Noah 🧡
@Michigan_Noah
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Misinfo Slayer, Writer, and Patient (the medical kind). I Work in Public Health @Voices4Vaccines . @StanfordAlumni . Personal Account.
Joined September 2018
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I was gonna post to bash RFK Jr, but instead I’m gonna post Fisher.
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Throughout the pandemic, we've gotten used to the idea that most
#COVID
cases are "mild." The CDC says mild cases account for 80% of symptomatic infections.
Some people hear this and think it's not worth worrying about. Are they right?
A thread on what "mild" really means. (1)
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@phealthsean
@wanderer_jasnah
>stops misinfo moderation
>gets fooled by misinfo on own platform
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Hey I know a lot of people are checking vaccination status right now for polio. If you're around my age (23) or in college, I'd recommend you check HPV vax status while you're at it.
There's a much larger chance you *didn't* get this vaccine and it's for a very common infection.
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I'm young enough to have received the HPV vaccine at 14, and am grateful for it. 20% of kids still don't even get a single dose.
The 💉 prevents 6 cancers with incredible safety. It does this much better the younger you're immunized so parents please consider it! (11-12 is best)
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People who deny the HPV vaccine prevents cancer have already been proven wrong: a NEJM study of 1.6 million girls showed a reduction in *actual cervical cancer.*
The scientists and cancer researchers were right. Ignoring them will have cost thousands of lives. (1/2)
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Robert Malone is upset he didn’t get a prize for a vaccine he spent two years telling us not to take…
Got it.
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As of late, America's favorite pastime has been predicting when the pandemic will end.
Last month its course changed radically. Now some say we're approaching an "endemic" state with SARS2 reduced to a cold or flu. The hope is for everything to return to normal...
Will it? 🧵
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You literally cannot say “less disease is bad” anymore without people tagging your employer and pretending you don’t know downsides exist.
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Human papillomavirus (HPV) is estimated to cause 4.5% of all cancers. Up to 87% of Americans will be infected. That isn't a rare impact.
Studies consistently show teens who get the HPV vaccine are no more likely to have sex. They are just less likely to get cancer.
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600+ days into the
#COVID19
pandemic, we finally have a vaccine for kids 5-11. This brings us close to near-universal access.
When this all started we were relieved COVID was easy on kids. Now some parents wonder why they need the vaccine.
A thread FULL of benefits 🧵
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But it was used poorly then too. After all, mild is an adjective and cannot be read on its own.
The disease SARS-CoV-2 starts with "Severe Acute" 😱
When you say someone has mild
#COVID
, you are literally saying they have mild SEVERE ACUTE disease. It's an oxymoron. (6)
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twitter comments section whenever you mention covid:
wow, people die of other things too. I've never seen you advocate for vending machine safety. I've never seen you talk about how many people slip on banana peels.
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When someone tells you that, they are technically saying: "For you, the disease will lie anywhere on a broad spectrum short of hospitalization and death 😊"
This is why it is important to critically examine language. Some words obscure FAR more than they reveal. (9)
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HPV vaccines have been shown in multiple RCTs to prevent precancer, which were then promptly treated in the control group.
The next level of evidence is literally letting people get cancer. That’s what CHD is advocating for.
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My point in saying this is: doctors don't use mild the same way we do.
Unfortunately, the science-free definition is now in circulation and people think it's not worth getting vaccinated.
Especially young people who are told as a demographic: "for you, the disease is mild!" (8)
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Impressed with
@IlhanMN
's commitment to openly and actively document signs of effectiveness. Helps politics feel less like a slog :)
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The full phrase is more honest, if inconvenient. Technically anything can be mild. For instance...
You can get MILD ebola |
You can have a MILD heart attack |
And mild covid includes "MILD pneumonia" 😮💨 (7)
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Here are common symptoms of MODERATE
#COVID19
: breathlessness, sore throat + persistent cough that keeps you up, diarrhea (for days), bronchiolitis, fatigue to the point of neglecting self-care, not wanting to eat or get out of bed. Lasts 1-2 weeks | (13)
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In the case of
#COVID
, this isn't quite right. Here the common definition of mild and the medical definition differ significantly.
Their confusion is a failure of communication. People are quick to underestimate the disease. They've taken "mild" as a synonym for unimportant. (3)
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600 days ago, the first human participants received the Pfizer mRNA vaccine.
We've since accumulated an immensity of data from hundreds of millions of doses given. Yet some people still worry about "long-term effects."
