Critical Care & Infectious Disease physician at @UVA. I mostly tweet about health topics and #COVID19. Tweets = me. Pronounced "TY-son"
Charlottesville, VA
- Tweets 10,385
- Following 941
- Followers 14,775
- Likes 16,221
Pinned Tweet
Today I had the incredible honor of delivering the keynote address for the #UVA22 graduating class.
My speech centered on how the physiology I teach in the @uvahealthnews Medical ICU relates to life’s journey.
The speech is available here👇🏾
1/ news.virginia.edu/content/fi…
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After 9 years, I still can’t bring myself to spread my son’s ashes.
Don’t ever downplay children dying.
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We just paused an entire vaccine rollout because of a complication with a risk of 1 in 1 million.
For Black men, the lifetime risk of being killed by police is 1 in 1000.
Where is our pause? pnas.org/content/116/34/1679…
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Homes are arranged in a way that assumes the child living there will be back.
When my 1st was stillborn, my wife and I didn’t rearrange. We just shut the door for a year.
These parents have dirty laundry hampers, toothbrushes, and half-empty boxes of cereal. It’s heartbreaking.
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Conversation with a community hospital ICU:
Me: Wait, so your entire census is COVID-19 patients?
ICU: yes
Me: and they're all unvaccinated?
ICU: 100%
*Silence*
Me: How's your staffing tonight?
ICU: Don't ask
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My wife's grandmother just left the ER diagnosed with COVID. She's in her 90s & ok-ish health but immunosuppressed.
Slam dunk for Paxlovid, right?
She was told by two separate providers that her kidney and liver function didn't support its use.
Their advice was wrong.
🧵1/3
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One day I was on a @zoom_us meeting and my son came in to ask for Tylenol for an achy tooth. I muttered the common “Sorry everyone...” before I got up to help him.
He later asked me, “Dad, did I do something wrong?”
It’s the last time I’ll ever apologize for openly parenting.
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When it comes to keeping my young kids safe w/ the #DeltaVariant circulating my wife and I live by three rules:
1) As soon as they're eligible, they're getting vaxed
2) If an adult will be in close contact w/ them, they need to be vaxed
3) If they are indoors, they will be masked
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I’ll be receiving the #CovidVaccine later this afternoon. It’s a day mixed with emotions but I’m happy this day has come. Let’s spread the word, get people vaccinated, and turn the tide on this pandemic!
#RightToBareArms 💪🏾
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I’ve debated all day whether to post this, but the world deserves to know that 9 years ago to this day my first child, Julian, was stillborn. While @k_scottbell and I knew him through his kicks and tumbles, he was born at full term and never took a breath. We don’t know why.
🧵
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A friend reached out b/c his daughter was flying in but learned en route she had an exposure.
He needed to find a rapid test. Called 8 places. Zero.
I give him one of mine. Comes back (+). Luckily she feels ok.
We’re over 1.5 years in. WHY is getting a test still an issue?
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The texts and DMs I'm getting from friends, colleagues, and family who either tested positive for COVID or had exposures is at an unreal level over the past few days.
It feels different this time.
Stay safe y'all.
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Conversation w/ a URM med student:
Me: How do I pronounce your name?
Student: I tell people “___”
Me: But how do you pronounce your name?
Student: Either “___” or “___”
Me: Ok…how would your mama pronounce your name if she were here?
MS: she would say “___” but…
Me: no buts
😤
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I don’t want Charlottesville and UVA trending again.
I don’t want the emergency alerts again.
I don’t want texts from friends and family checking to see if I’m ok again.
I don’t want to go to healing gatherings again.
I just want things to be…and STAY normal here.
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Her kidney function was mildly impaired, but not even at the level where you need to dose-adjust. Her liver function was completely normal!
This is exactly the kind of person you definitely want to get Pax. And she was denied.
We called her PCP and they're sending it now.
