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Carlos Mejia-Chew

@cmejiachew

Infectious Disease Consultant Mater Misericordiae, Dublin ๐Ÿ‡จ๐Ÿ‡ฎ NTM, TB, OPAT, HIV & sexual health. ๐Ÿ‡บ๐Ÿ‡ธ(WashU), ๐Ÿ‡ช๐Ÿ‡ธ(HULP), ๐Ÿ‡ฌ๐Ÿ‡น(Roosevelt)

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Latest posts by Carlos Mejia-Chew @cmejiachew

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BILL GATES: โ€œThe picture of the worldโ€™s richest man killing the worldโ€™s poorest children is not a pretty one.โ€

@financialtimes.com
www.ft.com/content/bdd9...

08.05.2025 12:25 ๐Ÿ‘ 34445 ๐Ÿ” 10632 ๐Ÿ’ฌ 1047 ๐Ÿ“Œ 672
Pope Leo XIV: โ€˜There Couldnโ€™t Be A Better Time To Get The Fuck Out Of America Foreverโ€™

Pope Leo XIV: โ€˜There Couldnโ€™t Be A Better Time To Get The Fuck Out Of America Foreverโ€™

Pope Leo XIV: โ€˜There Couldnโ€™t Be A Better Time To Get The Fuck Out Of America Foreverโ€™

08.05.2025 18:54 ๐Ÿ‘ 42293 ๐Ÿ” 6670 ๐Ÿ’ฌ 449 ๐Ÿ“Œ 324
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Distinct clinical features of extrapulmonary and disseminated tuberculosis in HIV and non-HIV-associated immunosuppression: a retrospective cohort study There is scarce information regarding the clinical differences between extrapulmonary and disseminated tuberculosis in patients with different types of immunosuppression.

Distinct clinical features of extrapulmonary and disseminated tuberculosis in HIV and non-HIV-associated immunosuppression: a retrospective cohort study

โœ… Just Accepted
#IDSky

29.04.2025 14:36 ๐Ÿ‘ 3 ๐Ÿ” 2 ๐Ÿ’ฌ 0 ๐Ÿ“Œ 0
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The Relationship Between Frailty and Respiratory Syncytial Virus Infection in Hospitalized Older Adults This study aimed to evaluate the impact of frailty on the clinical outcomes and disease severity of respiratory syncytial virus(RSV) infection in older adults using data from the Canadian Immunization Research Network(CIRN) Serious Outcomes Surveillance(SOS) Network.

The Relationship Between Frailty and Respiratory Syncytial Virus Infection in Hospitalized Older Adults

โœ… Just Accepted
#IDSky

29.04.2025 21:11 ๐Ÿ‘ 0 ๐Ÿ” 1 ๐Ÿ’ฌ 0 ๐Ÿ“Œ 0
May 5, 2025 cover of the New Yorker. 

Expository text:

https://www.newyorker.com/culture/cover-story/cover-story-2025-05-05

May 5, 2025 cover of the New Yorker. Expository text: https://www.newyorker.com/culture/cover-story/cover-story-2025-05-05

Barry Blittโ€™s first 100 days cover for the New Yorker.

28.04.2025 16:08 ๐Ÿ‘ 31215 ๐Ÿ” 6302 ๐Ÿ’ฌ 335 ๐Ÿ“Œ 251

*Of course* advance information on US combat operations is classified. Pretending otherwise is an insult to our troops, who all know this.

The Secretary is unfit to lead.

21.04.2025 00:01 ๐Ÿ‘ 72708 ๐Ÿ” 14883 ๐Ÿ’ฌ 1305 ๐Ÿ“Œ 468
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Hands off our healthcare!
Hands off our public education!
Hands off our jobs!
Hands off my 401k!
Hands off my neighbor who has committed no crime!
Hands off those Congressional seats that we are coming for in 2026!

