{"id":1232400575893057500,"conversation_id":"1232400575893057541","created_at":1582662168000,"date":"2020-02-25","time":"20:22:48","timezone":"UTC","user_id":21184460,"username":"billhanage","name":"Bill Hanage","place":"","tweet":"Had a great day which started out talking drug resistance at the Israeli Society for Infectious Diseases, and ended up discussing how to achieve effective #COVID19 response and isolation. Really really valuable and informative. I hope my contribution helped","mentions":[],"urls":[],"photos":[],"replies_count":0,"retweets_count":0,"likes_count":11,"hashtags":["#covid19"],"cashtags":[],"link":"https://twitter.com/BillHanage/status/1232400575893057541","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"21184460","username":"BillHanage"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1231743431057268700,"conversation_id":"1231743431057268738","created_at":1582505493000,"date":"2020-02-24","time":"00:51:33","timezone":"UTC","user_id":21184460,"username":"billhanage","name":"Bill Hanage","place":"","tweet":"Here’s a question: do #COVID19 cases outside China reflect export prior to movement restrictions that has been growing undetected? Or further introductions *since* restrictions were imposed? One of the Iran cases reported travel from China via other countries","mentions":[],"urls":[],"photos":[],"replies_count":2,"retweets_count":0,"likes_count":5,"hashtags":["#covid19"],"cashtags":[],"link":"https://twitter.com/BillHanage/status/1231743431057268738","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"21184460","username":"BillHanage"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1231652831532327000,"conversation_id":"1231652520444952578","created_at":1582483892000,"date":"2020-02-23","time":"18:51:32","timezone":"UTC","user_id":21184460,"username":"billhanage","name":"Bill Hanage","place":"","tweet":"It’s already influenced my grammar (last tweet should have contained ‘its’)","mentions":[],"urls":[],"photos":[],"replies_count":2,"retweets_count":0,"likes_count":3,"hashtags":[],"cashtags":[],"link":"https://twitter.com/BillHanage/status/1231652831532326912","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"21184460","username":"BillHanage"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1228539379532079000,"conversation_id":"1228539379532079104","created_at":1581741587000,"date":"2020-02-15","time":"04:39:47","timezone":"UTC","user_id":21184460,"username":"billhanage","name":"Bill Hanage","place":"","tweet":"For all who read that  - you should know that it was written with two very insistent house rabbits on the couch next to me, who now want attention.","mentions":[],"urls":[],"photos":[],"replies_count":1,"retweets_count":0,"likes_count":6,"hashtags":[],"cashtags":[],"link":"https://twitter.com/BillHanage/status/1228539379532079104","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"21184460","username":"BillHanage"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1228539057975758800,"conversation_id":"1228535420016844800","created_at":1581741511000,"date":"2020-02-15","time":"04:38:31","timezone":"UTC","user_id":21184460,"username":"billhanage","name":"Bill Hanage","place":"","tweet":"5)Finally, what is happening in the transmission chains we are *not* observing. Our data tend towards detecting superspreading clusters, the severe cases and places with good surveillance. What is happening where we are not shining the flashlight? 8/fin","mentions":[],"urls":[],"photos":[],"replies_count":4,"retweets_count":6,"likes_count":35,"hashtags":[],"cashtags":[],"link":"https://twitter.com/BillHanage/status/1228539057975758848","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"21184460","username":"BillHanage"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1228538190870515700,"conversation_id":"1228535420016844800","created_at":1581741304000,"date":"2020-02-15","time":"04:35:04","timezone":"UTC","user_id":21184460,"username":"billhanage","name":"Bill Hanage","place":"","tweet":"4)What has happened in China? Have the extraordinary restrictions on movement been helpful? or will transmission reemerge as folks go back to work? Hard to know without good data, but shifting reporting standards make it very difficult to interpret those trends 7/x","mentions":[],"urls":[],"photos":[],"replies_count":2,"retweets_count":1,"likes_count":26,"hashtags":[],"cashtags":[],"link":"https://twitter.com/BillHanage/status/1228538190870515712","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"21184460","username":"BillHanage"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1228537577600360400,"conversation_id":"1228535420016844800","created_at":1581741158000,"date":"2020-02-15","time":"04:32:38","timezone":"UTC","user_id":21184460,"username":"billhanage","name":"Bill Hanage","place":"","tweet":"I shouldn't need to point this out but this matters *hugely*. If a large number of people become infected, the difference between even 1% mortality and 3% is a lot. Also effects burdens on health care systems 6/x","mentions":[],"urls":[],"photos":[],"replies_count":2,"retweets_count":2,"likes_count":38,"hashtags":[],"cashtags":[],"link":"https://twitter.com/BillHanage/status/1228537577600360449","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"21184460","username":"BillHanage"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1228537243415044000,"conversation_id":"1228535420016844800","created_at":1581741078000,"date":"2020-02-15","time":"04:31:18","timezone":"UTC","user_id":21184460,"username":"billhanage","name":"Bill Hanage","place":"","tweet":"(I note that study of outbreaks on cruise ships may be helpful in defining at least the outlines of this, albeit in a situation about as far removed from what has been going on in Wuhan as can be imagined) 5/x","mentions":[],"urls":[],"photos":[],"replies_count":3,"retweets_count":2,"likes_count":27,"hashtags":[],"cashtags":[],"link":"https://twitter.com/BillHanage/status/1228537243415044096","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"21184460","username":"BillHanage"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1228536857849483300,"conversation_id":"1228535420016844800","created_at":1581740986000,"date":"2020-02-15","time":"04:29:46","timezone":"UTC","user_id":21184460,"username":"billhanage","name":"Bill Hanage","place":"","tweet":"3) The true mortality rate? At present we have a huge bias towards more severe infections – which is understandable given that they are easier to spot and the focus is on them. This means we miss milder infections and overestimate severity. 4/x","mentions":[],"urls":[],"photos":[],"replies_count":4,"retweets_count":2,"likes_count":34,"hashtags":[],"cashtags":[],"link":"https://twitter.com/BillHanage/status/1228536857849483269","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"21184460","username":"BillHanage"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1228536407389606000,"conversation_id":"1228535420016844800","created_at":1581740879000,"date":"2020-02-15","time":"04:27:59","timezone":"UTC","user_id":21184460,"username":"billhanage","name":"Bill Hanage","place":"","tweet":"2)What proportion of exported cases are detected? If your case definition includes ‘contact with a known case’, that's 1 missed infection away from losing the thread entirely. Singapore has transmission chains that can't be traced to the source, which bodes ill for elsewhere 3/x","mentions":[],"urls":[],"photos":[],"replies_count":4,"retweets_count":6,"likes_count":34,"hashtags":[],"cashtags":[],"link":"https://twitter.com/BillHanage/status/1228536407389605888","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"21184460","username":"BillHanage"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1228535980421984300,"conversation_id":"1228535420016844800","created_at":1581740777000,"date":"2020-02-15","time":"04:26:17","timezone":"UTC","user_id":21184460,"username":"billhanage","name":"Bill Hanage","place":"","tweet":"1)How much transmission happens before a person suspects they are infected, and how does this infect transmission dynamics?\n\n(depending on the underlying R0 and the proportion in each category, targeting symptomatic cases might still address the majority of transmission) 2/x","mentions":[],"urls":[],"photos":[],"replies_count":1,"retweets_count":3,"likes_count":26,"hashtags":[],"cashtags":[],"link":"https://twitter.com/BillHanage/status/1228535980421984256","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"21184460","username":"BillHanage"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1228535420016844800,"conversation_id":"1228535420016844800","created_at":1581740643000,"date":"2020-02-15","time":"04:24:03","timezone":"UTC","user_id":21184460,"username":"billhanage","name":"Bill Hanage","place":"","tweet":"Things important to know about #CoVid19, a personal non-exclusive list (I'm sure I will miss things out - my fault entirely and feel free to respond and alert me) 1/x","mentions":[],"urls":[],"photos":[],"replies_count":5,"retweets_count":54,"likes_count":99,"hashtags":["#covid19"],"cashtags":[],"link":"https://twitter.com/BillHanage/status/1228535420016844800","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"21184460","username":"BillHanage"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1226512813432201200,"conversation_id":"1226512813432201216","created_at":1581258416000,"date":"2020-02-09","time":"14:26:56","timezone":"UTC","user_id":21184460,"username":"billhanage","name":"Bill Hanage","place":"","tweet":"Apropos of nothing in particular I had a very vivid dream last night about wombats.","mentions":[],"urls":[],"photos":[],"replies_count":2,"retweets_count":0,"likes_count":3,"hashtags":[],"cashtags":[],"link":"https://twitter.com/BillHanage/status/1226512813432201216","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"21184460","username":"BillHanage"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1225941064038699000,"conversation_id":"1225941064038699008","created_at":1581122101000,"date":"2020-02-08","time":"00:35:01","timezone":"UTC","user_id":21184460,"username":"billhanage","name":"Bill Hanage","place":"","tweet":"Where are the latest #nCoV2019 