk, I thought that was a bad idea – the trials that found 95% efficacy were 2 shots; why add extra complexity & a new curveball. But facts on the ground demand a rethink. (1/7)

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Bob Wachter

@Bob_Wachter

2 years

Tragically, we've all become numb to Covid's death toll. Sometimes it takes a tangible comparison to shake us out of complacency. I had such a moment today, when Covid deaths in the U.S. hit 875,000. That, as it happens, is the population of my city, San Francisco. Staggering.

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Bob Wachter

@Bob_Wachter

2 years

39 years ago, I opened an envelope and learned I’d be an internal medicine resident @ucsf . One of my happiest moments. This morning, my daughter @zoemarklyon opened hers and found out that she’d also matched in medicine @ucsf . I couldn’t be more thrilled or proud. #MatchDay2022

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Bob Wachter

@Bob_Wachter

2 years

This is one of the most confusing times of the pandemic, w/ a firehose of new Omicron data (lots of fab work on #medtwitter putting it into context). In this (long) 🧵, I'll offer my take on how the new information is changing my thinking & behavior.(1/25)

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Bob Wachter

@Bob_Wachter

4 years

1/ Covid ( @UCSF ) Chronicles, Day 104 Let’s talk California. Until recently, our state managed to do so well that our experience has been dubbed The California Miracle. But let’s say it clearly: The Miracle is over. The sooner we acknowledge that, the better off we’ll be.

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Bob Wachter

@Bob_Wachter

2 years

The new Omicron math: somewhat milder x massively more infectious = overwhelmed hospitals and lots of deaths

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Bob Wachter

@Bob_Wachter

2 years

Any lessons? First, thank God for vaccines! Yes, he had Covid, but his vax slashed the odds of a severe case, hospitalization & death. 2nd, concerns re: false neg rapid tests in Omi are real, as are shortages of tests & meds. Omi's lesson: lower your guard & it'll pounce.(23/25)

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Bob Wachter

@Bob_Wachter

4 years

... Which is another argument not to allow the patient to unduly influence timing of discharge. No reason for him to be anywhere but the hospital for the next few days. He needs strict isolation anyway & can work from hospital, so leaving prematurely would only add risk. (2/2)

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Bob Wachter

@Bob_Wachter

3 years

When my older son Doug read "Moneyball" at age 12, he said, "Dad, this is what I want to do for a job." When he started working in baseball analytics 9 years ago, he said, "I really want to win a World Series." And now it's done – I couldn't be prouder of, or happier for, him.

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Bob Wachter

@Bob_Wachter

4 years

1/ Covid ( @UCSF ) Chronicles, Day 199 OK, now this is now officially mind-blowing. Of course, today’s thread will be all about the President’s illness, what might come next, and what it means.

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Bob Wachter

@Bob_Wachter

2 years

Should he have watched movies with his friend? I think so – it seemed like a fairly safe encounter. But while Omi is surging, even low risk stuff – things that were safe last mth – may now be risky. Given how quickly this storm may pass, it seems wise to hunker down a bit.(24/25)

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Bob Wachter

@Bob_Wachter

2 years

As blue states remove mask mandates, expect an odd dynamic: Unvaxxed (at highest risk of catching virus & getting sick) will ditch masks. Vaxxed x3 (far lower risk of both) may not, both because they respect the virus & because removal by unvaxxed makes space less safe for them.

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Bob Wachter

@Bob_Wachter

2 years

Saturday morning – when your wife asks you to buy some veggies for her from the local farmer's market, but years of experience have given her every reason to believe that you'll screw it up without visual aids. @katiehafner

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@Bob_Wachter

3 years

1/ Covid ( @UCSF ) Chronicles, Day 259 The vaccine news remains astoundingly positive. Reacting to my upbeat mood, a reporter asked me if there’s anything that keeps me up at night. Aside from the cataclysmic current state of Covid (likely to get worse, I fear), there are a few:

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Bob Wachter

@Bob_Wachter

4 years

d/ They pulled trigger & started dexamethasone. So they were clearly concerned. Given documented low O2, dex definitely was indicated. e/ Said they're starting to plan for possible discharge, as early as tomorrow. Even w/ WH's medical capacity, that seems like an awful call. 5/8

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Bob Wachter

@Bob_Wachter

2 years

Thanks, folks, for asking about my son. Better today, though throat's still bad. Many going through far worse. Yes, Twitter-verse has some nasty people (& bots), but I've been impressed more by the kindness. Grateful to people who offered test kits – we snagged a few so all set.

