Lunchtime pandemic reading.
Standard disclaimer: this is a roundup of informative pieces I've read that interest me on the severity of the crisis and how to manage it. I am not a qualified medical expert in ANY sense; at best I am reasonably well-read laity. ALWAYS prioritize advice from qualified healthcare experts over some person on Facebook.
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How many deaths could America have prevented? "How many of the 164,000 COVID deaths in the US were preventable, if we had a better response, leadership, & had done things sooner rather than playing defense? @ASlavitt
I estimate >70% less deaths. Here’s how. We are at ~490 deaths per million. Germany is 110 per million.
Germany is a good country to benchmark to. It has done a good job on COVID, and a country in Europe which we has good financial resources like us. Germany was surrounded by cases in Europe. But contained COVID. Germany’s 110 per million deaths is where we could have been.
If we benchmark to other European countries like Denmark, Austria, Finland, & all of Eastern Europe; the deaths per million in those countries are much lower than Germany. If we were to have acted like like them, we would have >80-90% less deaths.
I’m not even comparing us to Asian countries like S. Korea or Japan who have 6 to 8 deaths per million. If we were to have performed like them, we would have >95% fewer deaths.
So my estimate of >70% preventable deaths is conservative.
We are lower in deaths per million compared to 5 countries in Europe: Belgium, UK, Spain, Italy, & Sweden. Like us, it was failure of leadership and/or they got hit before they knew what hit them (Italy, Belgium, Spain) coz they didn’t have the extra month we did (Feb)
Well we won’t be lower that Belgium, UK, Spain, Italy, and Sweden for long, if we don’t slow down.
The only other countries with deaths per million higher than us in the whole world are Andorra, Peru, and Chile.
Brazil is just below us.
When we want to estimate how many deaths could have been prevented we need to compare ourselves to countries with similar resources who acted efficiently. We can’t compare ourselves to countries who may have made same mistakes like us, or didn’t have fair warning.
This is why I don’t feel comforted that our deaths per million is lower than UK, Sweden, Belgium, Italy, or Spain.
We saw Lombardy. But we still couldn’t prevent New York.
We can still turn things around. I really hope we do.
By the way. I did intentionally leave out the #1 country in deaths per million San Marino: the total population of San Marino is 33,000.
We can forgive them. Their rate is lower than deaths per million in NY, NJ, MA, and CT.
.@ASlavitt had a great thread that highlighted the number of deaths that could have been prevented, and listed what we can do to turn things around."
Source:
Commentary: 70% fewer deaths would mean at this point in time, America would have 66,000 dead instead of 222,000 dead. That is a tragic, appalling failure of the nation's COVID-19 strategy and a clear indication we need to completely rethink and reboot it.
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Death rates decline. "Two new peer-reviewed studies are showing a sharp drop in mortality among hospitalized COVID-19 patients. The drop is seen in all groups, including older patients and those with underlying conditions, suggesting that physicians are getting better at helping patients survive their illness.
"We find that the death rate has gone down substantially," says Leora Horwitz, a doctor who studies population health at New York University's Grossman School of Medicine and an author on one of the studies, which looked at thousands of patients from March to August.
The study, which was of a single health system, finds that mortality has dropped among hospitalized patients by 18 percentage points since the pandemic began. Patients in the study had a 25.6% chance of dying at the start of the pandemic; they now have a 7.6% chance.
That's a big improvement, but 7.6% is still a high risk compared with other diseases, and Horwitz and other researchers caution that COVID-19 remains dangerous.
The death rate "is still higher than many infectious diseases, including the flu," Horwitz says. And those who recover can suffer complications for months or even longer. "It still has the potential to be very harmful in terms of long-term consequences for many people."
Studying changes in death rate is tricky because although the overall U.S. death rate for COVID-19 seems to be dropping, the drop coincides with a change in whom the disease is sickening.
"The people who are getting hospitalized now tend to be much younger, tend to have fewer other diseases and tend to be less frail than people who were hospitalized in the early days of the epidemic," Horwitz says."
Source: https://www.npr.org/sections/health-shots/2020/10/20/925441975/studies-point-to-big-drop-in-covid-19-death-rates
Commentary: The conclusion thus far is that death rates are declining because of many confluent factors - different people getting infected, improvements in therapies, identification of more severe cases earlier - all good news.
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Boston schools go all virtual. "All students in Boston Public Schools will switch to remote learning due to the rising coronavirus numbers in the city.
Earlier this month the mayor put a pause on the reopening. Now, all students are going remote starting Thursday.