genome sequences from China? Now is the time we might expect to be able to use them to estimate transmission rates but... tumbleweed","mentions":[],"urls":[],"photos":[],"replies_count":1,"retweets_count":9,"likes_count":17,"hashtags":["#ncov2019"],"cashtags":[],"link":"https://twitter.com/BillHanage/status/1225941064038699008","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"21184460","username":"BillHanage"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1225539258984824800,"conversation_id":"1225539258984824840","created_at":1581026303000,"date":"2020-02-06","time":"21:58:23","timezone":"UTC","user_id":21184460,"username":"billhanage","name":"Bill Hanage","place":"","tweet":"I so hate getting emails on my phone asking me to do something it would take me a moment to do on my laptop but.... I’m on my phone and won’t be able to open my laptop for hours!","mentions":[],"urls":[],"photos":[],"replies_count":0,"retweets_count":0,"likes_count":3,"hashtags":[],"cashtags":[],"link":"https://twitter.com/BillHanage/status/1225539258984824840","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"21184460","username":"BillHanage"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1222715562444382200,"conversation_id":"1222685857372459008","created_at":1580353081000,"date":"2020-01-30","time":"02:58:01","timezone":"UTC","user_id":21184460,"username":"billhanage","name":"Bill Hanage","place":"","tweet":"This is also going to sometimes be shorter and sometimes longer than the average. It’s also similar to (but not exactly the same as) the time between transmission events or time between when people become infectious","mentions":[],"urls":[],"photos":[],"replies_count":1,"retweets_count":0,"likes_count":1,"hashtags":[],"cashtags":[],"link":"https://twitter.com/BillHanage/status/1222715562444382209","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"21184460","username":"BillHanage"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1222533250473701400,"conversation_id":"1222533250473701376","created_at":1580309615000,"date":"2020-01-29","time":"14:53:35","timezone":"UTC","user_id":21184460,"username":"billhanage","name":"Bill Hanage","place":"","tweet":"If you hear reports and see headlines that say the #coronavirus is 'mutating' remember that this is completely expected and doesn't necessarily mean it is adapting or becoming more dangerous.","mentions":[],"urls":[],"photos":[],"replies_count":3,"retweets_count":31,"likes_count":74,"hashtags":["#coronavirus"],"cashtags":[],"link":"https://twitter.com/BillHanage/status/1222533250473701376","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"21184460","username":"BillHanage"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1218254345222815700,"conversation_id":"1218254345222815745","created_at":1579289444000,"date":"2020-01-17","time":"19:30:44","timezone":"UTC","user_id":21184460,"username":"billhanage","name":"Bill Hanage","place":"","tweet":"Not for the first time I’m wishing life had the ability to hit ctrl-z","mentions":[],"urls":[],"photos":[],"replies_count":1,"retweets_count":0,"likes_count":7,"hashtags":[],"cashtags":[],"link":"https://twitter.com/BillHanage/status/1218254345222815745","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"21184460","username":"BillHanage"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1213142758745149400,"conversation_id":"1213142758745149441","created_at":1578070747000,"date":"2020-01-03","time":"16:59:07","timezone":"UTC","user_id":21184460,"username":"billhanage","name":"Bill Hanage","place":"","tweet":"OK. First paper of 2020 officially submitted🤞🏼","mentions":[],"urls":[],"photos":[],"replies_count":3,"retweets_count":0,"likes_count":36,"hashtags":[],"cashtags":[],"link":"https://twitter.com/BillHanage/status/1213142758745149441","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"21184460","username":"BillHanage"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1274181907597516800,"conversation_id":"1274181884591759361","created_at":1592623614000,"date":"2020-06-20","time":"03:26:54","timezone":"UTC","user_id":239210681,"username":"bob_wachter","name":"Bob Wachter","place":"","tweet":"20/ And, unlike in the movies, people don’t wake up after getting off a vent and go out for a beer. As we find effective treatments to prevent vent or shorten course, not only will lives be saved, but can expect fewer pts w/ post-ICU PTSD, cognitive problems, bad lungs, and more.","mentions":[],"urls":[],"photos":[],"replies_count":3,"retweets_count":66,"likes_count":334,"hashtags":[],"cashtags":[],"link":"https://twitter.com/Bob_Wachter/status/1274181907597516805","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"239210681","username":"Bob_Wachter"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1274181906804863000,"conversation_id":"1274181884591759361","created_at":1592623614000,"date":"2020-06-20","time":"03:26:54","timezone":"UTC","user_id":239210681,"username":"bob_wachter","name":"Bob Wachter","place":"","tweet":"19/ If remdesivir cuts mortality by 10-20% and steroids by 30%, perhaps combination will cut it by 35-40% (all educated guesses based on studies). Perhaps that’ll lower mortality for Covid patients needing intubation/vent to ~20%. Still scary, but much better than 3 months ago.","mentions":[],"urls":[],"photos":[],"replies_count":2,"retweets_count":15,"likes_count":139,"hashtags":[],"cashtags":[],"link":"https://twitter.com/Bob_Wachter/status/1274181906804862977","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"239210681","username":"Bob_Wachter"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1274181906007875600,"conversation_id":"1274181884591759361","created_at":1592623614000,"date":"2020-06-20","time":"03:26:54","timezone":"UTC","user_id":239210681,"username":"bob_wachter","name":"Bob Wachter","place":"","tweet":"18/ Studies in Italy and U.S. showed better odds, with mortality rates for intubated patients mostly ~50%. My totally back-of-the-envelope estimates: not being overwhelmed lowers mortality to 40%. Smarter care (proning, anticoagulants when needed) might get you to ~30-35%...","mentions":[],"urls":[],"photos":[],"replies_count":1,"retweets_count":10,"likes_count":98,"hashtags":[],"cashtags":[],"link":"https://twitter.com/Bob_Wachter/status/1274181906007875590","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"239210681","username":"Bob_Wachter"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1274181905215193000,"conversation_id":"1274181884591759361","created_at":1592623614000,"date":"2020-06-20","time":"03:26:54","timezone":"UTC","user_id":239210681,"username":"bob_wachter","name":"Bob Wachter","place":"","tweet":"17/ But the mortality improvements are significant. Some early studies from China cited 80-90% mortality in patients intubated for Covid – so high that there were tentative discussions about whether pts should be automatic DNRs, given such a low benefit and high infectious risk.","mentions":[],"urls":[],"photos":[],"replies_count":1,"retweets_count":8,"likes_count":73,"hashtags":[],"cashtags":[],"link":"https://twitter.com/Bob_Wachter/status/1274181905215193088","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"239210681","username":"Bob_Wachter"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1274181903617147000,"conversation_id":"1274181884591759361","created_at":1592623613000,"date":"2020-06-20","time":"03:26:53","timezone":"UTC","user_id":239210681,"username":"bob_wachter","name":"Bob Wachter","place":"","tweet":"15/ On last point, some of the improvements came before we had proven drug treatments (namely remdesivir & dexamethasone). For example, using prone positioning and diagnosing/treating blood clots has undoubtedly helped. But these therapies (remdes/dex) are likely playing a role.","mentions":[],"urls":[],"photos":[],"replies_count":1,"retweets_count":9,"likes_count":107,"hashtags":[],"cashtags":[],"link":"https://twitter.com/Bob_Wachter/status/1274181903617146887","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"239210681","username":"Bob_Wachter"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1274181902878912500,"conversation_id":"1274181884591759361","created_at":1592623613000,"date":"2020-06-20","time":"03:26:53","timezone":"UTC","user_id":239210681,"username":"bob_wachter","name":"Bob Wachter","place":"","tweet":"14/ ...c) In hard-hit regions, some at-risk people already infected/died; d) early mortality rates came from overwhelmed places (Wuhan, Italy, NYC). Hospitals w/ capacity may do better (good reason to avoid overwhelming the system); e) We’re getting better at treating Covid…","mentions":[],"urls":[],"photos":[],"replies_count":3,"retweets_count":7,"likes_count":103,"hashtags":[],"cashtags":[],"link":"https://twitter.com/Bob_Wachter/status/1274181902878912512","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"239210681","username":"Bob_Wachter"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1274181900559511600,"conversation_id":"1274181884591759361","created_at":1592623612000,"date":"2020-06-20","time":"03:26:52","timezone":"UTC","user_id":239210681,"username":"bob_wachter","name":"Bob Wachter","place":"","tweet":"12/ A friend recently said, “The virus is a great teacher.” Yes, but not really. Fire is a great teacher – touch it & it hurts like hell. For SARS Co-V2, a person or state can act badly & do fine–for a while, confirming a belief that precautions are for wimps. Until it’s too late","mentions":[],"urls":[],"photos":[],"replies_count":3,"retweets_count":40,"likes_count":195,"hashtags":[],"cashtags":[],"link":"https://twitter.com/Bob_Wachter/status/1274181900559511553","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"239210681","username":"Bob_Wachter"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1274181895580864500,"conversation_id":"1274181884591759361","created_at":1592623611000,"date":"2020-06-20","time":"03:26:51","timezone":"UTC","user_id":239210681,"username":"bob_wachter","name":"Bob Wachter","place":"","tweet":"9/ Today, we know a lot about the virus, including how it spreads and how to prevent it. So today's risks – for individuals & regions – are mostly about