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kit_delgadoMD's profile
M. Kit Delgado, MD, MS
M. Kit Delgado, MD, MS
M. Kit Delgado, MD, MS
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@kit_delgadoMD

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M. Kit Delgado, MD, MSVerified account

@kit_delgadoMD

ER doc, epi prof @PennNudgeUnit @PennCHIBE @PennCECPR @PennLDI @PennInjury @UPennDBEI. data/behavioral science for preventing injuries & improving acute care

Philadelphia, PA
med.upenn.edu/apps/faculty/i…
Joined October 2015

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    1. M. Kit Delgado, MD, MS‏Verified account @kit_delgadoMD Jan 2

      Boosted? Hardly saw anyone who had gotten a booster because if they caught Covid they’re likely at home doing fine or having regular cold/flu like symptoms

      14 replies 133 retweets 850 likes
      Show this thread
    2. M. Kit Delgado, MD, MS‏Verified account @kit_delgadoMD Jan 2

      Vaxxed/unboosted? Tons of patients like this: wiped out, dehydrated, febrile. If they were older (eg > 55 yo or had other medical problems) often had to admit for overnight IV hydration and supportive care. But usually go home within a day or two.

      10 replies 142 retweets 806 likes
      Show this thread
    3. M. Kit Delgado, MD, MS‏Verified account @kit_delgadoMD Jan 2

      Unvaxxed: These are the folks that get sick and had to be hospitalized because they need oxygen, some even younger than me. Fortunately Philly has a fairly high vaccination rate, particularly in older adults, so we’re not seeing severe cases as much as we used to.

      12 replies 114 retweets 733 likes
      Show this thread
    4. M. Kit Delgado, MD, MS‏Verified account @kit_delgadoMD Jan 2

      Covid is all around. Chances are you’ll get it at some point. I share these observations in case you’re on the fence about whether you want a booster or your first shot, or if you are fully boosted, that you have some peace of mind and feel less anxious. But...

      4 replies 66 retweets 582 likes
      Show this thread
    5. M. Kit Delgado, MD, MS‏Verified account @kit_delgadoMD Jan 2

      ...In the meantime, a jump in vaccination rates is not going fix this insane surge in cases we're seeing right now and for the next 4-6 weeks. Health and social systems need to seriously adapt and quickly, or our ability to provide health care will be seriously compromised...

      7 replies 93 retweets 647 likes
      Show this thread
    6. M. Kit Delgado, MD, MS‏Verified account @kit_delgadoMD Jan 2

      ...First, this Covid wave is different and we need to be smarter about how we interpret Covid cases that present to the ER and subsequent hospitalizations numbers (which are through the roof). They fall into three categories and can be managed differently...

      1 reply 50 retweets 450 likes
      Show this thread
    7. M. Kit Delgado, MD, MS‏Verified account @kit_delgadoMD Jan 2

      1) Hospitalized for Covid: mostly unvaxxed or elderly/chronic ill & unboosted 2) Covid exacerbated a chronic illness (e.g. COPD) aka "The Covid Tip” (h/t @jeremyfaust) 3) Incidental Covid (caught on screening) happens to everybody (maybe ~1/5 of hospitalizations I saw)...

      12 replies 99 retweets 631 likes
      Show this thread
    8. M. Kit Delgado, MD, MS‏Verified account @kit_delgadoMD Jan 2

      ...Based on increased immunity in the population, and this lower severity strain of Covid, less people are presenting with a need for ICU level care. But a HUGE number need supportive care over 1-3 days (e.g. IV fluids, brief oxygen support, optimization of chronic illness)...

      5 replies 155 retweets 715 likes
      Show this thread
    9. M. Kit Delgado, MD, MS‏Verified account @kit_delgadoMD Jan 2

      ...Second major difference in this wave is there a huge number of patients coming to the ER for testing with mild symptoms or even no symptoms because of the lack of available testing or timely outpatient evaluation capacity elsewhere...

      5 replies 80 retweets 671 likes
      Show this thread
    10. M. Kit Delgado, MD, MS‏Verified account @kit_delgadoMD Jan 2

      ...Lastly, the shear number of people testing positive with mild or no symptoms means there's a large population of patients with serious health needs that are having challenges accessing care because of their Covid + status...

      6 replies 93 retweets 660 likes
      Show this thread
      M. Kit Delgado, MD, MS‏Verified account @kit_delgadoMD Jan 2

      ...Dialysis patients report difficulty getting outpatient dialysis because they tested positive. Many psych crisis centers, detox units, homeless shelters, and some nursing facilities won’t accept Covid+ patients. This leads to extra time in the hospital to meet these needs...

      7:49 PM - 2 Jan 2022
      • 162 Retweets
      • 824 Likes
      • Marcelo H. Simoni geboosterter Grashalm 💉💉💉 tr AreeBird ferdi magellan Christina Cat bunchabunniculas Q. MOSES Chuck Grantham
      4 replies 162 retweets 824 likes
        1. New conversation
        2. M. Kit Delgado, MD, MS‏Verified account @kit_delgadoMD Jan 2

          ...So what can health systems do over the next 4-6 weeks to deal with the surge? 1) Set up Covid testing and flu like illness clinics outside the ER to divert low severity patients from ERs to more convenient care and allow ERs to focus on non Covid and Covid emergency care...