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Reflections from another ICU week:
- Seeing multiple family members admitted or have died from COVID. They’re unvaxed
- Admitting family members of staff (again). Also unvaxed
- Staffing is stretched beyond thin. Same story across the country
- Y’all, Omicron/Delta is crushing us
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I'm sharing because I wonder how many other elderly patients and their families are being told similar things about Pax.
It's true that you need to be careful with it, but that's not a reason to shy away from a very effective COVID treatment.😡
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I saw this 🙁 graphic on @dr_kkjetelina's substack. People age 80 and up are contributing to a growing proportion of patients dying from COVID-19.
But they are LESS likely to receive Paxlovid than those aged 50-64. We have to fix this now.
Source: bit.ly/3At1CKD
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*answering a page*
Me: Hi, it’s Taison from Hospital Epi. What’s up?
Nurse: Hi, I have a patient who tested negative for COVID 5 days ago but now has…
My 3-yr old: SHE NEEDS A COOOVID TEST!
🤣🤣🤣
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The @NICKIMINAJ tweets are a good chance to talk abt how good VAERS is. Let’s do the math if orchitis (ball swelling) happened in 0.5%:
- 179M adults vaxed
- 1/2 biological men
That’s ~447k men, and:
- assume 1.9 balls/man
850k swollen balls
Trust. We would have heard abt that
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Promoted! Now I associate in the professing.
Knew about this for a while but no way I was sharing until I called HR today to CONFIRM the title change 😂
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Black children have experienced higher rates of severe COVID.
Not surprisingly, I’ve yet to speak with a Black parent who supports ending masks in schools.
Ironic that the clamor to end masking is happening during a month designed to amplify Black voices.
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I had a patient w/ dangerously low oxygen levels all day.
We tried everything. Nothing worked. The nurse came out the room. Mask marks on her face. Sweat stains visible through her scrubs.
We looked at each other, dejected. I just said, “you’re doing a good job.”
I hate COVID
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We need a timeline of what happened and full explanation for why State Police came onto UVA Grounds to tear gas and arrest members of our community.
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Academic institutions should begin publishing data on Black faculty recruitment, retention, promotion/tenure, and salary levels compared to their White peers. We’re done with #BLM statements and hashtags. We want metrics & accountability.
#BlackintheIvory massivesci.com/notes/black-i…
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It’s my birthday today. 39 years. I don’t feel older but this is my 3rd one with this virus circulating.
My bday wish:
- If you’re not vaxed, #GetVaccinated 💉
- If you’re not boosted, #GetBoosted 🚀
- If you’ve done both, talk to someone who hasn’t.
Do it today. Show proof
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I just received the #CovidVaccine! Only felt a slight pinch when it went in. Arm is slightly sore but less so than the #FluVaccine from this year. I got card from @CDCgov and am signing up for the V-Safe monitoring system. Time to roll up more sleeves!
#RightToBareArms 💪🏾 💉
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I read the ruling and it's shocking.
The judge determined that masks do not count as "sanitation" by choosing one specific version of a definition they gathered from early-mid 20th century dictionaries.
Can't make this stuff up.
cnn.com/2022/04/18/politics/…
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AM Rounds
Resident: He’s been sick about a week. Started using BIPAP at home but didn’t improve.
Me: Wait, he has BIPAP? I thought you said he was healthy…
Res: Used his wife’s machine. She died of COVID last month.
Me: Was she unvaxed too?
*Silent nod yes*
Someone: Sh*t.
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The @CDCgov should update its guidance to advise universal masking in areas with low vax rates & surging cases.
Many local officials are already fighting an uphill battle against anti-science governors & constituents.
They don’t need to fight against the federal gov’t as well.
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Post Day 1 update: Only a little arm soreness and very mild swelling in the Rt arm. Otherwise feeing fine. No fevers, chills, or HA. I’ll keep you posted if anything else develops. Feel free to drop Qs in the comments!