behavior, particularly masking/distancing. And the surges are predictably occurring in places with the most at-risk behavior.","mentions":[],"urls":[],"photos":[],"replies_count":1,"retweets_count":37,"likes_count":161,"hashtags":[],"cashtags":[],"link":"https://twitter.com/Bob_Wachter/status/1274181895580864514","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"239210681","username":"Bob_Wachter"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1274181890799329300,"conversation_id":"1274181884591759361","created_at":1592623610000,"date":"2020-06-20","time":"03:26:50","timezone":"UTC","user_id":239210681,"username":"bob_wachter","name":"Bob Wachter","place":"","tweet":"6/ And it’s pretty hard to label Covid “a hoax” or “like the flu” when you hear constant wail of ambulances or see refrigerated morgues outside hospitals. \n\nFor spared regions, Covid remained a bit theoretical, especially when seen through through a red lens of partisanship.","mentions":[],"urls":[],"photos":[],"replies_count":2,"retweets_count":30,"likes_count":181,"hashtags":[],"cashtags":[],"link":"https://twitter.com/Bob_Wachter/status/1274181890799329280","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"239210681","username":"Bob_Wachter"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1274181889696264200,"conversation_id":"1274181884591759361","created_at":1592623610000,"date":"2020-06-20","time":"03:26:50","timezone":"UTC","user_id":239210681,"username":"bob_wachter","name":"Bob Wachter","place":"","tweet":"5/ Also: fewer at-risk people, as many either died (1 in 380 New Yorkers) or had Covid and are probably immune (1 in 5). There is also a political dimension (of course): early surge states are largely left-leaning; probably less likely to reject govt/policy advice & regulations.","mentions":[],"urls":[],"photos":[],"replies_count":3,"retweets_count":8,"likes_count":122,"hashtags":[],"cashtags":[],"link":"https://twitter.com/Bob_Wachter/status/1274181889696264192","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"239210681","username":"Bob_Wachter"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1274181888916123600,"conversation_id":"1274181884591759361","created_at":1592623610000,"date":"2020-06-20","time":"03:26:50","timezone":"UTC","user_id":239210681,"username":"bob_wachter","name":"Bob Wachter","place":"","tweet":"4/ The Northeast (especially NY) story is worth celebrating – without forgetting the tragedies of March-May. Falling case #'s translate to many lives saved. How did they begin to defeat Covid? a) Strong messaging/policies (Cuomo etc); b) citizens sheltering, distancing, masking…","mentions":[],"urls":[],"photos":[],"replies_count":1,"retweets_count":19,"likes_count":160,"hashtags":[],"cashtags":[],"link":"https://twitter.com/Bob_Wachter/status/1274181888916123648","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"239210681","username":"Bob_Wachter"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1274181886844133400,"conversation_id":"1274181884591759361","created_at":1592623609000,"date":"2020-06-20","time":"03:26:49","timezone":"UTC","user_id":239210681,"username":"bob_wachter","name":"Bob Wachter","place":"","tweet":"2/ A few weeks ago, I worried that Covid had become old news – that we were growing inured despite 700-1000 deaths per day in U.S. With the Floyd murder, racial justice rightly became above-the-fold news. But Covid remains an ongoing tragic story. It's crucial to focus on both.","mentions":[],"urls":[],"photos":[],"replies_count":3,"retweets_count":14,"likes_count":120,"hashtags":[],"cashtags":[],"link":"https://twitter.com/Bob_Wachter/status/1274181886844133376","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"239210681","username":"Bob_Wachter"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1273819862410817500,"conversation_id":"1273819835445547009","created_at":1592537296000,"date":"2020-06-19","time":"03:28:16","timezone":"UTC","user_id":239210681,"username":"bob_wachter","name":"Bob Wachter","place":"","tweet":"24/ … 4) What's the future impact on pts like her: “I wonder about my heart, lung and brain.” Finally, she worries about the stigma – people haven't wanted to see or touch her. And stigma is \"likely worse for those who also have the stigma of race or poverty\" on top of Covid.","mentions":[],"urls":[],"photos":[],"replies_count":2,"retweets_count":1,"likes_count":42,"hashtags":[],"cashtags":[],"link":"https://twitter.com/Bob_Wachter/status/1273819862410817536","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"239210681","username":"Bob_Wachter"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1273819861592846300,"conversation_id":"1273819835445547009","created_at":1592537296000,"date":"2020-06-19","time":"03:28:16","timezone":"UTC","user_id":239210681,"username":"bob_wachter","name":"Bob Wachter","place":"","tweet":"23/ @ 1:13:40: Coleen on her personal experience. “The most fun thing: being a citizen-scientist.” Her questions for study: 1) Why me?; 2) Why many partners are neg despite long-time Covid housemates; 3) How to interpret + viral tests, esp. how to be sure you’re not infectious…","mentions":[],"urls":[],"photos":[],"replies_count":1,"retweets_count":0,"likes_count":25,"hashtags":[],"cashtags":[],"link":"https://twitter.com/Bob_Wachter/status/1273819861592846337","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"239210681","username":"Bob_Wachter"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1273819860502339600,"conversation_id":"1273819835445547009","created_at":1592537295000,"date":"2020-06-19","time":"03:28:15","timezone":"UTC","user_id":239210681,"username":"bob_wachter","name":"Bob Wachter","place":"","tweet":"22/ @ 1:11:30: Cliff on stigma & anxiety w/ this illness. “I became so depressed that people around me were getting concerned.” Also wild mood swings, “almost bipolar but I missed the euphoria.” People thought he was faking it – good to be part of the study & see he’s not alone.","mentions":[],"urls":[],"photos":[],"replies_count":1,"retweets_count":1,"likes_count":26,"hashtags":[],"cashtags":[],"link":"https://twitter.com/Bob_Wachter/status/1273819860502339584","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"239210681","username":"Bob_Wachter"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1273819859659264000,"conversation_id":"1273819835445547009","created_at":1592537295000,"date":"2020-06-19","time":"03:28:15","timezone":"UTC","user_id":239210681,"username":"bob_wachter","name":"Bob Wachter","place":"","tweet":"21/ @ 1:02:00, Henrich talks about other post-infectious syndromes. Lasting immunologic, autoimmune, and neuro problems aren't rare. He also describes Coleen’s positive PCRs: quite sure she had non-replicating dead virus; no longer pathogenic or infectious. No test for this yet.","mentions":[],"urls":[],"photos":[],"replies_count":2,"retweets_count":1,"likes_count":28,"hashtags":[],"cashtags":[],"link":"https://twitter.com/Bob_Wachter/status/1273819859659264003","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"239210681","username":"Bob_Wachter"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1273819852793241600,"conversation_id":"1273819835445547009","created_at":1592537293000,"date":"2020-06-19","time":"03:28:13","timezone":"UTC","user_id":239210681,"username":"bob_wachter","name":"Bob Wachter","place":"","tweet":"15/ @ 25:45: I (RMW) won’t be shocked if folks start taking steroids at home (since they're oral & cheap). Sarah: “I think that is a bad idea.” (I agree, BTW.) Trial results: no benefit in people who didn’t require oxygen, and no theoretical benefit to starting steroids v. early.","mentions":[],"urls":[],"photos":[],"replies_count":2,"retweets_count":3,"likes_count":31,"hashtags":[],"cashtags":[],"link":"https://twitter.com/Bob_Wachter/status/1273819852793241600","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"239210681","username":"Bob_Wachter"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1273819851631603700,"conversation_id":"1273819835445547009","created_at":1592537293000,"date":"2020-06-19","time":"03:28:13","timezone":"UTC","user_id":239210681,"username":"bob_wachter","name":"Bob Wachter","place":"","tweet":"14/ @ 23:50, I asked Sarah re: Dexamth vs Remdesivir, or both. A) “No reason not to give both…no reason to think that steroids may hamper effectiveness of RSV.” We already give steroids plus antimicrobials in other illnesses, so prob. OK. But “steroids make ID people nervous.”","mentions":[],"urls":[],"photos":[],"replies_count":2,"retweets_count":1,"likes_count":25,"hashtags":[],"cashtags":[],"link":"https://twitter.com/Bob_Wachter/status/1273819851631603713","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"239210681","username":"Bob_Wachter"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1271641425134841900,"conversation_id":"1271641396257021952","created_at":1592017916000,"date":"2020-06-13","time":"03:11:56","timezone":"UTC","user_id":239210681,"username":"bob_wachter","name":"Bob Wachter","place":"","tweet":"22/ Is that low, moderate, or high? Seems low to me, & so I’d fly if the trip was important. Going to a movie in the age of Netflix: probably similar risk (inside but a little better ventilation & larger space, 2-3 hrs vs. 6 hrs on plane), but I wouldn’t do it: risk not worth it.","mentions":[],"urls":[],"photos":[],"replies_count":2,"retweets_count":13,"likes_count":128,"hashtags":[],"cashtags":[],"link":"https://twitter.com/Bob_Wachter/status/1271641425134841856","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"239210681","username":"Bob_Wachter"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1271641421741650000,"conversation_id":"1271641396257021952","created_at":1592017915000,"date":"2020-06-13","time":"03:11:55","timezone":"UTC","user_id":239210681,"username":"bob_wachter","name":"Bob Wachter","place":"","tweet":"20/ As an illustration of probabilistic thinking, consider whether to take a flight in July to see family. (I think this way when I decide whether to get a haircut, sit outside w/ friends, etc; yes, it's exhausting.) Importantly, for all activities, mask-wearing slashes the