05.04.2025 20:13 ๐Ÿ‘ 21859 ๐Ÿ” 4826 ๐Ÿ’ฌ 291 ๐Ÿ“Œ 166
Massive crowd at Hands Off rally in St. Paul, Minnesota

Massive crowd at Hands Off rally in St. Paul, Minnesota

Wow. #HandsOff rally in St. Paul, Minnesota is massive!

05.04.2025 20:08 ๐Ÿ‘ 53037 ๐Ÿ” 9996 ๐Ÿ’ฌ 579 ๐Ÿ“Œ 479

#HANDSOFF #NYC

05.04.2025 21:07 ๐Ÿ‘ 68341 ๐Ÿ” 10544 ๐Ÿ’ฌ 1013 ๐Ÿ“Œ 385
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This is Utah in case anyoneโ€™s wondering how pissed off people are. I have never seen anything like this.

05.04.2025 19:06 ๐Ÿ‘ 110579 ๐Ÿ” 23803 ๐Ÿ’ฌ 2067 ๐Ÿ“Œ 1547

When you look at the list of institutions they want to defund: libraries, museums, the Smithsonian, public schools, PBS, NPR, archives, you can clearly see that the real threat to an authoritarian regime is an informed and educated public

29.03.2025 16:44 ๐Ÿ‘ 34164 ๐Ÿ” 10841 ๐Ÿ’ฌ 650 ๐Ÿ“Œ 457
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75% of US scientists who answered Nature poll consider leaving More than 1,600 readers answered our poll; many said they were looking for jobs in Europe and Canada.

We polled Nature readers to ask if they were thinking of leaving the US for jobs abroad. Three-quarters of them (who said they were US-based scientists) said yes. ๐Ÿงช

www.nature.com/articles/d41...

27.03.2025 14:19 ๐Ÿ‘ 2332 ๐Ÿ” 1066 ๐Ÿ’ฌ 65 ๐Ÿ“Œ 216
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Histoplasmosis

New IDSA 2025 Guideline Update on the Treatment of Asymptomatic Histoplasma Pulmonary Nodules (Histoplasmomas) and Mild or Moderate Acute Pulmonary Histoplasmosis in Adults, Children, and Pregnant People

Led by @fungaldoc.bsky.social & Sandra Arnold

www.idsociety.org/practice-gui... #IDSky #MedSky

19.03.2025 11:19 ๐Ÿ‘ 44 ๐Ÿ” 27 ๐Ÿ’ฌ 1 ๐Ÿ“Œ 1
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Portuguese editorial cartoonist Zez Vaz reaches back to Tiananmen Square to call on American defiance.

15.02.2025 13:43 ๐Ÿ‘ 50500 ๐Ÿ” 16403 ๐Ÿ’ฌ 515 ๐Ÿ“Œ 1149
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Tesla Paid Zero Federal Income Tax in 2024, Despite $2.3 Billion in Income This brings Teslaโ€™s average tax rate over the past three years to 0.4 percent.

Tesla earned $2.3 billion in the United States in 2024.

You'd think it paid a lot in taxes, right?

Well it paid precisely $0 in federal income taxes last year.

You want waste and fraud? Look at what some big corporations and the rich are getting away with.

07.02.2025 23:00 ๐Ÿ‘ 47664 ๐Ÿ” 20295 ๐Ÿ’ฌ 1457 ๐Ÿ“Œ 1115
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Last week the Your Local Epidemiologist team released a survey on how the federal freezes are impacting your work.

The survey received over 3,000 responses, here are a few stories that were shared. See the full report here:

docs.google.com/document/d/1...

07.02.2025 20:44 ๐Ÿ‘ 101 ๐Ÿ” 54 ๐Ÿ’ฌ 3 ๐Ÿ“Œ 5

USAID, currently being shut down by Elon Musk, purchases about $2 billion annually in rice, wheat, lentils, and peas from American farmers.