#CovidVaccine
#RightToBareArms 💪🏾 💉
#BlackMenInMedicine ✊🏾
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Dose number 2 of the @pfizer #CovidVaccine is today. Side effects are more likely after this dose (it’s a good thing!) so I’ll keep you posted. Our focus needs to be fixing manufacturing/distribution issues and to making equitable distribution a priority.
#RightToBareArms 💪🏾💉
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A childhood friend just reached out to me. He was in line for the vaccine and starting to get nervous.
I think I got the message across 🙂
All the outreach we do is worthwhile. But it’s even more special when it’s to your own.
#GetVaccinated
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I asked a cafeteria worker for the fifty-leventh time if she was getting the #CovidVaccine. She always says “no” with a smile.
She finally said “yes!” B/c of a policy to test non-vaxed employees weekly it’s now more convenient for her to be vaxed.
She said it with a smile 😊
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I’m so impressed with the amount of data coming out of #SouthAfrica on the #Omicron variant. I expected high quality but the transparency and deep level analysis is next level.
Also, end the travel ban.
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I had a Black dentist in my neighborhood who started calling me “Dr. Bell” from age 6 when I told him my dream of becoming a physician. I asked him later why he did that. He said he wanted to speak it into existence. ❤️ 💪🏾
I grew up with Black physicians, like my mother, who cared for patients in the same Brooklyn neighborhoods where they were raised. My pediatrician was Black. Up until high school, I thought most physicians were Black, then found out that they were only 4% of all U.S. physicians.
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Had a person in the #MICU whose delirium improved once we started playing John Coltrane & Miles Davis. Turns out he’s a big jazz fan.
This is why social history is so important. “The patient” is not the same as human being in front of you. You have to know both to be effective.
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As an intern I thought that being a good physician meant you had to be the smartest person in the room. I later learned that it was more about how you use the expertise of the smart people around you to get the best outcome for the patient. Good luck interns! #MedTwitter 🧵
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Since cardiac arrest is a discussion point right now, let’s re-up this tweet showing Black and Hispanic folks are less likely to receive CPR in public — a potentially life saving skill that we need to expand.
NEW in @NEJM.
“Black and Hispanic persons were ⬇️ likely to receive bystander CPR at home (38.5%) than White persons (47.4%) and ⬇️ likely to receive bystander CPR in public locations than White persons (45.6% vs. 60.0%).“
This is a devastating finding.
nejm.org/doi/full/10.1056/NE…
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I start infectious disease consults tomorrow, which always reminds me of the time I switched from MICU attending right to ID attending. I came to the MICU for a consult, reviewed the chart, and wondered "what in the hell were they thinking?"
The attending the day before was me!
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While a lot of us initially focused on ventilator shortages, the most scarce resources right now are trained ICU nurses.
I’m recieving transfer requests due to RN shortage (beds are empty, but there’s nobody available to care for the patients). loss of bedside nurses (2/2 low pay & burnout) is a medical emergency 🚨
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“At the end of they day, our nurses will get the job done. They work harder, stay longer, and come in on their days off. But they’re suffering from a corrosive moral injury. They can’t do all the things they know they should be doing.”
- Colleague at another community hospital
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The oxygen levels were too low
We came in
We talked about how he liked to play guitar
He never got vaccinated
Thought all this was overblown
“Doc, I don’t want to die”
“Sir, we’ll try as hard as we can”
Breathing tube goes in. No problem
We succeeded
But we’ve also failed
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Julian was named after the civil rights icon Julian Bond. In honor of their legacies, my hope is to ignite your energy towards protecting children both here and abroad from illness, violence, and poverty—especially those in disadvantaged communities. We need action now. 🙏🏾❤️👶🏾 🌈
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I intubated a patient with #COVID19 & called his wife to give an update.
She was coughing and short of breath. She couldn’t complete full sentences. The regret was palpable:
“Why him and not me?”
“I wish we had gotten the vaccine.”
“Will he be ok?…Will I?”