risk.","mentions":[],"urls":[],"photos":[],"replies_count":3,"retweets_count":16,"likes_count":113,"hashtags":[],"cashtags":[],"link":"https://twitter.com/Bob_Wachter/status/1271641421741649920","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"239210681","username":"Bob_Wachter"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1271641408676393000,"conversation_id":"1271641396257021952","created_at":1592017912000,"date":"2020-06-13","time":"03:11:52","timezone":"UTC","user_id":239210681,"username":"bob_wachter","name":"Bob Wachter","place":"","tweet":"11/ Some risks aren’t really risky by themselves; they’re risky because they generate other risky behaviors – e.g., eating isn’t bad by itself but it requires taking off mask, which is; drinking alcohol is OK except a) need to remove mask & b) makes loud speaking & <6 ft likelier","mentions":[],"urls":[],"photos":[],"replies_count":2,"retweets_count":23,"likes_count":140,"hashtags":[],"cashtags":[],"link":"https://twitter.com/Bob_Wachter/status/1271641408676392960","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"239210681","username":"Bob_Wachter"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1271641407762006000,"conversation_id":"1271641396257021952","created_at":1592017912000,"date":"2020-06-13","time":"03:11:52","timezone":"UTC","user_id":239210681,"username":"bob_wachter","name":"Bob Wachter","place":"","tweet":"10/ Being w/ quiet people is safer than shouting or singing ones. No symptoms safer than coughing/sneezing. Short exposures (<10 min) safer than longer. Risk from touching surface: generally low, shiny surface riskier than rough; all are safer if you clean hands after touching…","mentions":[],"urls":[],"photos":[],"replies_count":1,"retweets_count":37,"likes_count":196,"hashtags":[],"cashtags":[],"link":"https://twitter.com/Bob_Wachter/status/1271641407762006017","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"239210681","username":"Bob_Wachter"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1271641406809862100,"conversation_id":"1271641396257021952","created_at":1592017911000,"date":"2020-06-13","time":"03:11:51","timezone":"UTC","user_id":239210681,"username":"bob_wachter","name":"Bob Wachter","place":"","tweet":"9/ “Should I get a haircut? Have a picnic? Fly?” The answers, of course, depend. But on what? The factors are pretty straightforward: Outdoors is safer than indoors. >6 ft is safer than <6 ft. Masks are safer than no masks…","mentions":[],"urls":[],"photos":[],"replies_count":2,"retweets_count":59,"likes_count":255,"hashtags":[],"cashtags":[],"link":"https://twitter.com/Bob_Wachter/status/1271641406809862144","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"239210681","username":"Bob_Wachter"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1271641405857788000,"conversation_id":"1271641396257021952","created_at":1592017911000,"date":"2020-06-13","time":"03:11:51","timezone":"UTC","user_id":239210681,"username":"bob_wachter","name":"Bob Wachter","place":"","tweet":"8/ How risky is opening up for a city? And how risky are various activities for individuals? These questions are now being asked by everyone, and they're vexing. And humans aren’t great at weighing risks, nor at estimating & dealing w/ probabilities. So let’s take a deeper dive.","mentions":[],"urls":[],"photos":[],"replies_count":2,"retweets_count":40,"likes_count":173,"hashtags":[],"cashtags":[],"link":"https://twitter.com/Bob_Wachter/status/1271641405857787904","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"239210681","username":"Bob_Wachter"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1271641399411146800,"conversation_id":"1271641396257021952","created_at":1592017910000,"date":"2020-06-13","time":"03:11:50","timezone":"UTC","user_id":239210681,"username":"bob_wachter","name":"Bob Wachter","place":"","tweet":"3/ Today, after a few general observations, I'm going to focus mostly on assessing risk – to individuals as they make decisions, and to states & cities, as they do the same. March/April were easy: stay at home. Now there are dozens of decisions for everyone to make, every day.","mentions":[],"urls":[],"photos":[],"replies_count":2,"retweets_count":51,"likes_count":151,"hashtags":[],"cashtags":[],"link":"https://twitter.com/Bob_Wachter/status/1271641399411146752","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"239210681","username":"Bob_Wachter"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1271276910933274600,"conversation_id":"1271276880478404608","created_at":1591931009000,"date":"2020-06-12","time":"03:03:29","timezone":"UTC","user_id":239210681,"username":"bob_wachter","name":"Bob Wachter","place":"","tweet":"22/ @ 1:07:30, probably most fascinating segment: what happens if, in October, FDA is asked to approve a vaccine with borderline results. Califf: with the stakes so high, the FDA commissioner – who normally stays out of drug approval decisions – would have to get involved.","mentions":[],"urls":[],"photos":[],"replies_count":1,"retweets_count":5,"likes_count":17,"hashtags":[],"cashtags":[],"link":"https://twitter.com/Bob_Wachter/status/1271276910933274624","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"239210681","username":"Bob_Wachter"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1271276909809111000,"conversation_id":"1271276880478404608","created_at":1591931009000,"date":"2020-06-12","time":"03:03:29","timezone":"UTC","user_id":239210681,"username":"bob_wachter","name":"Bob Wachter","place":"","tweet":"21/ @ 1:02:20: Califf: hard to require 1st author to review every analysis, but must ask hard ?s re: data provenance. He believes 1st authors often haven’t written the paper. Wants to use #AI to check papers against authors' past writings; suspects we’d find tons of ghostwriting.","mentions":[],"urls":[],"photos":[],"replies_count":2,"retweets_count":7,"likes_count":19,"hashtags":["#ai"],"cashtags":[],"link":"https://twitter.com/Bob_Wachter/status/1271276909809111040","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"239210681","username":"Bob_Wachter"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1271276907250606000,"conversation_id":"1271276880478404608","created_at":1591931008000,"date":"2020-06-12","time":"03:03:28","timezone":"UTC","user_id":239210681,"username":"bob_wachter","name":"Bob Wachter","place":"","tweet":"19/ @ 56:20: Redberg counters: Problem is FDA doesn’t require randomized data for drugs/devices, often approves based on observational data, surrogate endpoints. Califf: not just FDA problem; “Simply saying that FDA should do this… isn’t confronting the demon in your own house.”","mentions":[],"urls":[],"photos":[],"replies_count":1,"retweets_count":1,"likes_count":13,"hashtags":[],"cashtags":[],"link":"https://twitter.com/Bob_Wachter/status/1271276907250606081","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"239210681","username":"Bob_Wachter"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1271276906256588800,"conversation_id":"1271276880478404608","created_at":1591931008000,"date":"2020-06-12","time":"03:03:28","timezone":"UTC","user_id":239210681,"username":"bob_wachter","name":"Bob Wachter","place":"","tweet":"18/ @ 42:20: Califf enthusiastic re: using real-world data to assess drugs, “but no substitute for good methods.” Thinks FDA isn’t main problem; instead, healthcare delivery orgs don't enroll enough pts in trials; several reasons (time pressure, incentives, admitting uncertainty)","mentions":[],"urls":[],"photos":[],"replies_count":1,"retweets_count":1,"likes_count":12,"hashtags":[],"cashtags":[],"link":"https://twitter.com/Bob_Wachter/status/1271276906256588800","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"239210681","username":"Bob_Wachter"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1271276905312825300,"conversation_id":"1271276880478404608","created_at":1591931008000,"date":"2020-06-12","time":"03:03:28","timezone":"UTC","user_id":239210681,"username":"bob_wachter","name":"Bob Wachter","place":"","tweet":"17/ @ 39:00: All FDA commissioners need to manage tension between speed & safety. When Rob Califf became commissioner, there was some consensus that – for otherwise untreatable diseases – best to tilt toward speed/approval, letting pts/families make choice whether to accept risk.","mentions":[],"urls":[],"photos":[],"replies_count":1,"retweets_count":1,"likes_count":10,"hashtags":[],"cashtags":[],"link":"https://twitter.com/Bob_Wachter/status/1271276905312825349","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"239210681","username":"Bob_Wachter"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1271276901940605000,"conversation_id":"1271276880478404608","created_at":1591931007000,"date":"2020-06-12","time":"03:03:27","timezone":"UTC","user_id":239210681,"username":"bob_wachter","name":"Bob Wachter","place":"","tweet":"14/ @ 33:00: Redberg: preprints “can be helpful.” But “they should have a big watermark: ‘Not for Clinical Use, Certainly Not for Therapies.’” Data: only 20% of preprints end up getting published in peer-reviewed journals. But many patients look at them & want to follow recs.","mentions":[],"urls":[],"photos":[],"replies_count":3,"retweets_count":6,"likes_count":22,"hashtags":[],"cashtags":[],"link":"https://twitter.com/Bob_Wachter/status/1271276901940604928","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"239210681","username":"Bob_Wachter"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1271276896852926500,"conversation_id":"1271276880478404608","created_at":1591931006000,"date":"2020-06-12","time":"03:03:26","timezone":"UTC","user_id":239210681,"username":"bob_wachter","name":"Bob Wachter","place":"","tweet":"10/ @ 23:40: Q: What explains variation in state-by-state cases? Some opened & doing OK, others have done everything right & gotten hit. A) Some element of luck, random variation. But ultimately, chances of surge are higher if states (and people) ignore public health