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Bob Wachter

@Bob_Wachter

2 years

Day 10, finally! And just as I've memorized the instructions! This ends my son's Omicron saga; tens of millions are experiencing their own version. Wishing all of you good health, & thanks for your kind wishes. He's now 3 shots plus a breakthrough – about as immune as you can be.

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Bob Wachter

@Bob_Wachter

4 years

... But it seems far likelier that they found evidence of pneumonia or other manifestations of Covid lung involvement or inflammation, which is serious and raises the level of concern and risk. (4/8)

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Bob Wachter

@Bob_Wachter

4 years

1/ Covid ( @UCSF ) Chronicles, Day 150 Today, 150 days since I began my Covid tweets, I’m going to do something odd: write the speech that Trump should give. I have no faith he’ll do so, but it’s worth recognizing how little it would take to change course & save lives. Here goes:

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Bob Wachter

@Bob_Wachter

4 years

b/ Biggest news is that T had 2 episodes of hypoxia (down to 93-94% O2 saturation), & Conley evaded whether sat was ever <90. "Never in low 80s" is all he offered. c/ Re: Chest CT: "There were some expected findings but nothing of concern." What the hell does that mean?...(2/8)

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Bob Wachter

@Bob_Wachter

2 years

While it may seem like the decay in vax efficacy over 6 months portends a future of every-6-month boosting, the immune system doesn't work like that. There's every reason to believe shot #3 will last one or more years. Alas, there's no way to know other than to see what happens.

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Bob Wachter

@Bob_Wachter

2 years

My beloved dad passed away peacefully this morning. He was truly one of a kind. A remembrance:

In Memory of Murray Wachter

Murray Wachter passed away peacefully on November 26 after a long illness. He was 91 years old and lived in Boca Raton, Florida.

medium.com

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Bob Wachter

@Bob_Wachter

3 years

Wow, talk about hitting a tipping point…. As each organization and industry finds the courage to mandate or strongly incentivize vaccination, it makes it that much easier for the next one to do so. Until all the pressure is on leaders who have NOT done it.

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Bob Wachter

@Bob_Wachter

4 years

f/ Yes, they could give his last doses of IV remdesivir in WH, but still risky to discharge. In RECOVERY trial (which proved value of dexamethasone), mortality rate in TREATMENT group for pts requiring O2 was 23.3% (vs. 26.2% in usual care). A nearly 1-in-4 risk of death. (6/8)

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Bob Wachter

@Bob_Wachter

3 years

As we consider replacing @GavinNewsom with a more libertarian leader over handling of Covid (I guess), worth knowing that CA's per capita Covid deaths are ~21% below FL's, & ~16% below TX's. Translates into >10,000 Californians alive due to our performance.

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Bob Wachter

@Bob_Wachter

2 years

As we continue to head-scratch about getting unvaccinated people vaxxed, I'm struck by the crickets coming out of health & life insurance industries. Seems like vax is a volitional act that either increases (raise premiums) or lowers (cut them) a person's risk of illness & death.

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Bob Wachter

@Bob_Wachter

4 years

...To be clear, the "expected findings" on a chest CT is NORMAL. If it was normal, he should say that. Anything else should have been described. (The only semi-benign interpretation would be if the prez has a known chronic finding – like a benign nodule – that was seen)...(3/8)

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Bob Wachter

@Bob_Wachter

2 years

Next day, I called him at 9am – no answer. My brain knows the odds of a fully vaxxed young person dying are near-zero. Still, I wondered briefly if he’d survived the night: evidence-based medicine meets parental emotion. I tried again at 10, still no answer. I let myself… (8/25)

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Bob Wachter

@Bob_Wachter

2 years

For those of us who favor careful, last wk has shown: 1) Waning efficacy of boost after 4 mos; 2nd boost not available 2) Some concerning signals about long-term risks of Covid 3) Case rates falling fast but still fairly high We all want “normal” but prudent stance is “not yet”

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Bob Wachter

@Bob_Wachter

4 years

I feel like I'm getting a PhD in Covid this year. Required courses: Epidemiology, virology, immunology, clinical med, pharmacol, aerosol sci, logistics/supply chain, poli sci, data sci, econ, ethics, history, ethnic studies, communication, psychol, criminal & constitutional law

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Bob Wachter

@Bob_Wachter

2 years

...knew, deep down, that odds of a bad case were low. But when it’s your kid, you freak out a bit. Re: prognosis, youth helps: compared to his 64 yo dad, he has 1/4 the hospitalization risk, & 1/25th the death risk. An on-line risk calculator ()...(13/25)

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Bob Wachter

@Bob_Wachter

2 years

As we rethink behaviors in face of possible new threats, a reminder that SF – w/ 78% full vax rate, and sensible mask & other policies since Mar 2020 – has had 672 Covid deaths, 1/3rd the US per capita rate. If US had matched SF, ~500,000 people who died of Covid would be alive.

