Thank you for speaking up, Dr. Frieden
🇺🇸 physician, now in 🇨🇦. Committed to democracy.
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Thank you for speaking up, Dr. Frieden
It could be as part of a voter fraud / mail fraud investigation or something. Food for thought.
I have no expertise in this, I just have to imagine that the Postal Service has wide discretion in investigating suspected mail fraud or setting delivery times. Also there were widespread mail delays after the anthrax attacks, a similar pretense could be used to slow or stop some mail delivery
One thing I’m not seeing discussed: doesn’t the president nominally have influence over the Postal Service? Couldn’t the USPS investigate / impound / delay processing of mail in ballots?
Not necessarily. The skin can even become permanently stained from the iron in the bruise
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Physician here. The most common cause of hand bruising in an elderly Caucasian man is “solar purpura”—easy bruising due to fragile skin from prior sun exposure and age. Bruising to the back of one hand is usually not a sign of anything serious.
Physician here, I agree with this
Even if the president can't legally influence how states run their elections, what about the president's ability to influence USPS? Couldn't USPS be manipulated so that it is unwilling to handle election mail, subjects ballots to inspections or delays, etc.
@skyview.social unroll
Ke¢ha
Rolling Pebbles Cupcake The Lovin’ Teaspoonful Prince Harvest The Turtle Smooch
Thank you and Prof. Levitsky for doing what you could to try to avoid this outcome
Thank you and Prof. Enos for doing what you could to try to avoid this outcome
Right, like how well does AI do at routing me to the correct customer service representative when I call a company? Will it do that much better at interpreting complicated labs?
Thanks
Thank you
Can someone explain what this means, I don't get it but everyone else apparently does.
Yeah. And the question won’t be “is the pretense for firing so compelling that the firing is legal”, it’s “is the pretense so flimsy that the Supreme Court would allow a stay on the firing to remain in place while it’s litigated.”
www.pbs.org/newshour/amp...
This tweet is aging pretty well
Good point, thanks
What if ICE does its usual shenanigans of arresting someone in one state and then moving them to another? Could ICE pick up someone who is a citizen in that state, and then move them to a state where they're a non-citizen, and then deport them? Awful to think about.
Did you try self-prescribing?
If we had proportional representation this could happen all the time
This was always the case, you have to get a research card. But you can get a research card without an appointment.
It’s not really a branch, it’s essentially the main site that holds most documents
Before the affordable care act required private insurers to do so, many insurers did not cover vaccines
We're going to get a lot more use out of this GIF...
We still have a national security council?
They can continue to pay for vaccines, they just would not be required to.
I think it's notable notable that RFK appointed an even number of members on the panel. If they anticipated meaningful debates about anything, they would want an odd number as a built-in tiebreaker.
Don’t sleep on Pritzker and Walz either
An entire lineage of influenza B viruses literally went extinct due to COVID mitigation measures and people will still say “masks don’t work”
As expected, RFK has populated ACIP with antivaxxers. Expect federal vaccine recommendations to be withdrawn. A significant number of people will likely lose insurance coverage for vaccines by next year.
Pritzker has been giving great, fiery speeches for months. www.google.com/url?sa=t&sou...
Former CDC director @drtomfrieden.bsky.social weighs in
Here’s what I don’t understand, though, why approve Novavax and the new Moderna COVID shot if the goal is to end all vaccine access?
Nobody believed us when we warned them RFK Jr.’s endgame is to eliminate all vaccines. They told us we were histrionic and hysterical. I’ve been watching RFK Jr. for 20 years. He’s antivax to the core. He really means it, and NOTHING will change his mind. He will do all he can to eliminate vaccines.
Also, many children receive their vaccines through the federally administered Vaccines for Children (VFC) program. That program only provides ACIP-recommended vaccines. That program looks to be in jeopardy.
States cannot regulate federal entities like Medicare, VA, Indian Health Service, Dept of Defense, and the health insurance plans for federal employees and retirees. All of those groups could lose their vaccine coverage.
Can confirm.
I expect that the new ACIP panel of antivaxxers will quickly rescind all vaccine recommendations. Unless CDC leadership gets in the way, that would release insurance companies from having to pay for vaccines. Individual states could still step in and require most insurance plans to cover them.