recs.","mentions":[],"urls":[],"photos":[],"replies_count":1,"retweets_count":5,"likes_count":23,"hashtags":[],"cashtags":[],"link":"https://twitter.com/Bob_Wachter/status/1271276896852926464","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"239210681","username":"Bob_Wachter"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1271276895888216000,"conversation_id":"1271276880478404608","created_at":1591931005000,"date":"2020-06-12","time":"03:03:25","timezone":"UTC","user_id":239210681,"username":"bob_wachter","name":"Bob Wachter","place":"","tweet":"9/ @ 23:00: Q&A with George: Q) Is the virus getting milder. A) \"No. There’s no evidence of that… The virus doesn’t watch TV. It doesn’t read the paper…. It has one purpose in life, & that’s to reproduce in YOU.”","mentions":[],"urls":[],"photos":[],"replies_count":1,"retweets_count":11,"likes_count":40,"hashtags":[],"cashtags":[],"link":"https://twitter.com/Bob_Wachter/status/1271276895888216071","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"239210681","username":"Bob_Wachter"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1271276884165189600,"conversation_id":"1271276880478404608","created_at":1591931003000,"date":"2020-06-12","time":"03:03:23","timezone":"UTC","user_id":239210681,"username":"bob_wachter","name":"Bob Wachter","place":"","tweet":"3/ Note that the talk about a “surge in California” is sorta right (@ 8:35) - cases going up, but mostly in SoCal. Northern CA remains OK, though variation here too, with SF stable, mild upticks in Marin, Alameda. As George often says, North & South are two different epidemics.","mentions":[],"urls":[],"photos":[],"replies_count":1,"retweets_count":17,"likes_count":50,"hashtags":[],"cashtags":[],"link":"https://twitter.com/Bob_Wachter/status/1271276884165189633","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"239210681","username":"Bob_Wachter"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1270190650118377500,"conversation_id":"1270190621869789184","created_at":1591672024000,"date":"2020-06-09","time":"03:07:04","timezone":"UTC","user_id":239210681,"username":"bob_wachter","name":"Bob Wachter","place":"","tweet":"25/ That’s it. It seems like volume of Covid news is slowing a bit. So this’ll be last Monday thread. I’ll still post threads on Thurs (Grand Rds) & Fri weekly recap. Plus others as events dictate. Goal is to update, but not oversaturate.\n\nBack Thurs for grand rounds. Stay safe.","mentions":[],"urls":[],"photos":[],"replies_count":22,"retweets_count":6,"likes_count":350,"hashtags":[],"cashtags":[],"link":"https://twitter.com/Bob_Wachter/status/1270190650118377472","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"239210681","username":"Bob_Wachter"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1270190648201588700,"conversation_id":"1270190621869789184","created_at":1591672024000,"date":"2020-06-09","time":"03:07:04","timezone":"UTC","user_id":239210681,"username":"bob_wachter","name":"Bob Wachter","place":"","tweet":"23/ For an ED doc seeing a sick patient – if a hospital admission requires one phone call, whereas organizing HaH takes ten (bed, IV, O2, monitors, home nursing…), it’s just not gonna happen. Has to be one-stop-shopping, along w/ financial incentives that don’t stand in the way.","mentions":[],"urls":[],"photos":[],"replies_count":1,"retweets_count":4,"likes_count":53,"hashtags":[],"cashtags":[],"link":"https://twitter.com/Bob_Wachter/status/1270190648201588736","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"239210681","username":"Bob_Wachter"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1270190647253667800,"conversation_id":"1270190621869789184","created_at":1591672023000,"date":"2020-06-09","time":"03:07:03","timezone":"UTC","user_id":239210681,"username":"bob_wachter","name":"Bob Wachter","place":"","tweet":"22/ Telemedicine solves one big problem: MD can now see patients daily & as needed. We’ve also gotten better w/ equipment (home IVs, O2) & tech (sensors). Yet still haven’t hit tipping point for HaH, despite 20 yrs of data. Need 2 things: payment system alignment & ease-of-setup.","mentions":[],"urls":[],"photos":[],"replies_count":3,"retweets_count":10,"likes_count":70,"hashtags":[],"cashtags":[],"link":"https://twitter.com/Bob_Wachter/status/1270190647253667846","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"239210681","username":"Bob_Wachter"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1270190644053422000,"conversation_id":"1270190621869789184","created_at":1591672023000,"date":"2020-06-09","time":"03:07:03","timezone":"UTC","user_id":239210681,"username":"bob_wachter","name":"Bob Wachter","place":"","tweet":"19/ A few other thoughts on hospitals in Covid era: \n\nRe: telemedicine – we learned that not only can many (perhaps most) outpt visits go virtual, but also many hospital visits. This helped us lower # of visits (w/ lower PPE use & infection risk) & has big future implications.","mentions":[],"urls":[],"photos":[],"replies_count":2,"retweets_count":16,"likes_count":124,"hashtags":[],"cashtags":[],"link":"https://twitter.com/Bob_Wachter/status/1270190644053422081","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"239210681","username":"Bob_Wachter"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1270190641109102600,"conversation_id":"1270190621869789184","created_at":1591672022000,"date":"2020-06-09","time":"03:07:02","timezone":"UTC","user_id":239210681,"username":"bob_wachter","name":"Bob Wachter","place":"","tweet":"16/ Economic crunch will likely cause some hospitals to fail. That’ll be a hit to a town, yet – unless it's v. isolated – new capabilities (particularly virtual care) may lower need for full-service hospital in every town. Of course, can’t deliver baby or do surgery via telemed.","mentions":[],"urls":[],"photos":[],"replies_count":2,"retweets_count":1,"likes_count":40,"hashtags":[],"cashtags":[],"link":"https://twitter.com/Bob_Wachter/status/1270190641109102592","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"239210681","username":"Bob_Wachter"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1270190637904564200,"conversation_id":"1270190621869789184","created_at":1591672021000,"date":"2020-06-09","time":"03:07:01","timezone":"UTC","user_id":239210681,"username":"bob_wachter","name":"Bob Wachter","place":"","tweet":"14/ At UCSF, volumes are now about halfway between our pre-Covid baseline (ie, packed) and where we were in March (ie, half-empty). Our financial losses are also ~half of what they were in March. So we’re doing better than we were 2 mths ago, but still crawling out of deep hole.","mentions":[],"urls":[],"photos":[],"replies_count":1,"retweets_count":2,"likes_count":45,"hashtags":[],"cashtags":[],"link":"https://twitter.com/Bob_Wachter/status/1270190637904564225","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"239210681","username":"Bob_Wachter"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1270190631445508000,"conversation_id":"1270190621869789184","created_at":1591672020000,"date":"2020-06-09","time":"03:07:00","timezone":"UTC","user_id":239210681,"username":"bob_wachter","name":"Bob Wachter","place":"","tweet":"10/ All true, but God help any politician who tries to change this system. Even Obamacare was mostly about getting people health insurance, steering far away from taking on financing, paying for value (vs. volume), & overuse. And passing it wasn’t a picnic, as you may recall.","mentions":[],"urls":[],"photos":[],"replies_count":1,"retweets_count":6,"likes_count":94,"hashtags":[],"cashtags":[],"link":"https://twitter.com/Bob_Wachter/status/1270190631445508096","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"239210681","username":"Bob_Wachter"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1270190630384222200,"conversation_id":"1270190621869789184","created_at":1591672019000,"date":"2020-06-09","time":"03:06:59","timezone":"UTC","user_id":239210681,"username":"bob_wachter","name":"Bob Wachter","place":"","tweet":"9/ Of course, this economic model is dysfunctional – why should a hospital make its money off procedures? Why disincentivize primary care? Why don’t we pay based on “value” (outcomes divided by costs)? Why should employers subsidize the care of patients w/ government insurance?","mentions":[],"urls":[],"photos":[],"replies_count":2,"retweets_count":28,"likes_count":189,"hashtags":[],"cashtags":[],"link":"https://twitter.com/Bob_Wachter/status/1270190630384222209","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"239210681","username":"Bob_Wachter"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1270190626303180800,"conversation_id":"1270190621869789184","created_at":1591672018000,"date":"2020-06-09","time":"03:06:58","timezone":"UTC","user_id":239210681,"username":"bob_wachter","name":"Bob Wachter","place":"","tweet":"5/ As with other businesses, Covid led us to shut down as much as we could. But unlike \"normal\" businesses, hospitals needed to stay very much open, both for Covid patients and for other emergencies. So we cut all non-urgent work, including surgeries, procedures, & clinic visits.","mentions":[],"urls":[],"photos":[],"replies_count":1,"retweets_count":3,"likes_count":47,"hashtags":[],"cashtags":[],"link":"https://twitter.com/Bob_Wachter/status/1270190626303180803","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"239210681","username":"Bob_Wachter"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1270190625267146800,"conversation_id":"1270190621869789184","created_at":1591672018000,"date":"2020-06-09","time":"03:06:58","timezone":"UTC","user_id":239210681,"username":"bob_wachter","name":"Bob Wachter","place":"","tweet":"4/ Hospitals have long been felt to be “recession-proof,” but we now know that’s not true. Hospitals are like airplanes: with huge fixed costs, they need to run full. (Until/unless the payment system changes from mostly fee-for-service to capitated or “value-based” payments.)","mentions":[],"urls":[],"photos":[],"replies_count":1,"retweets_count":8,"likes_count":96,"hashtags":[],"cashtags":[],"link":"https://twitter.com/Bob_Wachter/status/1270190625267146752","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"239210681","username":"Bob_Wachter"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1270190624281485300,"conversation_id":"1270190621869789184","created_at":1591672018000,"date":"2020-06-09","time":"03:06:58","timezone":"UTC","user_id":239210681,"username":"bob_wachter","name":"Bob