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Bob Wachter

@Bob_Wachter

10 months

Thanks for the huge outpouring of kindness. (I just ignore the other foolishness.) Go figure – I finally got Covid and it was #5 on my ER problem list! FYI, I'm on the mend, done w/ Paxlovid, still testing +, stitches out soon, neck brace x 6 weeks. Overall I feel very fortunate.

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Bob Wachter

@Bob_Wachter

2 years

My wife @katiehafner , with perhaps a bit of an extreme response to the end of the airplane mask mandate.

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Bob Wachter

@Bob_Wachter

4 years

25/ By teaching the nation – including his followers – how serious this virus can be and how important masks and distancing are, in illness Trump may end up saving tens of thousands of lives – far more than when he was well. Wouldn't that be the ultimate irony.

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Bob Wachter

@Bob_Wachter

4 years

Not the kind of thing I generally share, but I found this one to be unusually on point.

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Bob Wachter

@Bob_Wachter

2 years

I’ve been gratified hearing from many people who have said that they’ve followed my lead in deciding what they'll do, and not do, in various stages of the pandemic. It’s a particularly confusing time now, so today’s 🧵 is a summary of the choices I'm making these days. (1/25)

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Bob Wachter

@Bob_Wachter

2 years

Anecdote showing how immune-escape-y Omicron is: spoke to NYC pal. Had Covid last yr & has had 3 mRNAs. Went to holiday parties last wk – proof of vax required but no masks. Today he tested pos. Feels flu-ish but luckily nothing worse. It's a different foe – treat it w/ respect.

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Bob Wachter

@Bob_Wachter

2 years

Am I worried about Long Covid? A little. The literature is a mess: some studies show 50% of people have persistent (>1 month) symptoms. Other studies say it's more like 5%. It seems like vax lowers the risk. So it’s a concern, but there’s not much we can do but wait & see.(22/25)

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Bob Wachter

@Bob_Wachter

2 years

My son, who lives in SF, is generally healthy but overweight, placing him in a moderately high-risk group. He’s been quite careful since March 2020, & has received 3 Modernas. He used to wear a 2-ply cloth mask; since Omi, he’s switched to an KN95 (with my “encouragement”).(2/25)

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Bob Wachter

@Bob_Wachter

2 years

… for another rapid test. This time, based on early reports that swabbing throat PLUS nose improves yield for Omicron (vs. nose alone), that’s what we did: a good rub around his tonsils & tongue, and then (same swab – a bit gross) both nostrils. (10/25)

Should you add a throat swab to your at-home covid test? Experts disagree.

The FDA is urging Americans to follow the instructions on at-home covid tests, which do not call for an added throat swab. Meanwhile, some experts say the extra swab could increase chances that...

www.washingtonpost.com

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Bob Wachter

@Bob_Wachter

2 years

...seemed secure. So one more case omitted from the public #'s (which makes skyrocketing case counts even more amazing). He called in sick to work, set himself up for at least 5d of strict isolation, & I set out to figure out his prognosis & if treatment was merited. I...(12/25)

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Bob Wachter

@Bob_Wachter

2 years

The 15-minute wait, and then...the pink line: he was positive. Like millions of other young people, my son had Covid. I felt a strange guilt – not entirely rational, but real – for not having protected him. We cancelled the PCR test (now 3 days away) since the diagnosis...(11/25)

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Bob Wachter

@Bob_Wachter

2 years

Growing peer pressure to go maskless in indoor spaces. I deal with it by likening it to driving on a speed-trap stretch of road & having a car zoom up behind me. While speeding is that driver's prerogative (& risk), I know my best move is to let them pass, not speeding up myself.

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Bob Wachter

@Bob_Wachter

3 years

25/ …psychologically prepped for some restrictions to return in fall (tho highly vaxxed places like SF will likely do fine). Nobody wants that, but the virus doesn’t care what we want. For unvaxxed, I wish you well but my sympathy is flagging. Your bad choice is looking worse.

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Bob Wachter

@Bob_Wachter

3 years

Why mandates? Because of situations like this – I doubt this teacher wanted to infect half of her class or thought she was putting them in danger. But she did and she was. It must not be allowed.

Laurie Garrett

@Laurie_Garrett

3 years

An unvaxed teacher carrying the #DeltaVariant , with mild #COVID19 symptoms passed virus to 55% of students, as far away as 5 rows, while reading to class w/out wearing a mask. Marin, California.