07.02.2025 21:28 ๐Ÿ‘ 6843 ๐Ÿ” 1336 ๐Ÿ’ฌ 131 ๐Ÿ“Œ 68
Unfortunately and unsurprisingly, the administration continues to charge ahead, running roughshod over norms, laws, and the dignity of and most basic protections for the people most vulnerable to infections. Many of the changes are summarized here, up to date as of Feb 4. Who will speak up, or better still, ACT UP for these individuals?

The National Science Foundation has reportedly shared with program officers a list of forbidden "DEI"-related words that will result in grants being flagged. These include routinely used terms like "female", "biased", "systemic", "inclusion" and "exclusion" along with other words that specifically target vulnerable populations. While few clinical researchers rely on NSF grants, it can be reasonably expected that similar censorship with grants from NIH, CDC, etc is inevitable.
USAID funding remains frozen, and in fact there are reports of efforts underway to eliminate the entire agency. The effects have already been devastating for programs dedicated to controlling TB, malaria, and HIV, among others. Despite claims that these would be exempt, distribution of antiretrovirals remains frozen.
The Senate Finance committee advanced RFK Jr for confirmation as HHS Secretary. Kennedy's disdain for evidence-based medicine is no secret. He is a conspiracy theorist who engages in dangerous race-based pseudoscience. The IDSA has fallen short of other professional societies (e.g. the American Public Health Association, which represents 25,000 public health professionals) in calling for the outright rejection of RFK Jr's nomination.
The CDC and NIH remain muzzled, unable to communicate with interstate or international agencies or the public. They have been instructed to recall submitted or accepted manuscripts to scrub objectionable language. They remain barred from traveling until at least the end of April. How will these actions affect our ability to detect and respond to infectious disease outbreaks?

Unfortunately and unsurprisingly, the administration continues to charge ahead, running roughshod over norms, laws, and the dignity of and most basic protections for the people most vulnerable to infections. Many of the changes are summarized here, up to date as of Feb 4. Who will speak up, or better still, ACT UP for these individuals? The National Science Foundation has reportedly shared with program officers a list of forbidden "DEI"-related words that will result in grants being flagged. These include routinely used terms like "female", "biased", "systemic", "inclusion" and "exclusion" along with other words that specifically target vulnerable populations. While few clinical researchers rely on NSF grants, it can be reasonably expected that similar censorship with grants from NIH, CDC, etc is inevitable. USAID funding remains frozen, and in fact there are reports of efforts underway to eliminate the entire agency. The effects have already been devastating for programs dedicated to controlling TB, malaria, and HIV, among others. Despite claims that these would be exempt, distribution of antiretrovirals remains frozen. The Senate Finance committee advanced RFK Jr for confirmation as HHS Secretary. Kennedy's disdain for evidence-based medicine is no secret. He is a conspiracy theorist who engages in dangerous race-based pseudoscience. The IDSA has fallen short of other professional societies (e.g. the American Public Health Association, which represents 25,000 public health professionals) in calling for the outright rejection of RFK Jr's nomination. The CDC and NIH remain muzzled, unable to communicate with interstate or international agencies or the public. They have been instructed to recall submitted or accepted manuscripts to scrub objectionable language. They remain barred from traveling until at least the end of April. How will these actions affect our ability to detect and respond to infectious disease outbreaks?

Meanwhile, our members are experiencing significant moral injury, and some have expressed levels of morale that rival the nadirs felt during the worst of COVID19. Every day it is a new insult, the cumulative effect being the disassembly of public health protections and further marginalization of the most vulnerable in society. 

Reticence to call attention to ourselves, potentially putting our work in the administration's cross hairs, is entirely understandable. After all, we don't want to imperil existing and ongoing advocacy efforts, including those related to bolstering the ID workforce. A sober analysis would concede that the likelihood of any potential actions moving the needle on any of these issues is low. I would argue, however, that standing up for what is right is the most important thing we can do to reinforce our commitment to social justice and to our members and the patients in our care. 

