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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This is why excess death counts matter. "One in four young adults between the ages of 18 and 24 say they've considered suicide in the past month because of the pandemic, according to new CDC data that paints a bleak picture of the nation's mental health during the crisis.
The data also flags a surge of anxiety and substance abuse, with more than 40 percent of those surveyed saying they experienced a mental or behavioral health condition connected to the Covid-19 emergency. The CDC study analyzed 5,412 survey respondents between June 24 and 30.
The toll is falling heaviest on young adults, caregivers, essential workers and minorities. While 10.7 percent of respondents overall reported considering suicide in the previous 30 days, 25.5 percent of those between 18 to 24 reported doing so. Almost 31 percent of self-reported unpaid caregivers and 22 percent of essential workers also said they harbored such thoughts. Hispanic and Black respondents similarly were well above the average.
Roughly 30.9 percent of respondents said they had symptoms of anxiety or depression. Roughly 26.3 respondents reported trauma and stress-related disorder because of the pandemic.
Another 13.3 percent of respondents said they have turned to substance use, including alcohol and prescription or illicit drugs, to cope with stress from the pandemic.
More than half of respondents who identified as essential workers reported some kind of adverse mental health or behavioral health condition related to the Covid-19 emergency."
Source: https://www.politico.com/news/2020/08/13/cdc-mental-health-pandemic-394832
Commentary: Excess death counts give us the full impact of the pandemic, and help us understand what things might have looked like if we hadn't had a pandemic and/or managed it very differently. Though in the United States we've had 167,369 deaths as of this writing, the New York Times reported earlier this week that the excess death count is well over 200,000.
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Are we improving or just hiding? "In Texas, new Covid-19 cases have fallen by 10% over the last two weeks, but testing is down by 53% over the same time.
For the first time in months, the daily growth of new coronavirus cases in the U.S. has steadily fallen over the past two weeks, giving some hope to U.S. officials who proclaimed there were “signs of progress” in Southern states that were hit particularly hard.
“No one’s declaring victory,” Adm. Brett Giroir, an assistant secretary at HHS, told reporters on a July 30 conference call. “We continue to see signs of progress across the Sun Belt and diffusely throughout the country.”
But testing shortages in key states and other gaps in Covid-19 data call into question the accuracy of those numbers and whether the outbreak in the U.S. is really improving or whether cases are simply going undiagnosed, epidemiologists say.
The country recorded an average of 52,875 new cases every day over the last seven days, down 19% from an average of 65,285 new cases per day on July 28, according to a CNBC analysis of data compiled by Johns Hopkins University. However, Covid-19 testing has declined as well, falling from a seven-day average of about 814,000 tests per day two weeks ago to about 716,000, a 12% decline, over the same two-week period, according to data compiled by the Covid Tracking Project, a volunteer project founded by journalists at The Atlantic magazine.
The decline in testing is particularly acute in some of the hardest-hit states with the worst outbreaks, which further skews the overall case numbers across the U.S.
In Texas, for instance, new cases have fallen by 10% to an average of 7,381 a day from 8,203 two weeks ago, based on a seven-day moving average. Testing, however, is down by 53% over the same time frame. Meanwhile, the percentage of positive tests has doubled over the last two weeks to about 24%, according to Johns Hopkins University. That compares with a so-called positivity rate of less than 1% in New York state, which was once considered the epicenter of the outbreak in the U.S.
“I really have come to believe we have entered a real, new, emerging crisis with testing and it is making it hard to know where the pandemic is slowing down and where it’s not,” Dr. Ashish Jha, director of the Harvard Global Health Institute, said in an interview with CNBC. The Texas data, he said, is “very concerning.”"
Source: https://www.cnbc.com/2020/08/12/accuracy-of-us-coronavirus-data-thrown-into-question-as-decline-in-testing-skews-drop-in-new-cases.html
Commentary: The axiom in management is that you can't manage what you don't measure. When you stop measuring, you stop being able to manage. A positivity rate of 24% is astonishingly high. At this point the only accurate measure you'll have of the pandemic's severity will be excess death counts, and that lags 8-12 weeks. Continue to press your elected officials wherever you are to maintain vigilance: test as much or more, and encourage the public to keep up health precautions. Wear a mask. Watch your distance. Wash your hands.
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Lingering symptoms. "Early on, patients with both mild and severe Covid-19 say they can’t breathe. Now, after recovering from the infection, some of them say they can’t think.
Even people who were never sick enough to go to a hospital, much less lie in an ICU bed with a ventilator, report feeling something as ill-defined as “Covid fog” or as frightening as numbed limbs. They’re unable to carry on with their lives, exhausted by crossing the street, fumbling for words, or laid low by depression, anxiety, or PTSD.
As many as 1 in 3 patients recovering from Covid-19 could experience neurological or psychological after-effects of their infections, experts told STAT, reflecting a growing consensus that the disease can have lasting impact on the brain. Beyond the fatigue felt by “long haulers” as they heal post-Covid, these neuropsychological problems range from headache, dizziness, and lingering loss of smell or taste to mood disorders and deeper cognitive impairment. Dating to early reports from China and Europe, clinicians have seen people suffer from depression and anxiety. Muscle weakness and nerve damage sometimes mean they can’t walk.
“It’s not only an acute problem. This is going to be a chronic illness,” said Wes Ely, a pulmonologist and critical care physician at Vanderbilt University Medical Center who studies delirium during intensive care stays. “The problem for these people is not over when they leave the hospital.”"
Source: https://www.statnews.com/2020/08/12/after-covid19-mental-neurological-effects-smolder/
Commentary: We still don't know the long-term effects of COVID-19. Believe it or not, the disease is only as old as a newborn, in terms of timing - 9 months. We will be learning more over the months and years to come, but thus far, it is proving to be medically very complex. The best insurance you can have against its long term health effects is to avoid contracting it, and keep it from spreading to others.
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On a lighter note, taking a lesson from history. "In Florence, Italy, small, quaint windows offer a glimpse of old world architecture – and some also serve, once again, as a place to get wine.
These little windows date back centuries, and were once used by wine producers selling their wine directly to customers. They became especially useful during the plague, according to Buchette del Vino, an Italian cultural association dedicated to wine windows.
The plague ravaged northern and central Italy from 1629 to 1631, during which these little windows offered a way to buy and sell wine, while limiting the spread of germs.
Like other contactless-delivery methods, wine windows are now having a resurgence during the coronavirus pandemic, which earlier this year prompted Italy to impose a nationwide lockdown. The country has had more than 251,000 coronavirus cases and 35,000 deaths due to the virus, according to Johns Hopkins University.
According to Buchette del Vino, two restaurants in Florence, Osteria delle Brache and Babae, are now selling wine through their wine windows. The Vivoli ice cream shop also reactivated its wine window to serve ice cream and coffee.
Wine windows in Florence were described in a book published in 1634, according to Buchette del Vino. Its author, academic Francesco Rondinelli, reported that sellers using the windows during the plague nearly 400 years ago understood contagion.
Sellers would use the windows to pass a flask of wine to a customer, as well as a metal pallet to collect money. The seller would then disinfect coins from the customer with vinegar, Rondinelli writes. Customers could also fill their own flask using a metal tube passed through the window, according to Buchette del Vino. "
Source: https://www.cbsnews.com/news/wine-windows-italy-covid-food-alcohol-contactless-plague/
Commentary: There's a wonderfully applicable expression from the Japanese martial arts - on ko chi shin - study something old to learn something new. History may not repeat, but it sure does rhyme. Good for these organizations and companies who are studying lessons of the past to apply to today's challenge.
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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. 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. 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.
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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.