The head of ACIP, Dr. Lakshmi Panagiotakopoulos, suddenly resigned last week. I wonder if she was instructed to remove the other members from the panel, and refused.
@melodyschreiber.com has posted the HHS press release.
I can't read the article due to paywall. This is quite bad news for vaccine access. ACIP is the CDC's advisory panel that issues vaccine recommendations. Their recommendations largely determine what vaccines insurance will pay for. Presumably RFK will install only antivaxxers on the panel.
You might need to spike that joke.
in mice!
*all of the remaining good doctors
It’s also on broadway. Most people like it, I was underwhelmed.
I'm deleting my comment.
Update: immunization schedule has been revised.
On the plus side, if this sticks, maybe NEJM will finally stop publishing the dishonest drivel from Makary and Prasad.
COVID vaccine remains on the CDC's immunization schedule, despite RFK's announcement that he was unilaterally removing it. Incompetence? Subtle pushback from the CDC?
Dr. Na
This also begins to explain why I only see car insurance ads on TV but not streetcar insurance
Oh shoot, that also hits medical residents (J-1 visa).
I don't think people realize that insurance is required to cover recommended vaccines. When RFK nixes the recommendation, insurance no longer has to pay. This shifts massive costs to children and pregnant women.
I see this as a test case. RFK is seeing if he can get away with this, before unilaterally revoking the recommendations for more vaccines in the future. Vaccine recommendations matter because they dictate what vaccines insurance will cover. It is all part of the multi-pronged assault on vaccines.
This NEJM article was published as a joke and a bunch of news outlets ran articles about how eating chocolate will help you win a Nobel prize.
An underappreciated point that this article makes: Makary and Prasad were chosen for their positions at FDA *because* they are anti-vaccine, and loudly so. That is essentially their only qualification.
Do we know if residents at Harvard teaching hospitals are affected? Are they sponsored by Harvard or by the hospitals themselves?
Makary and Prasad don’t care.
And wr already won’t, because Moderna had to pull their application for their next-generation covid vaccine, which reportedly is more effective.
I wonder if medical residents at the Harvard teaching hospitals are at risk from this, too. Most international residents are on J-1 visas. It's possible the hospitals are considered separate entities from the university, perhaps someone here knows.
@enirenberg.bsky.social is live-tweeting the VRBPAC meeting (FDA advisory committee vaccines). The members have a tough choice: do they recommend that we continue to use our current vaccine, which is not so well matched to current trains, or recommend an updated vaccine that risks rejection by FDA?
Also destroying some of the domestic scientific institutions and regulatory agencies that other countries depend on. Cuts at National Institute of Standards and Technology, CDC disease surveillance, weather data, tsunami monitoring, etc.
Even if the courts side with Harvard, I imagine this will dissuade some of Harvard's incoming international students from coming in the fall.
Have you considered peritoneal MRI, it runs overnight while you sleep
Remember, this is a multi-front assault on vaccines. -Suspending funding for vaccine research -Hindering vaccine approvals -Hindering vaccine updates -Reducing vaccine access -Altering vaccine recommendations -Shifting costs to patient -Spewing antivaccine misinformation -Sowing general confusion
Moderna is (temporarily?) withdrawing its FDA application for its newly-developed combo COVID/flu vaccine. Moderna published a study suggesting that the vaccine provides superior protection against COVID compared to current vaccines. A real loss, thanks to the antivaxx ghouls who now run the FDA.
The NEJM piece is so intellectually dishonest that it's draining to pick all of it apart. They claim that vaccination is less important now because people have prior immunity from past infections and past vaccines. Infants never had COVID or a vaccine. So why no vaccine for them?
14. FDA announces it will dramatically restrict access to COVID vaccines.
-Unfortunately, US government vaccine recommendations will become increasingly untrustworthy and increasingly divorced from the best science. It will become increasingly important to rely on others' recommendations. Consider NACI (Canada) and EMA (Europe). [END]
-Vaccines remain one of the most effective and cost-effective public health tools in human history. Our quality of life will become dramatically worse without vaccines, and life expectancy will drop. -Please continue to get vaccines and encourage those around you to get vaccinated as well.
-This is a multi-pronged attack on vaccines, at every stage. The government is cutting off research dollars and holding up vaccine approvals. They are restricting vaccine access and shifting costs to patients. Government agencies are putting out anti-vaccine public health comms.
