Dr Satoshi Akima, FRACP
@toshiakima
Nephrology & Internal Medicine. Immunothrombosis incl DIC. ISTH Member. No Conflicts of Interest. Views my own etc
Look at the impact of the pandemic on type 2 diabetes incidence 👀
Disclaimer. Buried deep in the fine details of the article is the correct statement: “Don't bother using cloth or surgical masks, since they don't really protect against the tiny particles found in wildfire smoke.” But a picture is worth a thousand words
I fail a qualitative fit test in a surgical mask (with fold and tuck) faster than I can start and stop the timer. Failure is instantaneous. Published studies show surgical masks have an average Fit Factor of 3, where the pass mark is > 100
Disposable N95s designed to form a good seal are also classified as respirators. That is why 3M are legally allowed to sell Auras as respirators
Surgical masks are not designed to reduce particulate inhalation injury because they leave gaps and the particulate pollution enters unfiltered through the path of least resistance
Hence, Koch's postulates contain nothing in them about spread by "close contact" being a prerequisite for a disease to fit the contagionist paradigm. The assumption of a need for close contact was a weakness of ancient and Medieval contagionism that was overcome by modern microbiology.
Professor Clive Beggs stated during his testimony to the UK COVID Inquiry that there is no situation where respiratory droplets could be produced without producing significant amounts of aerosols. [Courtesy of @catinthehat.bsky.social]
Some have misinterpreted my critique of the limitations of RCTs to say that in vitro lab modelling suffices for drug development. It doesn’t. But that doesn’t mean space suits (a form of respirator) need RCTs
N95/HEPA filters are tested at 0.3 microns because that is a weak spot for them. They work even better at 0.1 microns (the size of a SARS-COV-2 virus) but viruses travel, carried in much larger aerosols anyway
The pharmacology model of science is not the only model of what constitutes valid scientific method. Not a single textbook of the philosophy of science has ever accepted such an absurdly narrow definition of scientific validity.
Where a protective device doesn’t interfere with physiology eg bullet proof vests, helmets, seatbelts and respirators, lab predictive modelling is the gold standard of testing
“That’s why we don’t know if a well fitted respirator protects against inhalation injury any better than a surgical mask”
One key reason the French lost the Franco-Prussian War was because French troops had a lower vaccination rate than the Prussians (quote from Richard J Evan: The Pursuit of Power)
COBRRA is out. Don't prescribe Rivaroxaban. Choose Apixaban instead. No COI. Chart taken from pre-publication ISTH 2025 presentation
I saw one op-ed claim that COVID has left no impact on our “post-COVID world” but it has clearly helped unleash a quackistocracy that goes well beyond healthcare.
POTS review: ‘Patients who have been inappropriately labelled with psychiatric diagnoses throughout their diagnostic journey of many years can describe the effect of being believed as “lifechanging”’ www.heartlungcirc.org/article/S144...
A lesson to draw is that, when faced with an emerging infectious disease, we are better off being stricter about airborne mitigation than about droplet mitigation. Block selection of airborne variants.
Surgical masks leave gaps through which virus-laden aerosol leaks inwards and outwards unfiltered.
Remember there is no reason for alarm. You can easily protect yourself with a well-fitted respirator. Back it up with air filtration and vaccination.
Note: it isn't necessary to always run an ionised Ca (needs to be on a fresh specimen collected in an ABG syringe, no ice) as the whole Ca is 80% accurate. But where accurate clinical confirmation is needed, run the iCa. Here's how to interpret the ionised calcium
Debunking the myth of so-called “corrected” calcium. Use whole/uncorrected Ca as your screening test and confirm with an ionised Ca
Now, for something off-topic. Spring has brought forth bright yellow flowers of the Hymenosporum flavum tree, a native of New Guinea, Queensland and New South Wales. Although commonly known as the native frangipani, it is not related to the frangipani. #spring
As stated about influenza in Harrison's Principles of Internal Medicine, 18th Edition (2011): “Most pathogens exit via the same route by which they entered: respiratory pathogens by aerosols from sneezing or coughing”.
My dad today, aged 90. Used to jog daily along this beach. Caught COVID two years ago. Started to complain of back and hip pains. Slid out of bed and suffered a minimal trauma fractured neckof femur.
What Brett Sutton is saying now is nothing new. He was one of the few CHOs who openly stated that #COVIDisAirborne even in the early crisis years of the pandemic. This is an official Victorian Dept of Health video from 21 Dec, 2021.
What did you think of the 7-2-1 rule presented at ISTH this year? Fortunately for us, a $1 AU coin is similar in size to a 1 Euro coin