This concern has some significant flaws 🧵 (PT. 2)
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It was never meant to be. The term came from the first outbreak in China where
#COVID
emerged 😷
Doctors, effectively in a public health triage situation, defined as "mild" all cases that did not require hospitalization | (4)
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Of all the concerns behind refusal, potential long-term effects of mRNA vaccines are the most persistent.
Since we've been giving them out for a year now, the possibility of an unforeseen risk is the last holdout for some...
Here's why that risk is *incredibly* small 🧵 (PT. 1)
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The second reason we see
#COVID
as an event and not a process is that we are too focused on mortality (death) and not morbidity, or living with illness.
This is a point which deserves its own consideration. It is the single largest failing of the word mild. (25)
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This reduced the vast majority of cases to a single word.
The label was created before we knew much about the disease. In fact, it came months before the CDC even finalized its list of symptoms.
You can imagine why it's current use, knowing as much as we do, is misleading. (5)
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Mild and moderate
#COVID
aren't the same thing. Just look. Here are the typical symptoms of mild COVID: cough, low fever, lost taste or smell, fatigue and aches, feeling down. Lasts one week | (12)
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1⃣ Mild actually means Mild + Moderate.
Like any disease, symptomatic
#COVID19
is a spectrum. Our language divides it imprecisely: 81% mild, 15% severe, and 4% critical.
As you can imagine, that 81% contains contains a lot of variety. One thing missing are "moderate" cases (11)
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If this is surprising, we are still thinking mild. Mild illness seems at worst unpleasant.
Viruses are worse than that. Novel viruses can and do maim human bodies. That's why outbreaks of acute illness are followed by outbreaks of chronic illness. | (22)
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I don't know who needs to hear this, but your friends with health conditions almost certainly feel left behind this past year.
Our devaluation of vulnerable lives has been - put lightly - deeply hurtful. Please tell someone at risk that you love them.
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3⃣ Mild COVID can cause long-term disability.
From the start of the pandemic, it would have been reasonable to ask whether
#SARSCoV2
would lead to disability.
We have evidence to suggest that the original SARS lead not only to physical but terrible psychiatric problems. (26)
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In common language, the word mild usually describes something of minor importance. For example: health and medical websites often describe the cold as a "mild viral illness."
The implication is that while you may feel crummy, it really isn't a big deal 🍪 (2)
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People fail to anticipate this, for two reasons. The first is that we assume disease is natural and so something the body can overcome.
In reality, viral evolution in a global world can be random, cruel, and deadly. Its effects are as "natural" as natural disasters 🌪️ (23)
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Part one takes about a week, and packs a nasty punch.
#SARSCoV2
acts on the ACE2, a receptor found in lung, gut, heart, and other tissue. This means the virus can cause damage to multiple organ systems.
We'll soon see that even one week of this may cause lasting damage 💥 (18)
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This has held up over time. If anything changed, it's that we now know how long
#COVID19
can impact the body.
Even after 2 week, many people struggle to recover.
That's because the illness has two parts:
1) lowering your viral load and 📉
2) recovering from immune response (17)
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Here is a handpicked public health expert for Ron DeSantis saying “mRNA vaccines should never have been injected into people.”
Reminder: 87,000 people have died of COVID in Florida.
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Again, these are clearly not the same thing. But because people say mild and not moderate our impression is skewed towards the former.
What proportion are actually moderate? The truth is that there isn't a fine distinction. Many people will have symptoms in both categories. (14)
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The way to counteract this is to return to the data. What exactly is included in the term mild
#COVID
?
Here are FOUR True Facts about the condition. (10)
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Part two also takes about one week, but many cases go longer.
This is because the inflammation caused by the immune response can be severe. Pneumonia is a common outcome 🫁
Yet even the wear and tear of mild disease has been shown to sometimes cause months of suffering (19).
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I emphasize how miserable moderate
#COVID
can be. Here is just one symptom of note...
In a sample of mild cases w/ digestive symptoms, 57% had diarrhea that lasted for an average of 5.4 days with 4 bowel movements per day. Many had ongoing fever 🧻 | (15)
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Even flu can have severe side-effects: myocarditis, encephalitis, multi-organ inflammation, and sepsis, among others.
We know
#COVID19
engages more of the body, and more thoroughly than influenza. This increases the chance of such effects | (24)
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Two studies from the CDC illustrate this well.
