@mcnado@mstdn.social avatar

mcnado

@mcnado@mstdn.social

Hunter, ER doc, believer in democracy. I’m here to rant, combat medical misinfo, and get social therapy. Posts aren’t medical advice. This is the only platform I am currently on. If you find “me” elsewhere, it isn’t me. If you have COVID vaccine questions, I’m always happy to try to answer. Let’s all share good info, facts, and science, and keep ourselves and each other safe! “You can’t love your country only when you win” — JB ‘24

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mcnado, to random
@mcnado@mstdn.social avatar

I just want a minute to talk to the NYPD incident commander who made the call to allow officers to enter a window, on a ledge, to remove largely peaceful protestors, with their sidearms drawn.

See, the argument against lights on guns is that when you use a gun as a flashlight, you point a gun at everything you want to look at. Having a bunch of out of shape cops playing monkey on a ledge, holding loaded handguns, while using those guns as flashlights, is insanely negligent.

mcnado, to random
@mcnado@mstdn.social avatar

Remember that time Gaza protestors stormed a college campus, beat police with flagpoles bearing the stars and bars, built a gallows out front, broke down the doors of the admin building, shit on the walls, and took photos on the Uni president’s desk before stealing her computer?

Sorry, wait, that was Jan 6th 2021.

slcw, to Texas
@slcw@newsie.social avatar

In , face a real . They can either practice the way they’ve been taught, regardless of the personal consequences to themselves; they can try their best to comply with the arbitrary edicts of the state legislature and their own hapless medical board, and still risk ; or they can choose to leave the state of Texas and practice elsewhere.

https://www.dailykos.com/stories/2024/4/27/2237288/-Texas-is-about-to-make-pregnancy-even-more-dangerous

mcnado,
@mcnado@mstdn.social avatar

@slcw the choice is clear: GTFO of GOP states.

You can’t practice ethical medicine there, and the laws make it unacceptably risky anyway. Leave, and let the voters decide what is actually important to them.

mcnado,
@mcnado@mstdn.social avatar

@slcw I think some folks stay out of a sense of duty to their patients. That is great in some cases, but this is a democracy, voters have a say, and you don’t fix systemic problems one patient at a time. You fix them at the ballot box.

mcnado, to random
@mcnado@mstdn.social avatar

I can’t tell you what will happen or not, but I can level-set for you a bit. Here’s what a guy who was in the shit during the worst of COVID is doing about bird flu:

  • stocked up on baby formula for our new kid
  • picked up a few extra cases of diapers and wipes from Costco
  • ordered a case of 240 3M Aura N-95s to add to my stock
  • bought an extra bale of toilet paper rolls
  • made sure I have ~2 weeks of canned and dried food

Will I need any of it? Probably not.

mcnado,
@mcnado@mstdn.social avatar

As a HCW who can’t stay home when things go to hell (I work in the ER for a small physician group, and I’m one of the guys who goes in if anyone calls off/gets sick/quits), I also checked the price of filters for the half-face respirator I used in 2021, bought a new pair of decent safety goggles, and have started researching suppliers of PAPRs. I also have begun the deep dive on H5N1 symptoms and treatment. Again, probably won’t need it, but I learned from 2020…

mcnado, to random
@mcnado@mstdn.social avatar

Said it before, and I’ll keep saying it:
If you make protest illegal and suppress the vote, the only means for change that remains is violence.

mcnado, to random
@mcnado@mstdn.social avatar

If bird flu starts transmitting between people, what will that look like in the US? — a thread on our pandemic response today.

The single most important thing about bird flu is that it is influenza. We have decades of experience with rapid development of vaccines to fit a specific new flu strain (they make a shot for 3-4 new strains each year). If we stabilize things for a few months, people who want a vaccine will probably be able to get one. 1/…

mcnado,
@mcnado@mstdn.social avatar

What measures will be taken to stop community spread? This depends a bit on the state. Between 2020 and 2023, state and federal courts gutted the ability of governments to enact lockdowns, restrict travel or gatherings, close schools, and take other basic infection control measures. The misinfo campaigns of 2020 were also highly effective, so public support for public health measures will be low in many areas. Mitigation will be inconsistent and ineffective. 2/…

mcnado,
@mcnado@mstdn.social avatar

Mask mandates will be impossible to enact in some US states, and even in the areas where they can be enacted, enforcement will be very challenging. Law enforcement culture continues to, as a whole, be skeptical of public health measures like masking.

Universal testing mandates are likewise illegal in some states, hard to enact in others (for example, requiring passage of a law), and again will face public resistance.
3/…

mcnado,
@mcnado@mstdn.social avatar

Supply chains remain a weak link. We are in no better shape now than in 2020 in terms of domestic supply of medical goods. Everything from gloves to test reagents will become unavailable in days if a true pandemic of highly pathogenic influenza starts. We will be right back to wearing homemade masks, re-using single use equipment, and putting healthcare workers at high risk of illness. Ventilators and drugs will be on shortage immediately (some already are). 4/6

mcnado,
@mcnado@mstdn.social avatar

As for hospital capacity, physical bed space in most communities is either unchanged or worse than in 2020. Hospitals have closed all over the country, falling to financial pressures from COVID and rapacious private equity takeovers.

