More evidence BA.4 and BA.5 and now BA.2.12.1, (which is highly prevalent in NY) escape antibodies generated by infection with BA.1, increasing likelihood of reinfection, and may also have more immune evasion to current vaccines than BA.2 biorxiv.org/content/10.110 h/t
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Bob Wachter
@Bob_Wachter
Chair, UCSF Dept of Medicine. Career: What happens when a poli sci major becomes an academic physician. Author: "The Digital Doctor". Hubby/Dad/Golfer.
Bob Wachter’s Tweets
High-quality masks (N95, KN95) are important to reduce the the risk of infection and transmission by the Omicron family variants. But so is the fit.
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The final episode of season 2 is now available.
Klára Dán von Neumann encounters a new home, a new husband and a new project. We discuss her legacy in computing and beyond, plus the current state of gender and programming bit.ly/3s2NhQV 🎧
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I'm very concerned that we are seeing rebound of active, replicating and likely infectious virus occurring frequently after COVID-19 oral treatment
This may call for a 8 or 10 day course of treatment rather than 5 days
Here's what I think is happening and what we should do
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Good, but not 's obit for M. Sendak ("...Wild Things..."): "Roundly praised, intermittently censored and occasionally eaten, [his] books were essential ingredients of childhood for the generation born after 1960...& in turn for their children." nytimes.com/2012/05/09/boo
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I'm teaching at a science writing workshop this week, and we were asked in advance to send in our favorite ledes, and this was mine. Admittedly, not a science lede, but still, hands down, the best ever. twitter.com/jswatz/status/…
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The high protection vs Omicron infections and hospitalizations afforded by Prior Covid, further enhanced with vaccination, and a significant advantage over those w/o infection history. A large observational study from Quebec w/ ~700,000 cases and controls
medrxiv.org/content/10.110
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I'll now do 100% N95 in crowded indoor spaces. I'll strongly favor outdoor to indoor dining, though will eat indoors in small groups (recognizing it's a risk, but it seems worth it).
You should make your own choice, but do it w/ eyes open: there's a lot of Covid out there.(4/4)
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I'd still like to avoid Covid (mostly worried about Long Covid symptoms & long-term risks (heart/neuro/diabetes); also disruption of daily life). I'd slipped a bit re: masking in non-crowded spaces, & gotten less careful re: restaurants. I'm resuming more cautious behavior. (3/4)
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In last mth, SF has become far less mask-y. At this point, if you've decided you're OK getting Covid (which isn't crazy if vaxxed/boosted), then fine to keep mask off in crowded indoor spaces. If you'd prefer to avoid Covid & have become less cautious, it's time to re-think.(2/4)
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Covid case numbers less reliable than before (home testing, fewer test sites). Our asymptomatic test pos rate (ATPR) remains a good proxy for community prevalence.
Bad news: in last few weeks, ATPR is⬆3-fold, now 3.4%. Implies ~1/30 asymptomatic folks in SF are pos. (1/4)
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We had hope that Paxlovid could be used for preventing Covid, beyond treating it. Sadly, that was a bust in a randomized, placebo-controlled trial of ~3,000 participants who had household exposure
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We have Sid Caesar's brilliance on tap today for our "Smile for a Saturday feature" in our Steady newsletter. Thank you for reminding us about this comedic gem of a sketch.
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Clinicians/#MedEd folks: if you've never seen 's Dhaliwal work through a complex unknown case, this'll be a treat. For our grand rounds yest., we presented a case of rapid deterioration in a pt w/ history of Sjogrens. Masterful.
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I disagree.
Affectionately,
Newman
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For us dog lovers
When a widely held belief is refuted by data
The lack of correlation of behavior and personality by breed
science.org/doi/10.1126/sc
@ScienceMagazine
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We're proud to announce the spinoff of BeeKeeperAI, leading the way in zero-trust, confidential computing & privacy preserving analytics to train, validate & deploy healthcare AI. Congrats to & the founding team!
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You may have heard that Congress is considering funding for COVID
It's actually a pretty simple question in front of them
Do we continue to fight COVID or do we give up?