Just a few weeks ago, little Simon Castro was at City Hall with his sign for Mayor Marty Walsh that read: “I need school." We caught up with him Wednesday after news that Boston was going all remote.
His mother, Megan Castro, said, “It’s a bummer. The main frustration is this isn’t going to solve our problem.”
The announcement, made in a letter sent to parents Wednesday morning, states that due to a rising infection rate in the city, all students will shift to remote learning effective Thursday, October 22.
The numbers are going up. The city’s seven-day average COVID-19 positive test rate was reported at 5.7% which is an increase from last week’s rate of 4.5%.
Once the citywide seven-day COVID-19 positivity rate is below 5% for two consecutive weeks, students with the highest needs will have the option to return to in-person learning."
Source: https://www.boston25news.com/news/local/boston-public-schools-switching-all-remote-learning-due-rising-covid-19-numbers/KM5UI7FYWFBXHNHKKD7JZADL7A/
Commentary: A 5% positivity rate means that either the disease is expanding or testing is falling behind, and in Massachusetts, the state is hitting its testing goals - so the disease is expanding.
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3 minutes is all it takes. "New details have emerged of latest Covid infections that are currently being treated in New Zealand.
The Ministry of Health has revealed a breakdown of who is infected after a fresh outbreak among a group of Russian and Ukrainian seaman recently arrived in the country, and a new community outbreak involving port staff.
Yesterday was the largest increase in a 24-hour period of active cases since August's outbreak with 25 new cases.
It comes as concern mounts over the revelation one of the infected port workers contracted the disease after just three minutes of contact with a sick man."
Source: https://www.nzherald.co.nz/nz/covid-19-coronavirus-what-we-know-about-this-latest-outbreak/ZKGSBHIK4QL5X7OGYPS5QWSPZA/
Commentary: 3 minutes to infection indicates that what constitutes close contact with an infected person may need to be rethought. If you've been following the cigarette smoke rule, you should be okay - meaning you always wear a mask anytime you're within distance of a person where you could realistically smell them smoking.
Wear a mask at all times outside your home. Period.
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A reminder of the simple daily habits we should all be taking.
1. Wash/sanitize your hands every time you are in or out of your home for any reason. Consider also spraying the bottoms of your shoes with a general disinfectant (alcohol/bleach/peroxide) when you return home. Remember that cleaners are NEVER to be ingested or injected.
2. Always wear a mask when out of your home and if going to a high risk area, wear goggles. Respirators are back in stock at online retailers, too.
3. Stay home as much as possible. Minimize your contact with others and maintain physical distance of at LEAST 6 feet / 2 meters, preferably more. Avoid indoor places as much as you can; indoor spaces spread the disease through aerosols and distance is less effective at mitigating your risks.
4. Get your personal finances in order now. Cut all unnecessary costs.
5. Replenish your supplies as you use them. Avoid reducing your stores to pre-pandemic levels in case an outbreak causes unexpected supply chain disruptions.
6. Participate in your local political process. For Americans, go to Vote.org and register/verify your vote.
7. Ventilate your home as frequently as weather and circumstances permit.
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Common misinformation debunked!
There is no genomic evidence at all that COVID-19 arrived before 2020 in the United States and therefore no hidden herd immunity:
Source:
There is no evidence SARS-CoV-2 was engineered, nor that it escaped a lab somewhere.
Source: https://www.washingtonpost.com/world/2020/01/29/experts-debunk-fringe-theory-linking-chinas-coronavirus-weapons-research/
Source: https://www.nature.com/articles/s41591-020-0820-9
Source: https://www.nationalgeographic.com/science/2020/05/anthony-fauci-no-scientific-evidence-the-coronavirus-was-made-in-a-chinese-lab-cvd/
There is no evidence a flu shot increases your COVID-19 risk.
Source: https://www.factcheck.org/2020/04/no-evidence-that-flu-shot-increases-risk-of-covid-19/
Source: https://academic.oup.com/cid/advance-article/doi/10.1093/cid/ciaa626/5842161
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A common request I'm asked is who I follow. Here's a public Twitter list of many of the sources I read.
https://twitter.com/i/lists/1260956929205112834
This list is biased by design. It is limited to authors who predominantly post in the English language. It is heavily biased towards individual researchers and away from institutions. It is biased towards those who publish or share research, data, papers, etc. I have made an attempt to follow researchers from different countries, and also to make the list reasonably gender-balanced, because multiple, diverse perspectives on research data are essential.
This is also available as an email newsletter at https://lunchtimepandemic.substack.com if you prefer the update in your inbox.