Staffed beds are a problem day-to-day right now, so in a time of increased patient load, hospitals will be fighting each other for staff immediately. ICUs will be “full” because they won’t have staff.
5/6

mcnado,
@mcnado@mstdn.social avatar

In short, if an avian influenza strain starts making people sick, and transmitting widely in the community, the US will look a lot more like the movie Contagion and a lot less like it did in 2020 (which was still awful). Shortsighted political moves, asinine decisions by courts, and a concerted misinfo campaign have made it impossible to rapidly enact public health measures, supply chains remain broken, and hospitals are already shortstaffed. Hopefully it doesn’t come to pass. 6/6

mcnado, to random
@mcnado@mstdn.social avatar

Funny how no college admins, governors, or chiefs of police were calling for cops to sweep up the demonstrators when the demonstrators were carrying literal fucking swastikas.

mcnado, to random
@mcnado@mstdn.social avatar

Just a reminder that on Jan 6, 2021, police let a mob of right wing whackos gather at the capitol with the openly stated intention to effect violence on elected officials.

Months earlier, national guard helicopters, tear gas, and flashbangs were used on BLM protestors in the same city.

Now, 3 years later, police are beating students protesting against violence in Gaza.

The only OK protest is the right wing violent one apparently.

mcnado, to random
@mcnado@mstdn.social avatar

Something everyone should keep in mind when reading reports on bird flu — it is widespread in birds around the world, and it causes isolated cases of human illness somewhat regularly around the world. Does the prevalence of infection in cows raise concern? Yes, a bit. The things that I am watching for though are:

  1. Human cases with no animal exposures
  2. Widespread infection in pigs
  3. Infection in primates at the zoo
  4. Uptick in undifferentiated pneumonia admissions and deaths
mcnado, to random
@mcnado@mstdn.social avatar

Here’s some of what was in my medic kit during the 2020 protests in Denver:
Gloves
4x4 gauze
Roller gauze
Cloth tape
CAT tourniquets
Molefoam
Moleskin
Water (eyewash)
Baking soda in water (teargas wash)
Jolly ranchers (sugar)
Gatorade
Masks
Tampons
Sanitary pads
Wet wipes
Trauma shears
Sunscreen
Goggles
Personal helmet
Personal P-100 w/chem filter silometric respirator

Anyway, that’s what an ER doc who also works on ambulances and is wilderness trained carried. Stay safe out there.

mcnado, to random
@mcnado@mstdn.social avatar

Great reporting by @TexasObserver on the likely illegal repression of a protest at UT this week.

https://www.texasobserver.org/texas-dps-palestine-first-amendment/

mcnado, to random
@mcnado@mstdn.social avatar

Any of these DOJ lawyers gonna point out that if ordering a coup is an immune official act, so is violently purging the bench?

mcnado, to random
@mcnado@mstdn.social avatar

SCOTUS is more worried about hypothetical political prosecution of former presidents than they are about the actual crimes an actual former president actually committed AFTER he left office. Jesus…

mcnado, to random
@mcnado@mstdn.social avatar

By the way folks, even if the Biden admin were to completely win this Idaho EMTALA case (they won’t), everyone in Idaho will still suffer. The Idaho abortion law can put a doc in jail for doing the job that doc spent 12-15 years training for. The only people who will willingly work in that environment are folks who agree with the law (a minority in medicine, especially in OB), and people desperate for work. Everyone else will just stay the fuck out of there.

mcnado,
@mcnado@mstdn.social avatar

The ER doc job market here in Colorado sucks, especially along the front range. Many of us would live in Idaho and love it for the same reasons we’re here in Colorado. So why don’t we? Neo-nazis, strict abortion laws, and an anti-medicine climate that has gotten increasingly worse since 2020. I don’t even look at postings for Idaho anymore.

mcnado, to random
@mcnado@mstdn.social avatar

The right wing is going to keep cracking down hard on student protests specifically to get a reaction. A replay of summer 2020 is good for politics on the right. They want riots.

mcnado, to random
@mcnado@mstdn.social avatar

SCOTUS today is hearing a case that will decide if we open the door to losing univsersal access to ER care. Today, if you show up to my work, I will see you without any discussion of your ability to pay, or consideration of whether your visit is the “right kind” of emergency. If Idaho officials have their way at SCOTUS, that will all change. Once the door is open, EMTALA will fall, and uninsured people will lose access.

mcnado, to random
@mcnado@mstdn.social avatar

Guys, I hate to tell y’all, but particles from pathogens are found in all pasteurized milk. Pasteurization doesn’t remove pathogens, it kills them. So yeah, dead (inactive) bird flu is gonna be in milk if cows have it. So is E. coli, and many other pathogens. That’s why we pasteurize it.

https://www.sciencedirect.com/science/article/pii/S0022030213004104

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