          7 replies 172 retweets 1,151 likes
          Show this thread
        3. M. Kit Delgado, MD, MS‏Verified account @kit_delgadoMD Jan 2

          M. Kit Delgado, MD, MS Retweeted M. Kit Delgado, MD, MS

          ...2) Optimize care pathways in the hospital. We have shown the benefits of triaging lower severity patients (who are now the majority of hospitalizations) to dedicated Covid observation units. Better care, less time in the hospital. See article below...https://twitter.com/kit_delgadoMD/status/1476415348375265280?s=20 …

          M. Kit Delgado, MD, MS added,

          M. Kit Delgado, MD, MSVerified account @kit_delgadoMD
          This #Covid19 surge is different. Much bigger number and % of short stay hospitalizations for 1 to 3 of days for things like IV fluids and supportive care. Here’s a model of care our team developed that can improve care for these types of patients https://www.pennmedicine.org/news/news-blog/2021/november/how-observation-units-and-texting-create-hospital-capacity-during-covid19 …
          5 replies 83 retweets 620 likes
          Show this thread
        4. M. Kit Delgado, MD, MS‏Verified account @kit_delgadoMD Jan 2

          ...Another way to do this is to post a Hospitalist physician in the ER to help manage and optimize care for patients who are waiting for an inpatient bed to open up. By the time a bed opens up 24-48 hours later, the patient may be ready to be discharged from the ER...

          4 replies 46 retweets 536 likes
          Show this thread
        5. M. Kit Delgado, MD, MS‏Verified account @kit_delgadoMD Jan 2

          ...3) Dialysis centers, behavioral health treatment providers, and long term care providers need to adapt to the reality that a huge proportion of patients who need their care will incidentally test positive for Covid. Decreased access to care will worsen outcomes, and...

          5 replies 71 retweets 586 likes
          Show this thread
        6. M. Kit Delgado, MD, MS‏Verified account @kit_delgadoMD Jan 2

          ...and with staff in these facilities almost universally vaccinated and everyone wearing masks, the risks from Covid are no worse than any other aspect of society (family gatherings, public transportation, shopping, dining, bars, etc)...

          10 replies 37 retweets 444 likes
          Show this thread
        7. M. Kit Delgado, MD, MS‏Verified account @kit_delgadoMD Jan 2

          ...4) Finally, implementing a low-tech text-message based monitoring program can help the millions of patients who will test positive stay safe at home and get to the hospital at the right time if they get sick. See our work below...https://www.pennmedicine.org/news/news-releases/2021/november/automated-texting-system-saved-lives-weekly-during-first-covid-surge …

          7 replies 112 retweets 707 likes
          Show this thread
        8. M. Kit Delgado, MD, MS‏Verified account @kit_delgadoMD Jan 2

          M. Kit Delgado, MD, MS Retweeted Benjy Renton

          ......Thanks for reading. Hopefully by late Feb we will have more people boosted and access to new antivirals. Until then, things will be tough. Give us a hand in the hospital by helping to decrease the spread of Covid because right now it's unsustainable/https://twitter.com/bhrenton/status/1477510685408047104?s=20 …

          M. Kit Delgado, MD, MS added,

          Benjy Renton @bhrenton
          Tonight's Circuit Breaker Dashboard update: - 390 counties projected to be at hospital capacity (up from 354 yesterday) - 212 counties are at high risk of hitting capacity within the next 10 days (down from 285 yesterday) - 19 as "unsustainable" Explore: http://alexanderjxchen.github.io/circuitbreaker/  pic.twitter.com/a5fsQJR7GS
          11 replies 89 retweets 574 likes
          Show this thread
        9. M. Kit Delgado, MD, MS‏Verified account @kit_delgadoMD Jan 3

          M. Kit Delgado, MD, MS Retweeted M. Kit Delgado, MD, MS

          …PS - Fortunate to be part @Pennmedicine which has been very proactive in responding to this pandemic all along, increasing access vaccines, testing, remote monitoring and other innovations. But most of all, inspired by my colleagues. See thread belowhttps://twitter.com/kit_delgadoMD/status/1477436865632428036?s=20 …

          M. Kit Delgado, MD, MS added,

          M. Kit Delgado, MD, MSVerified account @kit_delgadoMD
          Happy New Year! Just finished my block of ER shifts this week. This Covid surge has caused some challenges to say the least, but proud to be a part of the ER team at @PennMedicine Presby hospital which has risen to challenge to make sure everyone gets the care they need pic.twitter.com/BrTHop7tto
          Show this thread
          15 replies 26 retweets 403 likes
          Show this thread
        10. M. Kit Delgado, MD, MS‏Verified account @kit_delgadoMD Jan 4

          M. Kit Delgado, MD, MS Retweeted M. Kit Delgado, MD, MS

          ..PS - Hospital and ER overcrowding, lack of bed capacity, and long ER waits are chronic problems made 100 times worse by Covid, omicron. Here's the best piece explaining underlying causes and short and long term solutions:https://twitter.com/kit_delgadoMD/status/1443559587064463366 …

          M. Kit Delgado, MD, MS added,

          M. Kit Delgado, MD, MSVerified account @kit_delgadoMD
          America's crowded ERs and full waiting rooms are a symptom of an untreated disease of the US health care system, only made worse by #COVID19. This is the piece you want to read to understand the problem and proven solutions to fix it. @nejmcatalyst https://catalyst.nejm.org/doi/full/10.1056/CAT.21.0217 … pic.twitter.com/XnYpZUFQlY
          7 replies 25 retweets 95 likes
          Show this thread
        11. End of conversation
        1. Rebecca Jaffe, MD‏ @RJmdphilly Jan 2
          Replying to @kit_delgadoMD

          This is what’s crushing us in hospital Med

          0 replies 0 retweets 1 like
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