Wachter","place":"","tweet":"3/ Today, a riff on hospitals in the Covid era:\n\nHospitals care for the very sick, sometimes perform miracles, are where most Americans die, and are where we spend ~30% of our healthcare $'s. Hospitals were vital in Covid, but pandemic has dealt a huge blow to their bottom lines","mentions":[],"urls":[],"photos":[],"replies_count":2,"retweets_count":7,"likes_count":66,"hashtags":[],"cashtags":[],"link":"https://twitter.com/Bob_Wachter/status/1270190624281485321","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"239210681","username":"Bob_Wachter"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1269096820610752500,"conversation_id":"1269096800096407552","created_at":1591411235000,"date":"2020-06-06","time":"02:40:35","timezone":"UTC","user_id":239210681,"username":"bob_wachter","name":"Bob Wachter","place":"","tweet":"21/ What a gloomy, painful week. \n\nStay well. Be kind. Back Monday.","mentions":[],"urls":[],"photos":[],"replies_count":15,"retweets_count":7,"likes_count":258,"hashtags":[],"cashtags":[],"link":"https://twitter.com/Bob_Wachter/status/1269096820610752513","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"239210681","username":"Bob_Wachter"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1269096817087504400,"conversation_id":"1269096800096407552","created_at":1591411234000,"date":"2020-06-06","time":"02:40:34","timezone":"UTC","user_id":239210681,"username":"bob_wachter","name":"Bob Wachter","place":"","tweet":"17/ Question of opening schools & camps remains huge & controversial. I still feel that benefits outweigh risks… if done carefully, w/ masks, distancing, cohorting & testing. My opinion rides on evidence that kids are both unlikely to get sick and to transmit disease to adults.","mentions":[],"urls":[],"photos":[],"replies_count":7,"retweets_count":4,"likes_count":75,"hashtags":[],"cashtags":[],"link":"https://twitter.com/Bob_Wachter/status/1269096817087504386","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"239210681","username":"Bob_Wachter"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1269096816257101800,"conversation_id":"1269096800096407552","created_at":1591411234000,"date":"2020-06-06","time":"02:40:34","timezone":"UTC","user_id":239210681,"username":"bob_wachter","name":"Bob Wachter","place":"","tweet":"16/ So add long-haulers to the list of Covid’s clinical surprises, along with the abnormal clotting, vascular injury, multi-system inflammatory syndrome in children (MIS-C), and, of course, the high frequency of asymptomatic disease. Covid continues to teach multitudes.","mentions":[],"urls":[],"photos":[],"replies_count":1,"retweets_count":15,"likes_count":64,"hashtags":[],"cashtags":[],"link":"https://twitter.com/Bob_Wachter/status/1269096816257101824","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"239210681","username":"Bob_Wachter"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1269096811530076200,"conversation_id":"1269096800096407552","created_at":1591411233000,"date":"2020-06-06","time":"02:40:33","timezone":"UTC","user_id":239210681,"username":"bob_wachter","name":"Bob Wachter","place":"","tweet":"11/ While people will say we've wasted money if vaccines are duds, this seems like smart investment. The alternative would be to wait until we’re sure which vaccine to bet on, then start ramping up production. That would cause a several-month delay: too costly in lives & dollars.","mentions":[],"urls":[],"photos":[],"replies_count":2,"retweets_count":4,"likes_count":51,"hashtags":[],"cashtags":[],"link":"https://twitter.com/Bob_Wachter/status/1269096811530076161","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"239210681","username":"Bob_Wachter"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1269096807809691600,"conversation_id":"1269096800096407552","created_at":1591411232000,"date":"2020-06-06","time":"02:40:32","timezone":"UTC","user_id":239210681,"username":"bob_wachter","name":"Bob Wachter","place":"","tweet":"7/ To expedite publication, many Covid studies come out in preprints (no peer-review), or press releases, or via leaks. Others w/ very small #'s published in major journals. Motivations mixed: to help patients, sure, but also competition to be 1st, for reasons of fame or fortune.","mentions":[],"urls":[],"photos":[],"replies_count":2,"retweets_count":4,"likes_count":50,"hashtags":[],"cashtags":[],"link":"https://twitter.com/Bob_Wachter/status/1269096807809691648","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"239210681","username":"Bob_Wachter"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1269096806002028500,"conversation_id":"1269096800096407552","created_at":1591411231000,"date":"2020-06-06","time":"02:40:31","timezone":"UTC","user_id":239210681,"username":"bob_wachter","name":"Bob Wachter","place":"","tweet":"5/ It would be naïve to believe that this shift would be risk-free. Now we’re seeing the risks. First, an unknown company (\"Surgisphere\") pitched an improbably huge dataset to researchers, promising answers to Covid questions. Racing for results, they bit. Hook, line & sinker...","mentions":[],"urls":[],"photos":[],"replies_count":1,"retweets_count":2,"likes_count":35,"hashtags":[],"cashtags":[],"link":"https://twitter.com/Bob_Wachter/status/1269096806002028546","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"239210681","username":"Bob_Wachter"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1269096805075042300,"conversation_id":"1269096800096407552","created_at":1591411231000,"date":"2020-06-06","time":"02:40:31","timezone":"UTC","user_id":239210681,"username":"bob_wachter","name":"Bob Wachter","place":"","tweet":"4/ In other news: \n\nAll industries need to balance speed and safety. In matters that pertain to human health, we tend to lean toward safety, because wrong moves can harm or kill people. But in a pandemic, there’s a natural, and correct, inclination to shift the dial toward speed.","mentions":[],"urls":[],"photos":[],"replies_count":1,"retweets_count":1,"likes_count":35,"hashtags":[],"cashtags":[],"link":"https://twitter.com/Bob_Wachter/status/1269096805075042304","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"239210681","username":"Bob_Wachter"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1268747388400746500,"conversation_id":"1268747371690684416","created_at":1591327924000,"date":"2020-06-05","time":"03:32:04","timezone":"UTC","user_id":239210681,"username":"bob_wachter","name":"Bob Wachter","place":"","tweet":"22/ @ 1:04:00: Can healthcare solve social determinants? No, but it can expose problems, push accountability. Who should? Ian: States, but they’re broke. “The very places that should be stepping up to social determinants are local govts, which won’t have the resources to do it.”","mentions":[],"urls":[],"photos":[],"replies_count":1,"retweets_count":2,"likes_count":16,"hashtags":[],"cashtags":[],"link":"https://twitter.com/Bob_Wachter/status/1268747388400746497","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"239210681","username":"Bob_Wachter"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1268747387708702700,"conversation_id":"1268747371690684416","created_at":1591327924000,"date":"2020-06-05","time":"03:32:04","timezone":"UTC","user_id":239210681,"username":"bob_wachter","name":"Bob Wachter","place":"","tweet":"21/ @ 1:02:00:  Mark Smith: “Some of the anger… not just from black people… is informed by the widespread recognition of the disproportionate impact of Covid among people of color.” Covid-related disparities plus racial violence are leading to a new energy. “I’m optimistic.”","mentions":[],"urls":[],"photos":[],"replies_count":2,"retweets_count":2,"likes_count":16,"hashtags":[],"cashtags":[],"link":"https://twitter.com/Bob_Wachter/status/1268747387708702722","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"239210681","username":"Bob_Wachter"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1268747387020824600,"conversation_id":"1268747371690684416","created_at":1591327923000,"date":"2020-06-05","time":"03:32:03","timezone":"UTC","user_id":239210681,"username":"bob_wachter","name":"Bob Wachter","place":"","tweet":"20/ @ 1:00:40: A. Verghese: “Great lesson of novels is that character is defined by decisions taken under pressure. It's been very revealing… to witness [Trump] make stupid decisions under pressure…[With the new critiques], I think that this is the moment, things are changing.”","mentions":[],"urls":[],"photos":[],"replies_count":1,"retweets_count":4,"likes_count":15,"hashtags":[],"cashtags":[],"link":"https://twitter.com/Bob_Wachter/status/1268747387020824576","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"239210681","username":"Bob_Wachter"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1268747386290987000,"conversation_id":"1268747371690684416","created_at":1591327923000,"date":"2020-06-05","time":"03:32:03","timezone":"UTC","user_id":239210681,"username":"bob_wachter","name":"Bob Wachter","place":"","tweet":"19/ @ 58:45: With all the discussions about ethical issues in Covid, Abraham Verghese says that the biggest ethical issue of all is “what we saw in Minneapolis.” “I feel ashamed about it… I think this is the moment of change.”","mentions":[],"urls":[],"photos":[],"replies_count":2,"retweets_count":2,"likes_count":11,"hashtags":[],"cashtags":[],"link":"https://twitter.com/Bob_Wachter/status/1268747386290987009","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"239210681","username":"Bob_Wachter"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1268747385586385000,"conversation_id":"1268747371690684416","created_at":1591327923000,"date":"2020-06-05","time":"03:32:03","timezone":"UTC","user_id":239210681,"username":"bob_wachter","name":"Bob Wachter","place":"","tweet":"18/ @ 55:50: On vaccine challenge trials. Sue D-H: If you had a Covid cure, then a human challenge might be OK. But “I’m not going to challenge somebody if there isn’t a cure.” “I don’t think [the model of a human challenge] is crazy, but I understand why people are avoiding it.”","mentions":[],"urls":[],"photos":[],"replies_count":1,"retweets_count":2,"likes_count":11,"hashtags":[],"cashtags":[],"link":"https://twitter.com/Bob_Wachter/status/1268747385586384896","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"239210681","username":"Bob_Wachter"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1268747383518552000,"conversation_id":"1268747371690684416","created_at":1591327923000,"date":"2020-06-05","time":"03:32:03","timezone":"UTC","user_id":239210681,"username":"bob_wachter","name":"Bob Wachter","place":"","tweet":"15/ @ 48:20: M. Smith thinks (over next 5 yrs) Covid has upped probability of universal coverage, but not of single payer. “Will people rise up and say ‘no more VA, no more retiree healthcare, no more Kaiser Permanente, all the insurance companies are banned?'