#GetVaccinated
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I stood with the ultrasound over his heart. Watching it quiver, struggling to keep up.
I thought, “What else can I do?” We tried everything. Everything wasn’t enough.
His nurse took his hand. I took the other.
We told him it would be ok to rest
Please. Just #GetVaccinated
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My 2 year-old daughter usually doesn’t get out of bed once we put her down. But tonight she wandered down while @KamalaHarris was speaking. I held her in my lap and taught her how to say “Kamala.” Now I’m rocking her back to sleep telling her she can be anything.
#BidenHarris2020
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📍Looks like I will be receiving the @pfizer #COVID19Vaccine. Earliest date I can receive it is Dec 15th. Calendar date is in 🗓. I’ll keep tabs on any side effects I have and share with the community. Drop any q’s you have in the comments.
#RightToBareArms 💪🏾
#ScienceMatters
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Happy Inauguration! If you swooned over @MichelleObama and @KamalaHarris and are now a fanboy/fangirl of @TheAmandaGorman, carry that forward and ask out loud where the Black women are in your leadership circles.
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I was honest with my son and told him about all the pain our community is experiencing this year. Now, after all that has happened, how do I tell him that his superhero has died?
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The anti-vaccine rhetoric is kicking up this week so posting this powerful table that shows just how successful vaccines have been in nearly eradicating several diseases that affected so many adults and children.
Source: sciencenews.org/article/epid…
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I also added a tie! 👍🏾
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I’m getting more worried about the elderly & immunocompromised patients as the #DeltaVariant spreads. Some concerning stats:
- 75% of patients hospitalized with breakthrough infections are 65 & older
- 44% are immunocompromised despite making up only 2.7% of the population.
🧵
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After finishing up a week in the medical ICU I have three takeaways:
1) #COVID19 really has become serious just for the unvaccinated.
2) #HealthCareWorkers are at the end of their rope. It’s been a long year and a half.
3) My colleagues are truly amazing people.
#GetVaccinated
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Cases from the #DeltaVariant are increasing in every state. So should you start wearing a mask indoors again if you're fully vaccinated? I have, and for most people I think the answer is yes. But this is especially true for folks who live in areas with low vaccination rates. 🧵
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So when I speak about my concern for unvaccinated children or child mortality in general, I’m coming from a space of knowing what it’s like to say goodbye to a child who died of something that “doesn’t really happen.” You can’t stop blaming yourself. You feel like a failure.
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I’ve noticed a change in how my staff respond when they hear about new unvaxed COVID cases.
1st it was disbelief
Then it was outright anger
Next was sadness
Now it’s just acceptance
I thought this was all explained by burnout. But now I realize it’s also the grieving process.
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In Spain bars and restaurants are open and festivals are happening. All without a surge in cases like most other parts of Europe. The difference:
- Nearly 90% vax rate in those 12 and older
- Indoor mask requirements
Prevention works.
news.yahoo.com/why-spain-has… via @YahooNews
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I can’t believe I just recorded a segment to fact check a physician who advised using hydrogen peroxide nebulizers for #COVID19. 2+ years in, y’all.
This is dangerous. It doesn’t work. And it’s dangerous and it doesn’t work.
Say no to quacks pushing lies.
Get a vaccine!
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Well this is quite exactly the wrong thing to do going into fall/winter.
nbcnews.com/politics/politic…
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🚨Pub Alert!🚨
Fitting that my first @NEJM piece is #ForTheCulture ✊🏾
The Path Forward — An Antiracist Approach to Academic Medicine. @nworahayogu nejm.org/doi/full/10.1056/NE…
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Irresponsible. Dangerous. False. Uninformed. Ignorant. Foolish. Anti-science. Absurd. Disgusting. Shameful. Infuriating.
Sadly, not surprising.
Bob Good can come to our ICU and see what “phony” actually looks like. All I’ll need for him is a mirror.
SHAMEFUL: “This is a phony pandemic."
Folks—this is the newly elected quack congressman Bob Good @GoodForCongress of Virginia.