1) Researchers surveyed 292 people. Among adults aged 18-34 without prior health conditions, those who had become ill still felt unwell after 2-3 weeks |
Mild illness seems to have hurt the body (20)
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2) Researchers reviewed 3171 mild cases. 66% of patients saw a doctor and received a new diagnosis within 6 months, often related to
#COVID
(eg cough). 33% of patients saw a new specialist in the same period |
This suggests health problems may linger (21)
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doctor: hey, kids should be protected from viruses
twitter: why? the world’s oldest man is far more at risk. kids are also at greater theoretical risk from an asteroid strike
doctor: typically societies can talk about more than one problem at a time
twitter: [epoch times link]
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While
#COVID19
seems to cause less extreme energy problems, we are seeing a similar kind of syndrome known as
#LongCovid
(LC)
The most common long-term effect of
#COVID
in adults is fatigue. People also report brain fog and issues with attention | (28)
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One study of 233 survivors found 40% were suffering from mental illness 3.5 years later |
27% of them the CDC's criteria for Chronic Fatigue Syndrome: a deadening disease where even basic activities can cause extreme fatigue 😨 (27)
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Nigeria is deploying a vaccine that could eventually wipe out most of the 8000 cervical cancer deaths they suffer each year.
Despite all the negativity online, public health is doing good things in the real world.
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I can attest. As someone who lives with pulmonary disability, specifically pulmonary hypertension, I've found my own world has shrunk ⬇️
Last month I left a great job early because I was so tired and at-capacity. That's just one example of how it has affected me (30)
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One single school asked one single class to wear masks for ten days only because of an active outbreak. Almost no other schools are doing this.
AND STILL: they were harassed so badly including on national news that they had to move recess inside.
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Mind you, I am an endurance athlete (3X 50-Mile Runner). But it doesn't matter: illness isn't always about how tough you are.
I wouldn't wish this kind of disability on anyone. And while I mean LC,
#COVID19
may also cause pulmonary hypertension | (31)
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The website you run literally says kids are better off completely unvaccinated. ‘Corporate media’ didn’t write that. You did.
The two main lies that Corporate Media cites to make me look crazy are that I am antivaccine and that I compare the Covid mandates to the Holocaust. Thank you
@nypost
@LJMoynihan
for letting me clarify that I’m not an anti-vaxxer.
#Kennedy24
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One of the greatest achievements of US public health is that almost all kids reach adulthood. That’s like a whole genre of heartbreak made very rare.
So when we have the opportunity to reduce it *even further* with a vaccine, you take it. You don’t say “eh that’s not that many.”
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These problems cause disability, which is a robust indicator of unhappiness.
Princeton Economists Anne Case and Angus Deaton put it simply: “Not being able to spend time with friends, go out for a meal, go to a ballgame, or just hang out all shrink and impoverish lives.” (29)
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This article by Tracey Hoeg and Leslie Bienen has a number of issues, some of which are quite overt.
Since I work in vaccine advocacy and have been promoting pediatric COVID vaccination for a while, I wanted to write a quick response.
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Every year, 1-2 million children get hepatitis B due to lack of a vaccine and proper care. One in four chronic carriers of HepB get liver cancer.
I am against this. I hope being against vaccine inequity is an easy choice for you too.
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the ‘vaccine scientists fighting neglected diseases’ fandom just grows stronger every time a podcaster insults one
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Those whose only concern is hospitalization and death are missing the big picture.
I am of the belief, one thoroughly grounded in evidence, that epidemic illness is itself worth avoiding.
We will never achieve this goal if we consistently underestimate the disease (45 - END).
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Our incomplete understanding provides the final reason to avoid mild
#COVID
.
4⃣ We don't know the long-term effects of the disease.
One reason people refuse to get
#vaccinated
is because they fear the "long-term effects." It seems no one told them about the virus itself... (34)
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Some people argue that vaccinating kids for COVID is of low value since they're low risk.
I disagree. COVID is not only a significant cause of severe disease in kids, but one of the few where we have a clear & simple way to reduce burden.
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A study in the NEJM which examined health records for 19% of Israel’s entire population found mRNA vaccination did NOT increase rates of heart attack or arrhythmia. This remained true after matching with demographic controls for age, sex & health history.
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We've followed patients with vax myocarditis over-time, and deaths are astronomically rare (close to if not 0 in the US). We also monitor heart attack & arrhythmia as safety outcomes (no signal).
If your study doesn't prove something, you can't just "imagine" it's true.