What we can do and how we can do it is up for debate; some bold ideas have already been presented in the IDea exchange forum and I welcome further input from colleagues. What is certain is that as rank-and-file individuals, our voices can easily be dismissed, but as a trusted, bipartisan professional organization that represents >13,000 infectious diseases experts, we cannot be ignored, and we must not allow ourselves to cower in silence. The reality is that things are going to get worse, and standing up to the assault on public health will only get more difficult as the administration becomes further emboldened and the actions set in motion gather steam. 

In the words of John Lewis, "If not us, then who? If not now, then when?"

Meanwhile, our members are experiencing significant moral injury, and some have expressed levels of morale that rival the nadirs felt during the worst of COVID19. Every day it is a new insult, the cumulative effect being the disassembly of public health protections and further marginalization of the most vulnerable in society. Reticence to call attention to ourselves, potentially putting our work in the administration's cross hairs, is entirely understandable. After all, we don't want to imperil existing and ongoing advocacy efforts, including those related to bolstering the ID workforce. A sober analysis would concede that the likelihood of any potential actions moving the needle on any of these issues is low. I would argue, however, that standing up for what is right is the most important thing we can do to reinforce our commitment to social justice and to our members and the patients in our care. What we can do and how we can do it is up for debate; some bold ideas have already been presented in the IDea exchange forum and I welcome further input from colleagues. What is certain is that as rank-and-file individuals, our voices can easily be dismissed, but as a trusted, bipartisan professional organization that represents >13,000 infectious diseases experts, we cannot be ignored, and we must not allow ourselves to cower in silence. The reality is that things are going to get worse, and standing up to the assault on public health will only get more difficult as the administration becomes further emboldened and the actions set in motion gather steam. In the words of John Lewis, "If not us, then who? If not now, then when?"

I am deeply disappointed by the subdued response of the Infectious Diseases Society of America (@idsainfo.bsky.social) to the dismantling of public health structures, both in the US & globally

Here's what I wrote in the closed listserv (response: ๐Ÿฆ—) in hopes of stimulating discussion here #IDSky

07.02.2025 18:32 ๐Ÿ‘ 308 ๐Ÿ” 90 ๐Ÿ’ฌ 14 ๐Ÿ“Œ 2
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Censor CDC scientists and ask them to withdraw papers from medical journals?

This is not how it works, Mr President.

Our response @bmj.com on the Trump Executive Order and his "forbidden words"

www.bmj.com/content/388/...

04.02.2025 17:30 ๐Ÿ‘ 1308 ๐Ÿ” 522 ๐Ÿ’ฌ 67 ๐Ÿ“Œ 85
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CDC advisers push agency to explain data removal, say when info will be restored Information on topics such as gender, teens' behavior, and infectious diseases was removed from the CDC's website.

BREAKING: CDC's top advisors demand answers and a restoration of crucial public health data. New story by me: www.statnews.com/2025/02/01/c...

01.02.2025 23:41 ๐Ÿ‘ 3820 ๐Ÿ” 1344 ๐Ÿ’ฌ 65 ๐Ÿ“Œ 52

Feels like the Covid emergency again

Except the epicentre is now the US, and the virus is a deadly cocktail of

- white supremacy
- heteropatriarchy
- racial capitalism
- autocracy
- broligarchy

01.02.2025 22:38 ๐Ÿ‘ 145 ๐Ÿ” 31 ๐Ÿ’ฌ 1 ๐Ÿ“Œ 2
01.02.2025 13:37 ๐Ÿ‘ 12 ๐Ÿ” 5 ๐Ÿ’ฌ 0 ๐Ÿ“Œ 0
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How Democracy dies.