-It is not yet clear whether healthy children will be able to access the COVID vaccine at all. -The overall picture remains grim. The FDA has been subverted by anti-vaxxers, and whether the public can access vaccines is subject to their whims.
-Every week the specifics of this overarching plan become a bit clearer. It is difficult to keep up, and there remain a number of unknowns. -At this juncture, it appears adults will be able to access COVID vaccine in the US. It may require some extra effort and possibly cost hundreds of dollars.
-The Trump-appointed anti-vaxxers who have taken over the FDA instead are placing arbitrary restrictions on vaccines for political ends. They are making it harder for companies to develop and update vaccines. They are making it harder for people to afford vaccines, or obtain them at all.
-Pfizer/Moderna/Novavax have been shown to be convincingly safe and effective. -The FDA's job is to scientifically evaluate whether a vaccine is safe, and if so, approve it. Then, others decide which groups it is cost-effective to give the vaccine to.
To summarize a bit: -The COVID vaccine remains quite important for people of all ages to receive. COVID infection and reinfection causes cumulative, progressive damage to the body, It causes organ damage, immune dysfunction, and brain injury. [THREAD]
Also, it’s just not true. They cite Canada as an example, but Canada recommends that all ages may get the COVID vaccine
A very important distinction that is not yet clear--will COVID boosters be FDA-approved for children with risk factors, or merely *authorized*? FDA-approved would mean children w/o risk factors could obtain it off-label, albeit with some difficulty. But authorized means no off-label prescribing.
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Do you have one of the "high-risk" conditions that would make you eligible for the COVID vaccine? Well, corticosteroid use is one of those "high-risk" conditions. Did you know that over-the-counter hydrocortisone cream is a corticosteroid? Now you know.
US COVID vaccine update: The Trump-appointed ghouls running the FDA have published a piece in NEJM. Their plan will make it difficult for people to receive COVID shots if they are under the age of 65.
What will the US do? The FDA's advisory committee, VRBPAC, meets Thursday. If it recommends updating the vaccine strain, there is a risk that the politicized FDA will ultimately deny approval.
COVID vaccine update: The European Medical Agency (EMA) is recommending that COVID vaccines be updated to target the newest emerging variant (LP.8.1) . By comparison, the WHO says it is OK to keep vaccines as is. I agree with the EMA's recommendations here.
Sounds sensible
For reference, FDA approval letter is here. www.fda.gov/media/186545...
The longer-term picture is fairly grim. The RFK regime has subverted the process for vaccine approvals and is restricting access to vaccines at its whims. This does not bode well for vaccine approvals in the future, including future adjustments to the strains of the COVID and flu vaccines. [END]
So in the near term, if you 65+ or an adult with a serious health condition, you should be able to get Novavax this year and have it paid for. If you are 12 y/o-64 y/o without serious health issues, your insurance may not pay for Novavax and you might have to see a physician to get a prescription.
It is worth discussing off-label prescribing. Physicians are allowed to prescribe an FDA approved medication in a manner other than how it is spelled out on the drug label. So if you are an adult <65 y/o without serious medical issues, a physician may be willing to prescribe you Novavax off label.
However, the overall picture is fairly grim. The RFK regime has subverted the process for vaccine approvals and is restricting access to vaccines at its whims. This does not bode well for vaccine approvals in the future, including for needed future updates for COVID and flu. [END]
Generally, the FDA's job is to figure out in which people it is safe to give the vaccine. Then, the CDC, with the help of an advisory panel called ACIP, figures out who it recommends giving the vaccine to. The FDA has cut out the CDC/ACIP here and restricted access to the vaccine on its own.
The FDA approval letter does not spell out what exactly those underlying conditions are. This ambiguity is problematic, because insurance companies take advantage of any ambiguity to deny coverage. The FDA does not have any scientific reason for restricting the vaccine this way.
FDA approved Novavax, with significant restrictions. This is mostly bad news as far as vaccine access. It is now FDA approved for 65+ y/o, and for 12 - 64 y/o "who have at least one underlying condition that puts them at high risk for severe outcomes from COVID-19."
Yes it is.
I canceled my Atlantic subscription when they published these hacks. I had been a loyal subscriber for years. The Atlantic has blood on their hands.