Neil Sehgal, PhD, MPH

Associate Professor of Health Systems and Population Health @UWSPH studying Health Organizations. Formerly @UMDPublicHealth, @UCBerkeleySPH, @UCSF, & @UCLAFSPH.

[Neil Sehgal, PhD, MPH @NeilSehgal]

Policy matters: Deaths in Republican counties aren’t limited to people who are unvaccinated or unwilling to mask because of their political opinions.

New work in @Health_Affairs with my colleagues @professor_roby and @DahaiYue and stellar PhD students @ellefpope and @RenHaoWang.

[Health Affairs @Health_Affairs]

In their paper, @UMDPublicHealth's @NeilSehgal +coauthors find that counties in which a majority of presidential votes cast were for the Republican presidential candidate in 2020 experienced 72.9 additional #COVID19 deaths per 100k people relative to majority Democratic counties.

[Neil Sehgal, PhD, MPH @NeilSehgal]

So, if we want Americans to get vaccinated against COVID with more urgency than they do the flu, we should probably stop equating the two.

If the flu shot really is our benchmark, we can expect ~40% coverage as an upper bound and for disparities in vaccination rates to continue.

[Neil Sehgal, PhD, MPH @NeilSehgal]

Not to be pedantic, but @AshishKJha46’s fact that “a majority of American adults go get the flu shot every fall” is… well… an alternative fact.

A very slim majority of adults got the flu shot last fall (50.2%) and pre-pandemic rates were as low as 37%.

https://t.co/AfE69S5fXk

[Dan Diamond @ddiamond]

At White House, @tylerpager presses @AshishKJha46 on low covid booster rate + if Biden’s “pandemic is over” rhetoric contributed.

JHA: A majority of American adults go get the flu shot every fall… they don’t do it because the president comes out and says we have a flu pandemic.

[Neil Sehgal, PhD, MPH @NeilSehgal]

Examining that uptick in flu shots last season, nearly all of the additional coverage is explained by an increase in shots among White people. Flu vaccination coverage wasn’t markedly different year-over-year for Hispanic people and coverage actually decreased among Black people.

[Neil Sehgal, PhD, MPH @NeilSehgal]

@giordynne @AShihipar @masknerd @linseymarr You can find the 3M VFlex 9105 on @projectn95 here: https://t.co/RZ8MPHPciI

Also available from Amazon: https://t.co/PeDU8hjMYH

[Neil Sehgal, PhD, MPH @NeilSehgal]

@wsbgnl @ddiamond @alexmeshkin Framing that people have simply ‘tuned out’ minimizes the impact that social influences (including the media) have had on those decisions to move on. Authorities have long asserted that COVID is mild for vaccinated people. Why would we expect them believe they need a booster now?

[Neil Sehgal, PhD, MPH @NeilSehgal]

We struggle in public health, especially preventing infectious diseases, because the reality of it is sometimes emotionally difficult for people.

It’s not pleasant to think that your COVID infection contributed to a chain of transmission which maybe cost someone else their life.

[Harry Thomas @DrHarryThomas]

Time to get your flu shot, especially if you're in Texas or D.C.

[Neil Sehgal, PhD, MPH @NeilSehgal]

In fact, a lot of people who likely didn’t vote for Trump, let alone listen to him, lost their lives needlessly since the beginning of the pandemic.

The ‘us’ vs. ‘them’ feels a little hollow when you consider the magnitude of that excess death.

h/t @paulgp for the figure below.

[Neil Sehgal, PhD, MPH @NeilSehgal]

Respectfully, @notcapnamerica, I feel bad for anyone who loses their life needlessly. Regardless of our political differences or where they got their COVID-19 information from.

And as a reminder, about 500 Americans still are every day. Not all of those people listened to Trump.

[chris evans @notcapnamerica]

Do you feel bad for people who listened to Trump, didn’t get vaccinated and died from COVID?

[Neil Sehgal, PhD, MPH @NeilSehgal]

@JReinerMD You (not you @JReinerMD) can’t equate COVID to the flu and expect better vaccine uptake. The ‘silent’ roll-out of updated boosters mostly mirrored the annual flu shot roll-out.
About 40% of US adults get vaccinated for the flu in a typical year. That’s likely our upper-bound now.

[Neil Sehgal, PhD, MPH @NeilSehgal]

According to @KFF’s September Vaccine Monitor, 32% of adults indicated they either have gotten the updated COVID booster or were planning to as soon as possible.

[Neil Sehgal, PhD, MPH @NeilSehgal]

If we wanted Americans to get vaccinated for COVID with more urgency than they do the flu, public health luminaries probably shouldn’t have equated the two.

Before COVID, about 40% of US adults got vaccinated for the flu each year.

[Leana Wen, M.D. @DrLeanaWen]

“Through good science and luck, there is welcome alignment between the prevalent coronavirus strain and the booster shot to combat it…. But the vaccines are useless if the public doesn’t get them.” @PostOpinions https://t.co/PVUEolfc3d

[Neil Sehgal, PhD, MPH @NeilSehgal]

I hate to be the reminder guy, but on Wednesday 916 Americans lost their lives to COVID-19. On Thursday @AshishKJha46 and @Surgeon_General were bantering about ice cream cones.

Just wondering: do either of you have a plan to fix that? Or, would @POTUS not approve of that either?

[Ashish K. Jha, MD, MPH Archived @AshishKJha46]

This man may be an amazing @Surgeon_General

But he's got a thing or two to learn about ice cream

Its not an ice cream cone without ice cream

@potus would not approve

[Neil Sehgal, PhD, MPH @NeilSehgal]

In this new ‘post-pandemic’ we’ll collectively abdicate our responsibility to keep vulnerable people safe, because it’s no longer politically expedient, and because people who aren’t vulnerable — or don’t realize they are — would rather feel comfortable than protect other people.

[Neil Sehgal, PhD, MPH @NeilSehgal]

We struggle in public health, especially preventing infectious diseases, because the reality of it is sometimes emotionally difficult for people.

It’s not pleasant to think that your COVID infection contributed to a chain of transmission which maybe cost someone else their life.

[Neil Sehgal, PhD, MPH @NeilSehgal]

Our leaders backed away from that narrative as soon as that political liability became apparent — it’s not good politics to make people sad.

It’s much easier to assert that the vulnerable people should have done something differently, and that now ‘they have the tools’ to do so.

[Neil Sehgal, PhD, MPH @NeilSehgal]

I admire @ZekeEmanuel for taking the steps he does to keep himself and his students safe. And clearly we know how to make lecture halls safer.

But not everyone in academia has the means to, or would be allowed even if they did.

So, Zeke’s classroom is probably safer than yours.

[Neil Sehgal, PhD, MPH @NeilSehgal]

Hey #AcademicTwitter — quick question (especially for you adjuncts, assistant professors and non-tenure track faculty):

How many of you have the ability (financially and by school policy) to run multiple HEPA air filters in your classroom and hand out N95 masks to every student?

[Devabhaktuni "Sri" Srikrishna @sri_srikrishna]

Not just one but 4 HEPA purifiers… “The oncologist, bioethicist, and professor @ZekeEmanuel provides each of his students with an N95 and runs four HEPA air filters during lectures.”

[Neil Sehgal, PhD, MPH @NeilSehgal]

Since colleges dropped policies that protect vulnerable faculty, students, and staff, we’re all sort of on our own. When our schools allow us to be, that is.

At the @UofMaryland we’re not allowed to require masks in our classrooms, and UMD cautions is about even requesting them.