01.02.2025 14:37 ๐Ÿ‘ 47 ๐Ÿ” 12 ๐Ÿ’ฌ 1 ๐Ÿ“Œ 1
Let's Hope the MMWR Resumes Publication Sooner Rather Than Later To us specialists in Infectious Diseases, there are certain verities we hold near and dear to ourย hearts: Antibiotics are miracle drugs, but the bugs will become resistant if we donโ€™t use them respons...

The communications pause for federal health agencies meant that the CDC couldn't publish the MMWR this week -- the first time in the publication's 60+ year history this has happened.

Unhappy about this! Getting good data published on infectious threats is critical, especially as H5N1 looms. #IDSky

25.01.2025 10:42 ๐Ÿ‘ 122 ๐Ÿ” 45 ๐Ÿ’ฌ 2 ๐Ÿ“Œ 4
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Trump Pauses Disbursements to Program Supplying H.I.V. Treatment Worldwide Pepfar, which is estimated to have delivered lifesaving treatment to as many as 25 million people in 54 countries, faces a funding delay of as long as 180 days.

PEPFAR is one of the most successful global health programs ever

It provides HIV treatment for 20 million people

And now it faces a funding delay of up to 6 months

Without access to treatment, HIV can rebound in less than a month.

This is self-defeating stupidity. www.nytimes.com/2025/01/24/u...

24.01.2025 22:27 ๐Ÿ‘ 107 ๐Ÿ” 51 ๐Ÿ’ฌ 5 ๐Ÿ“Œ 7
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Trump Pauses Disbursements to Program Supplying H.I.V. Treatment Worldwide Pepfar, which is estimated to have delivered lifesaving treatment as many as 25 million people in 54 countries, faces a funding delay of as long as 180 days.

This will kill so many people living with HIV who depend on PEPFAR programs to stay on their HIV treatment driving further HIV drug resistance.

www.nytimes.com/2025/01/24/u...

24.01.2025 21:27 ๐Ÿ‘ 867 ๐Ÿ” 469 ๐Ÿ’ฌ 45 ๐Ÿ“Œ 129

No study section...no grant reviews
No grant reviews...no grants awarded
No grants awarded...no research
No research...no functional NIH

22.01.2025 21:21 ๐Ÿ‘ 1025 ๐Ÿ” 442 ๐Ÿ’ฌ 32 ๐Ÿ“Œ 40
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Ebola and a Decade of Disparities โ€” Forging a Future for Global Health Equity | NEJM Since the 2014โ€“2016 West African Ebola outbreak, there have been numerous proposals and promises to reform global health infrastructure. Yet inequity remains deeply entrenched.

From HiV to Ebola to Covid and mpox, inequities in access is a defining feature

Grateful to @craigspencer.bsky.social for his advocacy

www.nejm.org/doi/full/10....

18.01.2025 23:30 ๐Ÿ‘ 96 ๐Ÿ” 39 ๐Ÿ’ฌ 1 ๐Ÿ“Œ 5
Graphic image of a single line bar chart titled "Bird flu, a timeline." 

A large teal bar goes halfway across frame starting on left is titled "Bird flu isn't real". Large orange bar to the immediate right of the teal bar going almost the rest of the way across the frame, titled "Okay, bird flu is real, but it poses no meaningful risk to humans." Small red bar to immediate right of that titled "Oops" and smaller yellow bar at far right titled "Fuck."

Graphic image of a single line bar chart titled "Bird flu, a timeline." A large teal bar goes halfway across frame starting on left is titled "Bird flu isn't real". Large orange bar to the immediate right of the teal bar going almost the rest of the way across the frame, titled "Okay, bird flu is real, but it poses no meaningful risk to humans." Small red bar to immediate right of that titled "Oops" and smaller yellow bar at far right titled "Fuck."

Yup, this about sums it up.

Image credit: Xitter account om_rxd
#MedSky #IDSky

17.01.2025 16:15 ๐Ÿ‘ 106 ๐Ÿ” 25 ๐Ÿ’ฌ 1 ๐Ÿ“Œ 5