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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Dr. Christopher Murray on reopening the country: "If the first testing we've done on this is if you opened up the entire country may 1, then we would very clearly have a rebound. We don't think that capability in the states exists yet to deal with that volume of cases. And so by July or August, we could be back in the same situation we are now. I think what Dr. Fauci was talking about this morning is that different states are on different timings. And so maybe some states can open up mid May. But we have to be very careful and make sure that we don't sort of lose all the effort that the American people have put into closures by premature opening."
Source:
Transcript: https://otter.ai/s/xN18Iz53TEOOnrJ6WMzK6g
Until testing ramps up, opening up the country in any capacity puts us back on the path of massive deaths. In the grand scheme of things, relatively few people have had this disease, it's highly contagious, and it's substantially dangerous to a significant part of our population. There is no place in the world that is ready to just go back to normal - even China has re-enacted restrictions because of a resurgence of cases.
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Serology testing may be of limited value at this point in time, according to Dr. Scott Gottlieb: "Well, it may be widely available, but I think it's of marginal utility and impact for these kinds of discussions. What serology tells you is if you have circulating antibodies in your blood, if you've been exposed to the virus, and you've developed some level of immunity, but I think when we actually do serology on the population, we're going to find the actual level of exposure across the population is very low, somewhere between maybe two or 5%. And I'd put on the low end of that range. That's certainly the modeling the data coming out of Europe where they have anywhere from two to 5% of their populations exposed. If you look in certain professions, healthcare workers, police, people who work on grocery checkout lines, flight attendants, TSA agents, people come in contact with a lot of people as part of their work, the rates may be higher, maybe on the order of 10% that had been exposed and develop some immunity. So you can make decisions in those professions to preferentially return certain people or certain people on the front lines right away. But on the whole, we're going to find that a very small percentage of this population, certainly in the single digits have actually been exposed to infection. So the perception that there's 30 or 40% that have been exposed and develop immunity, it's not going to be the case."
Source:
Transcript: https://otter.ai/s/GWXg16h1RXWZ_xusB1HQ1Q
We absolutely should test. What we will find out is that we are very far from any kind of herd immunity.
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Walmart's CEO says we're in the "hair color" phase of panic buying. ""You can definitely see that as people have stayed home, their focus shifted," Walmart CEO Doug McMillon said on the Today Show, Friday. After stocking up on food and consumable products, shoppers turned to puzzles, games and other timeless forms of entertainment as well as education, he said. Now, sales are showing that — without the ability to venture to a hair salon — folks are getting shaggy. "People are starting to need a haircut," McMillon said. "You see more beard trimmers and hair color and things like that. It's interesting to watch the dynamic play out."
Source: https://www.cnn.com/2020/04/11/business/panic-buying-walmart-hair-color-coronavirus/index.html
If you want to figure out what will happen next, there's no better way than to pay attention to search trends and how you live your life. What are the things you'd normally do outside of your home? What are the logical alternatives you'd search for? Monitor with Google Trends and you'll find out quickly whether a panic buying phase is about to begin on that item - and if you're lucky, you'll anticipate it before the rush and procure the necessary items before the crowd.
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A new pre-print study from Brazil shows that chloroquine trials had to be stopped due to adverse effects. "Preliminary findings suggest that the higher CQ dosage (10-day regimen) should not be recommended for COVID-19 treatment because of its potential safety hazards. Such results forced us to prematurely halt patient recruitment to this arm. Given the enormous global push for the use of CQ for COVID-19, results such as the ones found in this trial can provide robust evidence for updated COVID-19 patient management recommendations."
Source: https://www.medrxiv.org/content/10.1101/2020.04.07.20056424v1
This is the first new study on chloroquine and its variants that really illustrates just how dangerous it is for non-medical professionals to be handing out medical advice. When prominent politicians quip, "What have you got to lose?" the answer is: your life.
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EpiForecasts has a great subnational data analysis for the United States - the key being the reproduction rates at state levels.
Source: https://epiforecasts.io/covid/posts/national/united-states/
The chart to pay attention to in this collection is the reproduction rates by state; the dashed line indicates that the state either is in growing or declining infection modes.
Some states, like New Mexico, West Virginia, South Dakota, and Rhode Island are in dangerous territories; their social distancing efforts may not be sufficient. Other states, like Washington, seem to have contained their outbreak thus far.
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Stat News has a well-thought out piece on the upsides and downsides of immunity certifications. "Immunity certificates offer the enticing promise that an increasing number of people can stop sheltering in place and instead help the world revive. They could play an important role in the period before we have excellent treatments or an effective vaccine. But they raise issues about the science of Covid-19 immunity, about how such certificates would be provided and policed and, most important, about a country split between the free and the confined. Let’s look at the science first. No one knows whether infection with SARS-CoV-2 confers immunity to reinfection and, if it does, how strong that immunity is and for how long it lasts. Not only is that information missing, but we cannot get it soon — it will be nine months before we can know if antibodies last a year."
Source: https://www.statnews.com/2020/04/10/immunity-certificates-covid-19-practical-ethical-conundrums/
The idea of immunity certificates will conflict with the reality - that these will be only a small part of the overall toolkit (and that forgery will be a problem). Ultimately, the only normalcy guarantee is a vaccine.
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A reminder of the simple daily habits we should all be taking.
1. Wash/sanitize your hands often, and 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.
2. Wear gloves and appropriate protective equipment if you have it when out of your home in any enclosed airspace (stores, etc.).
3. Stay home. Just stay home.
4. Get your personal finances in order now. Cut all unnecessary costs.
5. Donate any PPE you can. https://getusppe.org/give/