…I don’t think so.”","mentions":[],"urls":[],"photos":[],"replies_count":1,"retweets_count":2,"likes_count":14,"hashtags":[],"cashtags":[],"link":"https://twitter.com/Bob_Wachter/status/1268747383518552064","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"239210681","username":"Bob_Wachter"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1268747382830665700,"conversation_id":"1268747371690684416","created_at":1591327922000,"date":"2020-06-05","time":"03:32:02","timezone":"UTC","user_id":239210681,"username":"bob_wachter","name":"Bob Wachter","place":"","tweet":"14/ Inevitably, @ 45:10: we talk Single Payer. Ian M.: Today's economy “calls the bluff on tying health insurance to employment.” BUT states are near-broke. Ian: “We’d love to do single payer but we have a $4 trillion deficit… And even Bernie can’t come up with $10 trillion.”","mentions":[],"urls":[],"photos":[],"replies_count":3,"retweets_count":2,"likes_count":12,"hashtags":[],"cashtags":[],"link":"https://twitter.com/Bob_Wachter/status/1268747382830665729","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"239210681","username":"Bob_Wachter"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1268747382071517200,"conversation_id":"1268747371690684416","created_at":1591327922000,"date":"2020-06-05","time":"03:32:02","timezone":"UTC","user_id":239210681,"username":"bob_wachter","name":"Bob Wachter","place":"","tweet":"13/ @ 39:30, Ian M: Covid has exposed \"The Game: the financial hydraulics” of US healthcare. Elective/surgical procedures are source of big profits; that pays for all the other stuff. He predict that Jan 2020 will be all-time high in U.S. employer coverage, as unemployment grows.","mentions":[],"urls":[],"photos":[],"replies_count":1,"retweets_count":3,"likes_count":20,"hashtags":[],"cashtags":[],"link":"https://twitter.com/Bob_Wachter/status/1268747382071517184","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"239210681","username":"Bob_Wachter"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1268747381358510000,"conversation_id":"1268747371690684416","created_at":1591327922000,"date":"2020-06-05","time":"03:32:02","timezone":"UTC","user_id":239210681,"username":"bob_wachter","name":"Bob Wachter","place":"","tweet":"12/ Sue D-H: Makes point that it’s one thing to use digital (whether for patient care or for a workplace team) if you have an preexisting relationship. But we need to avoid assuming virtual is a perfect substitute for in-person, especially if you don’t have a prior relationship.","mentions":[],"urls":[],"photos":[],"replies_count":3,"retweets_count":1,"likes_count":26,"hashtags":[],"cashtags":[],"link":"https://twitter.com/Bob_Wachter/status/1268747381358510081","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"239210681","username":"Bob_Wachter"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1268747380377059300,"conversation_id":"1268747371690684416","created_at":1591327922000,"date":"2020-06-05","time":"03:32:02","timezone":"UTC","user_id":239210681,"username":"bob_wachter","name":"Bob Wachter","place":"","tweet":"11/ M. Smith: yes, there’s something lost, but human touch needn't be by MD – could be a nurse, or a high school graduate w/ good technology. If we get this right, “there is unlimited potential to redesign healthcare in ways that are more efficient, effective and higher quality.”","mentions":[],"urls":[],"photos":[],"replies_count":2,"retweets_count":2,"likes_count":20,"hashtags":[],"cashtags":[],"link":"https://twitter.com/Bob_Wachter/status/1268747380377059329","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"239210681","username":"Bob_Wachter"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1268747379664019500,"conversation_id":"1268747371690684416","created_at":1591327922000,"date":"2020-06-05","time":"03:32:02","timezone":"UTC","user_id":239210681,"username":"bob_wachter","name":"Bob Wachter","place":"","tweet":"10/ Adds Mark Smith: a digital practice requires rethinking every part of what MDs do. “If we can offload low value visits to non-physical means, you can see people more frequently or for longer…. But then you have to rethink your definition of what physician productivity is.”","mentions":[],"urls":[],"photos":[],"replies_count":3,"retweets_count":3,"likes_count":19,"hashtags":[],"cashtags":[],"link":"https://twitter.com/Bob_Wachter/status/1268747379664019456","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"239210681","username":"Bob_Wachter"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1268747378963562500,"conversation_id":"1268747371690684416","created_at":1591327921000,"date":"2020-06-05","time":"03:32:01","timezone":"UTC","user_id":239210681,"username":"bob_wachter","name":"Bob Wachter","place":"","tweet":"9/ @ 25:50: Ian M. says the key question is this: “Are we just paving the cow path?” (substituting televists for in-person visits). Or is this only one part of a major digital transformation in the way care is delivered? I completely agree – that is the question.","mentions":[],"urls":[],"photos":[],"replies_count":3,"retweets_count":2,"likes_count":9,"hashtags":[],"cashtags":[],"link":"https://twitter.com/Bob_Wachter/status/1268747378963562497","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"239210681","username":"Bob_Wachter"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1268747378254733300,"conversation_id":"1268747371690684416","created_at":1591327921000,"date":"2020-06-05","time":"03:32:01","timezone":"UTC","user_id":239210681,"username":"bob_wachter","name":"Bob Wachter","place":"","tweet":"8/ @ 20:50: A. Verghese on telemedicine. He worries re: loss of touch, but sees an upside: “The first time we can look into people’s homes” & observe their real life. “I’m all for it, I think it’s a wonderful trend.” Downside: “It’s really hard to teach [young MDs] effectively.”","mentions":[],"urls":[],"photos":[],"replies_count":1,"retweets_count":1,"likes_count":14,"hashtags":[],"cashtags":[],"link":"https://twitter.com/Bob_Wachter/status/1268747378254733312","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"239210681","username":"Bob_Wachter"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1268747377558450200,"conversation_id":"1268747371690684416","created_at":1591327921000,"date":"2020-06-05","time":"03:32:01","timezone":"UTC","user_id":239210681,"username":"bob_wachter","name":"Bob Wachter","place":"","tweet":"7/ @ 17:20: Long segment on telemedicine. M. Smith: “Every MD will be a hybrid doctor” – part in-person/part-virtual. Why did telemed take so long? Answer: Incentives were wrong, things were organized for MD/system convenience (rather than pts), & inertia. Covid overcame all 3.","mentions":[],"urls":[],"photos":[],"replies_count":1,"retweets_count":2,"likes_count":24,"hashtags":[],"cashtags":[],"link":"https://twitter.com/Bob_Wachter/status/1268747377558450176","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"239210681","username":"Bob_Wachter"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1268747376853835800,"conversation_id":"1268747371690684416","created_at":1591327921000,"date":"2020-06-05","time":"03:32:01","timezone":"UTC","user_id":239210681,"username":"bob_wachter","name":"Bob Wachter","place":"","tweet":"6/ @ 15:50: I asked Ian M. why, with so much waste in healthcare, 10% cuts aren’t good thing (to prompt efficiency). Answer: “Covid & high-deductible healthcare are similar” – they’re both too-blunt instruments; they lead to cuts in both appropriate and inappropriate care.”","mentions":[],"urls":[],"photos":[],"replies_count":1,"retweets_count":3,"likes_count":16,"hashtags":[],"cashtags":[],"link":"https://twitter.com/Bob_Wachter/status/1268747376853835777","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"239210681","username":"Bob_Wachter"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1268747375331340300,"conversation_id":"1268747371690684416","created_at":1591327921000,"date":"2020-06-05","time":"03:32:01","timezone":"UTC","user_id":239210681,"username":"bob_wachter","name":"Bob Wachter","place":"","tweet":"4/ @ 6:40: same Q to A. Verghese. “I’m witnessing this & watching the story unfold…We’re all trying to weave one narrative out of this; our own personal narrative… We need instruction on how to digest this – without the kind of leadership that would help us digest it.”","mentions":[],"urls":[],"photos":[],"replies_count":1,"retweets_count":2,"likes_count":23,"hashtags":[],"cashtags":[],"link":"https://twitter.com/Bob_Wachter/status/1268747375331340288","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"239210681","username":"Bob_Wachter"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1267654287825367000,"conversation_id":"1267654261128617986","created_at":1591067308000,"date":"2020-06-02","time":"03:08:28","timezone":"UTC","user_id":239210681,"username":"bob_wachter","name":"Bob Wachter","place":"","tweet":"19/ I support opening up, but do it thoughtfully and gradually, with strong masking & distancing; robust testing/tracing programs; and with clear benchmarks to either open more – or close back down. Absent that, I fear that Covid's brutal next phase will be in places like