Virginia is better than this conspiracy peddler. @bluevirginia #COVID19
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Happy Birthday to our 1st born, Julian. He would have been 11 today. Probably close to as tall as his mom & begging us for a cell phone.
We’re forever grateful to the L&D nurse who encouraged us to name him & keep his memory/presence with us. Here’s one of my favorite pics. 🖤
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After writing papers at 3AM in the hospital, taking exams w/ children climbing on me, and pausing for a pandemic, I’m finally graduating! Many thanks to my wife, my colleagues, my professors, & my classmates. This one really took a village 🙂
#MDMBA
#PandemicScholar
#WhyDarden
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I’m grateful for Virginia Family Therapy sharing this guide on talking about the UVA shooting with children.
School is cancelled and kids in the community will find out one way or another.
@k_scottbell and I are trying to figure out how to do this now.
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Because of this my living children have toys and books of his that they are “borrowing.” They say his name in their prayers every night. On his birthday we sing and eat cupcakes. They tell their friends and teachers about him. He has always been very much alive in our household.
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New intern: I haven't gotten any pages. Is everything ok?
Supervising resident: ...well we only have three patients and they're ok...
Intern: Ok, I just wanted to make sure something wasn't wrong.
Nobody:
Resident: Do you...want me to page you?
💀
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The Little: Daddy, I can’t sleep.
Me: You can do it. You have to believe in yourself.
Little: Why?
Me: Because you’ve slept every night of your life.
Little: Oh. *goes back into room*
*comes back out*
Little: But you don’t sleep every night. Do you believe in yourself??
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Imagine it’s #NewYearsEve 2019. You’re hearing whispers of a new virus circulating & someone is describing to you what the next two years up to NYE 2021 will look like.
Do you think you could do it?
Well, you’re here. And you are doing it.
Don’t be so hard on yourself in 2022.
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📌 Match day pro tip: Best advice I received on match day was to keep in contact with a classmate going into derm so you can txt them pictures of rashes later in life.
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I don’t want other parents to know this feeling. We need to work as hard as we can to make sure kids live long and healthy lives. Too many children suffer because of our actions and inactions at the policy level. Our children deserve better. This needs to end.
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My family went on the record with @KatherineJWu to discuss their thoughts about me receiving the #CovidVaccine. It was also touching to read about friends like @KrutikaKuppalli and two fantastic NPs I work with at @uvahealthnews
#RightToBareArms 💪🏾 💉
nytimes.com/2020/12/26/healt…
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Dr. @EbonyJHilton_MD has received the very first #CovidVaccine at @uvahealthnews!
#RightToBareArms 💪🏾
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Dose 2 is in! Just some mild arm soreness that will probably be worse tomorrow. I’ll check in tomorrow to give an update.
h/t: @gradydoctor for the T-shirt idea
#RightToBareArms 💪🏾 💉
#ShotOfHope
#BlackMenInMedicine
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The sense that you can’t disconnect from work is a major source of burnout in academic medicine.
In the @UvaDOM we’re rolling out a new email guideline for faculty and staff to help alleviate this.
I don’t expect it to be perfect, but it’s worse to not try something.
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It’s been a busy summer but it was nice to take a small break to sing happy birthday to Julian.
He would have turned 10 today. I hope he would have liked Rice Krispy treat cake 🙂
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For a person hospitalized with #COVID it takes on average:
- 6 days from initial infection to symptom onset
- up to 7 days from symptom onset to hospitalization
So if hospitalizations are ticking up, you could already be two weeks behind on getting control. This👇🏾is bad
Here are six states with rapidly growing cases. We continue to wish Florida reported hospitalizations.
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As a parent, I don't give a damn about when full approval is coming for young children. Let's get that EUA ASAP!