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Bob Wachter

@Bob_Wachter

4 years

While being appropriately excited re: vaccine, it's worth remembering that it probably won't make a material difference in everybody's life/schools/economy until next summer. If so, that means the time from now to then is equal to the time from the 1st Covid cases in U.S. to now.

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Bob Wachter

@Bob_Wachter

2 years

...has also been quite careful, came over Monday night to watch a movie. She felt fine, as did he. Wednesday am (~36 hours later), he woke up & felt awful. Sore throat, dry cough, muscle aches, chills. No taste/smell abnormalities. I told him to stay home, drink fluids…(4/25)

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Bob Wachter

@Bob_Wachter

2 years

Some folks are a bit confused about why things are likely to be much safer in a month than now – not why virus will peak & fall (we don’t entirely know) but why the risk to individuals will plummet – & with that, why activities that are unsafe now will be much safer then.(1/20🧵)

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Bob Wachter

@Bob_Wachter

2 years

…into his place & found him sleeping… and breathing. An hour or so later, he heard from the friend he saw Monday pm. She had tested pos. Of course, that increased my son’s odds of having Covid, but still the incubation time of <2 days seemed awfully short. It was time…(9/25)

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Bob Wachter

@Bob_Wachter

3 years

Far better to have 100M people who are 80% protected than 50M people who are 95% protected, particularly as we are facing a foe that is getting smarter and nastier. Or at least it seems that way to me. You? (7/7)

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Bob Wachter

@Bob_Wachter

3 years

An really smart idea to encourage vaccinations: Report hospitalizations & deaths (both local & nationally) in 2 categories: in vaccinated people vs. in unvaccinated people. It would take about 10 minutes for benefits of vaccination to be obvious. (H/T to @UCSF 's Matt Springer)

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Bob Wachter

@Bob_Wachter

3 years

The first 10 months of Covid were a test of sociology, behavior, logistics, & politics. The U.S. flunked the test. November was about the science. The results were exceptional, an A+. The next six months will be about sociology, behavior, logistics, & politics. We'll see...

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Bob Wachter

@Bob_Wachter

2 years

The bad news: virtually every piece of good news in the two years of this damn pandemic has been followed by bad news. (25/end)

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Bob Wachter

@Bob_Wachter

3 years

A milestone in my own journey toward "normal": with SF running ~30 cases/d & test pos. rate 0.9%, we felt OK to resume our monthly poker game last pm. With everybody vaccinated, the risks from the junk food may exceed the risk of Covid. Great fun & I broke even (for me, a win).

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Bob Wachter

@Bob_Wachter

2 years

As much as we hate externally imposed rules, they do make things easier. As masking mandates are lifted even in blue states, those of us who have been cautious will have to answer a new question. Not “must I mask?” but “should I?” Today, a 🧵on how I’m thinking about this. (1/25)

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Bob Wachter

@Bob_Wachter

2 years

… vaccine,” he said. He seemed sick enough to be infectious; I wondered if he’d be an example of the newly reported problems with false-negative rapid tests in the first days of an Omicron infection. He called the @UCSFHospitals Covid hotline... (6/25)

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Bob Wachter

@Bob_Wachter

3 years

Covid ( @UCSF ) Chronicles, Day 495 When I began my tweets 494d ago, it was before we had reliable local, US, or world data. So I focused on data from @UCSFHospitals . Today, we’re awash in data, yet I find my hospital's data still provides a unique lens into our situation. (1/20)

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Bob Wachter

@Bob_Wachter

2 years

He works in downtown SF in customer service, so he has a lot of people contact. I’ve worried that he’d get it from work, or from the bus. But that’s not how it happened. Instead, one of the few friends he sometimes sees in person – another fully vaxxed young person who… (3/25)

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Bob Wachter

@Bob_Wachter

3 years

If you're wondering how bad Delta really is, even in highly vaccinated SF (76% of >age 12 fully vaxxed) & still w/ a lot of masking (most folks in stores), we're seeing a pretty steep Covid uptick. Daily cases up 4-fold (10->42; Fig L), hospital pts doubled (9->19; R)(Thread 1/4)

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Bob Wachter

@Bob_Wachter

2 years

There are 4 main treatment options for a symptomatic outpatient. One: monoclonal antibodies. But the only one that works against Omicron, (I’m assuming he has Omicron, because it’s now dominant in the U.S. and because the lightning-fast incubation is an Omicron tell)… (15/25)

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Bob Wachter

@Bob_Wachter

2 years

…(he’s a patient) to get a PCR or Color (PCR-like) test. 1st available: 4 days away, so no help. I heated up some chicken soup, bought an oximeter (97%, whew – though his heart rate was 120: concerning) & told him to call me if his symptoms changed or his O2 sat fell <95%.(7/25)

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