these.","mentions":[],"urls":[],"photos":[],"replies_count":4,"retweets_count":15,"likes_count":89,"hashtags":[],"cashtags":[],"link":"https://twitter.com/Bob_Wachter/status/1267654287825367047","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"239210681","username":"Bob_Wachter"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1267654287057797000,"conversation_id":"1267654261128617986","created_at":1591067308000,"date":"2020-06-02","time":"03:08:28","timezone":"UTC","user_id":239210681,"username":"bob_wachter","name":"Bob Wachter","place":"","tweet":"18/ Worth noting that Covid brought NYC to its knees. The city has 62 acute care hospitals, 1600 ICU beds, and some of the most advanced healthcare in the world. Thinking about rural counties in MS, IA, and TX, it won’t take much of a surge to overwhelm their healthcare systems.","mentions":[],"urls":[],"photos":[],"replies_count":3,"retweets_count":12,"likes_count":66,"hashtags":[],"cashtags":[],"link":"https://twitter.com/Bob_Wachter/status/1267654287057797121","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"239210681","username":"Bob_Wachter"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1267654276882395100,"conversation_id":"1267654261128617986","created_at":1591067306000,"date":"2020-06-02","time":"03:08:26","timezone":"UTC","user_id":239210681,"username":"bob_wachter","name":"Bob Wachter","place":"","tweet":"13/ This morning, Katie was on the phone w/ a customer support rep. Katie: “How are things where you are?” Answer: “Scary.” The rep said that 2 dozen cases of the virus had shown up in one day in her small town in northern Mississippi, and “she wished the state hadn’t reopened.”","mentions":[],"urls":[],"photos":[],"replies_count":3,"retweets_count":7,"likes_count":46,"hashtags":[],"cashtags":[],"link":"https://twitter.com/Bob_Wachter/status/1267654276882395137","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"239210681","username":"Bob_Wachter"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1267654275301142500,"conversation_id":"1267654261128617986","created_at":1591067305000,"date":"2020-06-02","time":"03:08:25","timezone":"UTC","user_id":239210681,"username":"bob_wachter","name":"Bob Wachter","place":"","tweet":"11/ But we’re past the lockdown stage. Today’s question is what happens w/ opening up. One fear is that we’ll see a more broadly distributed case & death toll, which’ll make it harder to garner public support for doing hard things – including returning to lockdown if we need to.","mentions":[],"urls":[],"photos":[],"replies_count":1,"retweets_count":2,"likes_count":31,"hashtags":[],"cashtags":[],"link":"https://twitter.com/Bob_Wachter/status/1267654275301142528","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"239210681","username":"Bob_Wachter"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1267654271144562700,"conversation_id":"1267654261128617986","created_at":1591067304000,"date":"2020-06-02","time":"03:08:24","timezone":"UTC","user_id":239210681,"username":"bob_wachter","name":"Bob Wachter","place":"","tweet":"8/ As we enter the newest stage of opening up, a couple of new studies offer a sense of the impact of the lockdowns in March... and, by implication, the risks of opening up when the virus is still out there, as infectious and deadly as ever.","mentions":[],"urls":[],"photos":[],"replies_count":1,"retweets_count":0,"likes_count":28,"hashtags":[],"cashtags":[],"link":"https://twitter.com/Bob_Wachter/status/1267654271144562688","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"239210681","username":"Bob_Wachter"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1267654270121152500,"conversation_id":"1267654261128617986","created_at":1591067304000,"date":"2020-06-02","time":"03:08:24","timezone":"UTC","user_id":239210681,"username":"bob_wachter","name":"Bob Wachter","place":"","tweet":"7/ If everyone masks, risk is tolerable. But it's real: nothing about virus has changed, and 80-99% of protestors are as susceptible to SARS-CoV-2 as they were in 2019. Given the stakes & passion, we can’t & shouldn’t tell people not to protest, but please wear a mask if you can.","mentions":[],"urls":[],"photos":[],"replies_count":3,"retweets_count":41,"likes_count":208,"hashtags":[],"cashtags":[],"link":"https://twitter.com/Bob_Wachter/status/1267654270121152517","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"239210681","username":"Bob_Wachter"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1267654269240402000,"conversation_id":"1267654261128617986","created_at":1591067304000,"date":"2020-06-02","time":"03:08:24","timezone":"UTC","user_id":239210681,"username":"bob_wachter","name":"Bob Wachter","place":"","tweet":"6/ I had some press calls today re: “Should people be out protesting?” My answer: the gatherings aren’t risk-free, but the status quo is dangerous too. While the protests are outside (safer than inside), we’re talking large crowds, jammed together, shouting – a setup for spread.","mentions":[],"urls":[],"photos":[],"replies_count":2,"retweets_count":17,"likes_count":119,"hashtags":[],"cashtags":[],"link":"https://twitter.com/Bob_Wachter/status/1267654269240401925","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"239210681","username":"Bob_Wachter"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1266567277576466400,"conversation_id":"1266567254528847873","created_at":1590808145000,"date":"2020-05-30","time":"03:09:05","timezone":"UTC","user_id":239210681,"username":"bob_wachter","name":"Bob Wachter","place":"","tweet":"19/ And it’s hard to be anything but sad and outraged at the brutal, senseless and repulsive deaths of African-Americans gripping the nation. At a time when our shared challenge should bring us together, we grow more & more apart, abetted by political leaders stoking the flames.","mentions":[],"urls":[],"photos":[],"replies_count":4,"retweets_count":32,"likes_count":242,"hashtags":[],"cashtags":[],"link":"https://twitter.com/Bob_Wachter/status/1266567277576466432","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"239210681","username":"Bob_Wachter"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1266567274736914400,"conversation_id":"1266567254528847873","created_at":1590808144000,"date":"2020-05-30","time":"03:09:04","timezone":"UTC","user_id":239210681,"username":"bob_wachter","name":"Bob Wachter","place":"","tweet":"17/ Jim Kim described why Korea seems to be doing particularly well with Covid. “They talk about the virus like a person: it’s nasty, it zeroes in on the most vulnerable…” They know that IT is the enemy, not one another. The two keys, he says, are “humility and solidarity.”","mentions":[],"urls":[],"photos":[],"replies_count":1,"retweets_count":24,"likes_count":136,"hashtags":[],"cashtags":[],"link":"https://twitter.com/Bob_Wachter/status/1266567274736914433","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"239210681","username":"Bob_Wachter"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1266567273801674800,"conversation_id":"1266567254528847873","created_at":1590808144000,"date":"2020-05-30","time":"03:09:04","timezone":"UTC","user_id":239210681,"username":"bob_wachter","name":"Bob Wachter","place":"","tweet":"16/ Sara Cody: “Ordering shelter-in-place was a piece of cake, compared to what we have to do now.” Current stage is much more complex & nuanced: how much do you open, what are the guardrails to ensure you didn’t go too far, will it be politically feasible to shut down again...?","mentions":[],"urls":[],"photos":[],"replies_count":1,"retweets_count":10,"likes_count":63,"hashtags":[],"cashtags":[],"link":"https://twitter.com/Bob_Wachter/status/1266567273801674757","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"239210681","username":"Bob_Wachter"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1266567271712911400,"conversation_id":"1266567254528847873","created_at":1590808143000,"date":"2020-05-30","time":"03:09:03","timezone":"UTC","user_id":239210681,"username":"bob_wachter","name":"Bob Wachter","place":"","tweet":"14/ Always questions re: flying. I’d feel reasonably safe to fly now with universal masking & enhanced cleaning. Would I feel perfectly safe: no, and if it were purely elective I might put it off. But if I needed to get somewhere, I’d do it – with lots of wipes, gel, and a mask.","mentions":[],"urls":[],"photos":[],"replies_count":5,"retweets_count":16,"likes_count":91,"hashtags":[],"cashtags":[],"link":"https://twitter.com/Bob_Wachter/status/1266567271712911361","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"239210681","username":"Bob_Wachter"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1266567270806909000,"conversation_id":"1266567254528847873","created_at":1590808143000,"date":"2020-05-30","time":"03:09:03","timezone":"UTC","user_id":239210681,"username":"bob_wachter","name":"Bob Wachter","place":"","tweet":"13/ Going against summer break: surges in cold Detroit & warm New Orleans, Singapore. And now a surge in Brazil, where it’s plenty warm. Summer drop (in flu, for example) might relate to folks spending more time outdoors (lower risk than indoors), and perhaps end of school year.","mentions":[],"urls":[],"photos":[],"replies_count":4,"retweets_count":7,"likes_count":50,"hashtags":[],"cashtags":[],"link":"https://twitter.com/Bob_Wachter/status/1266567270806908930","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"239210681","username":"Bob_Wachter"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
{"id":1266567265442361300,"conversation_id":"1266567254528847873","created_at":1590808142000,"date":"2020-05-30","time":"03:09:02","timezone":"UTC","user_id":239210681,"username":"bob_wachter","name":"Bob Wachter","place":"","tweet":"9/ And there’s no way to identify super-spreaders in advance, which makes large group gatherings highly problematic. Of all the parts of “getting back to normal,” big gatherings will likely (and correctly) be the last to come back. Yes, that means churches. And ballparks.","mentions":[],"urls":[],"photos":[],"replies_count":3,"retweets_count":13,"likes_count":65,"hashtags":[],"cashtags":[],"link":"https://twitter.com/Bob_Wachter/status/1266567265442361345","retweet":false,"quote_url":"","video":0,"near":"","geo":"","source":"","user_rt_id":"","user_rt":"","retweet_id":"","reply_to":[{"user_id":"239210681","username":"Bob_Wachter"}],"retweet_date":"","translate":"","trans_src":"","trans_dest":""}