Finally, is it really that hard to imagine that mRNA COVID-19 vaccines that increase myocarditis in young men by 10x, 20x, or 30x (see Karlstad et al,
JAMA Cardiology, 2022) also increase the risk of cardiac death in that age group?
Of course it's not, and we all know that. 😉
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I disagree with this piece about
@PeterHotez
’s book.
Public health ain’t perfect but Republican leaders are constantly doing things like having RFK Jr. testify in Congress. We can’t excuse that as naive. It’s stuff you can only explain by opposing science for political points.
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The sad fact is that
#LongCovid
is relatively common. The UK government says that one million of their citizens are living with it |
A striking study from Norway also found that 52% of adults 16-30 had issues 6 mo. later | (32)
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Why is this happening to people, even after mild illness? We don't know which means we can't predict who is vulnerable.
Remember:
#COVID19
is unpredictable because it is a NOVEL virus. We cannot just assume it is something the body will naturally and completely overcome. (33)
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What people do is confuse the idea of a virus becoming endemic with it "attenuating."
Attenuation is the idea that a virus naturally becomes less severe over time.
It is a hope, not a scientific axiom. The direction a virus takes depends upon a number of things…
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If you want a simple way to get the benefits of physical activity, taking a long walk is soooooo underrated.
I used to run ultramarathons and I still feel markedly better after walking an hour. Seems like I never hear that from people who talk fitness but it’s very very helpful.
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Mask shaming is so weird—just let people do it. An N95 is effective, and it's not like most of us are doing anything else to blunt transmission.
Life moves smoothly when everyone feels comfortable choosing protective tools and practicing self-care. Let's not make this awkward 🤷♂️
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This stage of COVID has a common feeling.
I use
@Jill
's term ethical loneliness: a sense of isolation that comes from others' failure to recognize injustice you yourself can't help but see.
It's the quiet hurt of losing people preventably and then watching lessons go unlearned.
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Over the past few months, I looked into the issue of COVID mitigation and The Great Barrington Declaration (GBD) thoroughly.
In this series of essays I argue that the GBD wasn't going to work. Buckle up: it's a long-read that covers much of the pandemic.
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Some other helpful facts:
1⃣ Boys are not immune to HPV cancers.
2⃣ Most aren't screened for so 💉 is the best prevention.
3⃣ Giving the vaccine early reduces the # of doses needed (3 > 2).
4⃣ Studies show HPV vaccination does not increase sexual activity (contrary to myths).
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Thanks for reading! Why not get vaccinated today? Find a spot:
Thanks to
@VirusesImmunity
for her inspiring work on
#LongCovid
and
@felicitycallard
for her essay on Mild Covid (in
@somatosphere
).
I help
@Voices4Vaccines
but these are my claims alone.
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The virus has hospitalized over 100,000 kids. 7500 had a severe multisystem inflammatory disorder. Many have sequelae. Upwards of 1000 have died.
Contrast w/ the vaccine which has had ~1000 cases of generally self-limiting myocarditis, virtually non-existent in 5-11 year olds.
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For many people, the answer is that they aren't afraid of mild disease. Yet we come to believe
#COVID
is mild by relying on rhetoric, not science.
Let's do better. Strength comes not in downplaying threats, but in using evidence to avert their impact (44)
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In the past week, two high-profile doctors
@ZDoggMD
(Zubin Damania) and
@DrLeanaWen
have come out hard against California's efforts to regulate misinfo.
As someone who fights misinfo at my job, I wanted to write a response. I'll go over the policy basics if you're unfamiliar. 🧵
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Maybe it will be more heart attacks. Maybe nothing! No one can say for sure.
The point is: if you are concerned about long-term effects, focus on the virus. The mRNA vaccine - which contains only the code for a small portion of said virus - is clearly a better option ⚖️ (40).
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An estimated 12,000 Floridians died preventably by September 2021 for lack of a vaccine. Disproportionately they were from this guy’s base. But he wants you to think doctors are the bad guy.
"These experts like Fauci got it wrong [on COVID],” says Governor
@RonDeSantisFL
.
“So my question is: where is the accountability for these people for all the damage that they did to our country?”
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@DrAseemMalhotra
@crypto_pastuh
They actually can, and it's tragic.
I was very into running long before I found out I had a heart condition. Healthy people can develop them and heart problems are common.
Please spread awareness not rumors.