Approval for COVID vaccine for kids 5-11 years-old unlikely before end of 2021, @NIHDirector Francis Collins tells @NPRinskeep on @MorningEdition. Data for it still not submitted to @US_FDA
Community note
This is a bit misleading. Collins actually said he DOES expect approval for kids 5-11 by end of this year: "Realistically, I don't think we're going to see approval for kids under 12 until late in 2021."
ny1.com/nyc/all-boroug
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After looking over the @CDCgov slide set released by @washingtonpost, this slide really sets the stage. We are dealing with a strain that is in a class of its own now. It’s one of the most transmissible respiratory viruses we have ever seen…in history. 🧵
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Can I say something out loud? It’s appropriate & normal to have questions or reservations abt something being injected into your body. Most people do not jump for new things. So let’s stop ridiculing folks who have concerns abt the #CovidVaccine & focus on addressing them.
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While it's true that children tend to do better than adults and cases are relatively low in my region, they are rising and Delta is essentially a different virus. It's more easily spread and is affecting young people. These rules are simple to follow and are proven to work,
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I want to be clear that my hospital is fortunate to not be in a crisis care situation like some other places. But, like at other hospitals, the combo of lower staffing and higher volumes means it’s harder to deliver care—both COVID and non-COVID.
There’s nothing mild about this.
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Congratulations to my cousin, the newly minted Dr. @Mad_R_Wil, who graduated from @UChiPritzker School of Medicine today! She’ll soon begin #InternalMedicine residency at @UCSF. I’m feeling all the feels 😊
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One year ago today I received my first dose of the Pfizer vax with @EbonyJHilton_MD.
The year flew by at the same time the days and nights were long.
Grateful for the friendships I’ve strengthened, started, or renewed. Sad for all the lives lost.
Let’s keep fighting
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"There is no room for players who are willing to risk the health and lives of their teammates, the staff and the fans simply because they are unable to grasp the seriousness of the situation or do the necessary research."
- @kaj33 cnn.com/2021/09/27/us/kareem…
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Happy New Year from the @uvahealthnews Medical ICU!
In this picture:
- 5 doctors
- 34 years of medical training
- 7 languages spoken
The team is phenomenal. But please enjoy from afar.
Make sure to #MaskUp😷, #GetVaccinated💉and #GetBoosted 🚀
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It’s truly a desperate situation when hospitals in #Florida, #Texas, and #Alabama are calling our ICU in central #Virginia to transfer patients.
We have to do better. #HealthCareWorkers don’t have much left in the tank.
#MaskUp
#GetVaccinated
"It's sad. It's infuriainfuriating. We began the ramp up for Covid-19 thinking this race was going to be a sprint, it's now turned into a marathon. Many people have tapped out," @TaisonBell shares frustration as demands on ICU & healthcare workers mount @CNN #NewDayWeekend
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During intern year I shadowed the hospital CEO & noticed how he would stop to pick trash off the floor. Every single time. It was a small gesture of respect for the people around you & the work they do—seen or unseen. It’s one of the best leadership lessons I’ve ever received.
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Great article from @KatherineJWu on why she’s going to #MaskUp again:
1) I don’t want to get #COVID19
2) I don’t want people around me to get COVID-19
3) I trust the vaccines but they have limitations
4) Wearing a mask is not a big deal theatlantic.com/health/archi…
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Sadly, I’m getting recruiting emails for infectious disease and critical care work from Florida hospital recruiters. Start date: immediately
Credentialing: emergency privilege
Housing: provided
Schedule: anything you can do.
So sad to see these (again).
#MaskUp
#GetVaccinated
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Evidence of the shorter incubation period with #Omicron means that those infected are contagious sooner than with earlier variants. This makes it both spread faster + harder to detect before it's too late.
Good explainer from @KatherineJWu: theatlantic.com/science/arch…
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Today we discharged one of our #COVID19 patients, who had been with us for weeks, to a rehab facility.
We lined up in the hallway & clapped as they wheeled out.
As I walked back to rounds, I noticed 3 of my staff were literally in tears with happiness.
This is why we do this.
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