Let's talk about what happens if Congress decides to give up
It's not pretty
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After vaccination, T cells directed to the #SARSCoV2 spike are broader than after infection, lending further support for the need for vaccination post-Covid
nature.com/articles/s4156
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1/ Starting NOW - #UCSFMGR w/ amazing Clinical Problem Solving by Dr , case prepared by Dr , presented by Dr , & mystery discussant to come shortly. Join us live in HSW-300 or virtually on Zoom now! Pearls frm the Master Clinician:
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Another great pre-pub review of my wife 's novel, "The Boys" .
"There's a lot to love in this book... filled with clever invention & loopy charm...and a growing pile of unanswered questions that will keep you flying through it..."
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Young epi researchers should study work of Don Redelmeier – who asks/answers key ?'s w/ offbeat & wildly creative methods ('s NYT profile: nytimes.com/2010/08/31/sci).
Don's new study: Oscar winners live 4 years longer than co-stars:
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I'm thrilled that researcher, filmmaker & public health leader will be new chief of our Division of Prevention Science . Jesus has had an amazing career & life, and he'll be an inspiring addition to DOM & . Full announcement:
medicine.ucsf.edu/chairs-corner/
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New thought piece from on opportunities to use #EHR data to ⬇�malpractice risk and ⬆�patient safety. Support from .
Read more:
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Wonderful @UCSFDOM small group multidisciplinary dinner tonight to reconnect with our amazing colleagues! Peninsula professors, sunshine and baklava. @AaronNeinstein @SuneilKoliwad @AparajitaSingh @JonathanDavisHF @NiharikaDixit16 @Bob_Wachter
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Write what you know?
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Nearly 60% of Americans and ~75% of children have been infected by Omicron, as indicated by antibody testing
cdc.gov/mmwr/volumes/7
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In the first 10 months they were available, #COVID vaccines prevented ~1.5 million infections, ~73K hospitalizations & nearly 20K deaths in CA, a / study found. “The impacts that vaccines have had... are dramatic,� says.
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We're now moving to the BA.2.12.1 wave as it has increased to 29% of new cases and will quickly out-compete BA.2 with its heightened infectiousness
covid.cdc.gov/covid-data-tra today's weekly genomic surveillance update
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Low dose aspirin for prevention of cardiovascular disease gets a major downgrade
jamanetwork.com/journals/jama/
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“If (Musk) thinks it can exist without extensive content moderation, he is in for a shock.… A platform that refuses to dirty its hands by taking down content will soon become flooded with scammers, porn, terrorist recruiters….�
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Last 10 min is a chat about interoperability, with a focus on & other companies trying to move us into the post-EHR era. (And why the digital giants – , , , – have struggled so much in healthcare.)
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Nice chatting about digital transformation with , director of . We talked about virtual health, telemedicine, value-based care, health equity, my career path, and a little bit about Covid.
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"These results highlight the importance of
booster vaccine doses for protection against all Omicron [BA.1 and BA.2] variants, and provide insight into the [lack of] immunity from natural infection against Omicron sub-lineages."
cell.com/cell-host-micr 🆕
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Need a laugh? I'm reading Mel Brooks' autobiography & he mentioned a skit he wrote for Sid Caesar's "Your Show of Shows" – MB called it the funniest in TV history. Per Brooks: much of it was improv by Caesar.
Can see seeds of Python, SNL, Blazing Saddles.
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Months ago, Paxlovid was scarce
With lots of work, this is no longer the case
Over the next week, you'll hear a lot more about what the Biden Administration is doing to make Pax widely available and easily accessible to all Americans
What are we working on?
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Biden's team is planning an event next week to announce that Pfizer's Covid pill is, finally, abundant - that doctors should prescribe it more and more people can seek it out.
(How long the supply will last without new funding from Congress is unclear.)
bloomberg.com/news/articles/
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"... from researchers at UC San Francisco in collaboration with the California Department of Public Health draws the clearest picture to date on what the state might have looked like had the vaccines never materialized."
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Our project of snatching female scientists from the jaws of historical oblivion is a proud grantee. #WomenInSTEM moore.org/grantees
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THREAD on Covid in England over last 2 yrs:
ONS just released esimates of % people infected since end Apr 2020 to Feb 2022.
A huge *70%* of people in England - *not* including the 1st wave or recent BA.2 wave!
50% infected since last summer.
What are the consequences? 1/7
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