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I had to go the hospital in Nov 2020 for the first time. In a room maybe 10 feet from my bed I heard a guy coughing up a lung, before eventually one of the doctors said he would probably have to be ventilated and was unlikely to make it.
I remember that clearly, not masked kids.
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I am already disappointed by media coverage of RFK Jr.'s campaign. I've heard about him like 5 separate times, usually with a weak comment about his "controversial views on vaccines."
They're not controversial. They're wrong. And his stunt to give them attention is working well.
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When you get it, you RISK 2 weeks of uncomfortable illness, disability, and potential long-term side effects.
Will these things happen to you? Probably not! Maybe you'll be asymptomatic.
The question is: why would you even take that chance when millions have fallen victim? (43)
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Even if you get a breakthrough infection, the symptoms pass more quickly and are less severe.
You are 1/2 as likely to have a fever, less likely to cough, and will on average spend 60% fewer days in bed |
That all suggests less potential for harm 🛡️ (41)
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Knowing who to trust with your health is hard. But a rule of thumb is to avoid those without accountability for it.
For example, doctors who spent the past 3 months bashing COVID boosters while suggesting no alternative for the coming winter. Their plan for you is:
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Anyone who makes tens of thousands of dollars a month in subscription fees by bashing vaccines online has more of a “conflict of interest” than pretty much any medical professional on earth.
Not even debatable.
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"I followed the rules. COVID is over 😡"
This pandemic isn't a video game. You're not collecting science points that magically unlock the next level.
If you think enough is enough, then own that. But don't pretend like morality starts and ends with what the CDC said months ago.
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For
#COVID19
(new) we have no idea what they might be.
Maybe it will be ⬆️ rates of dementia. We are now finding changes to brain tissue |
Maybe it will be ⬆️ rates of IBS. Viral RNA often shows up in stool 1+ month later | (39)
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What’s worse?
> A pandemic that killed a million ppl
> Shoes not loud anymore 🥺
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We have not done enough research to know the actual prevalence, but this rate appear to be many times higher than from the mRNA vaccine.
It's concerning because viral myocarditis is a cause of sudden death in young athletes and servicemen | (36)
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Take concerns over myocarditis. Myocarditis from the disease is a phenomenon of unknown scale. Surveys have often found high rates.
In one study of 1597 Big Ten athletes, .3% had symptomatic myocarditis after infection and 2.3% had it asymptomatic | (35)
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He continues "But we don't have the data."
This point is 🗝️: to learn about the natural course of a disease, you have to monitor it over time. Effects can occur years later.
We detect them through careful study, and the cumulative operation of multiple reporting systems. (38)
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Favorite artist?? Nah 🚫
Mention your favorite doctor, other HCW, or scientist and see if they respond to you 😁
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I'm young & athletic with a condition that affects my heart. I've received 3 doses of mRNA vaccines in between screenings, and not a single cardiologist across 3 care systems has ever blamed anything on my vax nor said it put me at risk.
#DiedSuddenly
rumors don't scare me ❤️
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For
#COVID19
the significance of myocarditis is unknown. Doctors called it a "gray-zone cardiac finding."
Dr. Eike Nagel, an expert in experimental heart imaging, says we may "see an increased incidence of heart failure in a couple of years" 💔 (37)
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HPV causes 13 million infections each year. It’s asymptomatic and chronic. We can't stop that without a vaccine so it makes no sense to waste resources mass reporting it.
We vaccinate because it causes 34000 cancers every year. Studies already show it's sparing kids that fate.
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The American people also deserve to know that an estimated 16,000 Floridians lost their lives because they didn’t get a vaccine. Not because they got too many.
CDC & FDA continue to push COVID vaccines that are not backed by clinical evidence, but blind faith alone with ZERO regard for widespread immunity. The American people deserve the truth, but the Biden admin only wants to control your behavior.
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Better to protect yourself now than wait. The delta variant has been a global game-changer. We know it is MUCH more infectious, shedding 1000x viral particles.
Some data published in the Lancet also suggest it doubles hospitalization rates 🏥 | (42)
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This is a “meta-analysis” whose conclusion relies on two studies, one of which was anonymously authored, not peer reviewed, and directly edited by a Fox News regular to downplay the benefits of vaccination. Not useful.
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Marty Makary spread severe misinformation and refuses to own up to it.
On Saturday, Makary made several tweets alleging the CDC had lowered speech milestones to hide the harms of masks.
He was corrected within an hour by many people but went on Fox THE NEXT DAY to double down.
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