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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Around America, things are worsening. Dr. Scott Gottlieb: "Well, hospitalizations nationally are flat, they're not going down. They're flat when you look at the total hospitalizations across the entire United States. And what we're seeing is that parts of the country that had persistent spread that never really crushed the epidemic, now have flare ups in the cases surging cases as they reopen. That was expected but the chat That parts of the country states like Texas, Florida, Georgia, North Carolina, South Carolina, where you see those outbreaks right now never really reduced the number of cases substantially. They had spread. It was persistent. And now it's flaring up. So in Arizona, you see 1500 cases recorded recently in Florida, 2600, California 3700. To put that in perspective, at its peak of the epidemic in New York City, there were 5000 cases a day recorded. Now granted, we weren't diagnosing as high of a percentage of cases. But these are pretty big outbreaks right now underway in these parts of the country. And what you also see is the positivity rate going up, the percentage of people who are testing positive is increasing. So that's a bad combination seen cases go up and seeing the positivity rate also increased suggests that there are outbreaks underway.
Well, it's certainly attributed to the reopening. I mean, we all expected that as we reopened, we were going to see an uptick in cases. So in some respects, we shouldn't be surprised by this. I think the challenge for these states in these cities, if you look at Texas, the outbreak is really centered around Houston and Austin, the challenges that they aren't able to trace it back to a certain set of sources or activities. So they can't take targeted measures, what we're going to have to do going forward is take targeted mitigation steps to try to contain these outbreaks by perhaps closing certain venues. If you find that bars are the source of the spread, you might temporarily close bars or limit the number of people that can be in or if you find that certain large gatherings outdoor gatherings are the source of the spread, you might target those kinds of gatherings. Right now, we haven't been able to trace them back to the source because we don't have all that track and trace work in place. And so that's a challenge for public health officials in the state of Arizona. that's largely left to local officials to the counties you might see the state start to take that over. If they can start to trace these cases, these surgeon cases back to the sources."
Source:
Commentary: Viruses are immune to political rhetoric. They only know to do what their hardware and software has told them to do. Do not let up on your preventative health measures.
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Americans, don't plan on going anywhere outside the country. "Other countries are starting to think about resuming international travel. The US will be seen as too risky. Another way we are losing economic ground by not controlling our outbreak."
Source:
Commentary: This is unsurprising. Policy matters, doubly so when it's public health, and no amount of insistence by American politicians will change the fact that America is a hotspot. The silver lining, I suppose, is that a lot of American vacation spots may see those dollars spent there rather than abroad.
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Early models turned out to overestimate hospital needs. "“All of those models were based on assumptions, then we were smacked in the face with reality,” said Robyn Gershon, a clinical professor of epidemiology at the NYU School of Global Public Health, who was not involved in the models New York used. “We were working without situational awareness, which is a tenet in disaster preparedness and response. We simply did not have that.”
While hospitals were able to add beds more quickly than experts realized they could, some other resources were harder to come by. Masks, gowns and other personal protective equipment were tough to get. So were ventilators. Anesthesia agents and dialysis medications were in short supply. And every additional bed meant the need for more doctors, nurses and respiratory therapists."
Source: https://www.propublica.org/article/how-americas-hospitals-survived-the-first-wave-of-the-coronavirus
Commentary: The rule of thumb in crisis situations is to plan for the worst case. Hospitals did that based on models that were too aggressive, and that's a good thing. We ran out of a lot of things, but hospital beds weren't one of them. Hopefully the lessons learned through this pandemic will inform future efforts against diseases yet unknown. AS the cliche goes, better to overreact and then not need capacity than to underreact and be caught without resources.
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Musical events, restaurants, and workplaces. "Hitoshi Oshitani at Tohoku University in Sendai, Japan, and his colleagues analysed clusters of at least five infected people who had all attended the same event or venue (Y. Furuse et al. Emerg. Inf. Dis. http://doi.org/ggz2hg; 2020). Many of the 61 ‘superspreading’ incidents they identified occurred in hospitals, nursing homes and other care facilities, but a little more than half took place at venues such as musical events, restaurants and workplaces.
One concert, for example, was the source of infection for more than 30 people, including performers, audience members and staff.
The team identified the probable founders of 22 of the superspreading events, and the timing for 16 of them. The results showed that half of the superspreading individuals were under the age of 40, and 41% had had no symptoms when they transmitted the virus."
Source: https://www.nature.com/articles/d41586-020-00502-w
Commentary: The pandemic isn't over by far. Research continues to show that indoors and proximity are the two strongest indicators of spread, so stay out of indoor spaces that aren't your home as much as possible, and stay away from other people as much as possible.
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Words matter. "Calls to US poison control centers regarding exposures to cleaning products and disinfectants increased more than 20% during the first quarter of 2020 compared with 2019, according to a CDC analysis"
Source:
Commentary: Poisonings nearly doubled after leaders advocated for the improper use of disinfectants, such as swallowing or injecting them. This highlights two serious problems: first, political leaders with no understanding of science giving out unfounded advice to their citizens, which is bad. But more important, a lack of baseline knowledge about science on the part of citizens who didn't think to question the advice they were being given from someone in a leadership position but not a scientific authority. Critical thinking clearly failed in both instances, and is something that will continue to be a problem in future crises.
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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.
2. Wear gloves and a mask when out of your home. Consider wearing a face shield.
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.
4. Get your personal finances in order now. Cut all unnecessary costs.
5. Donate any PPE you can. https://getusppe.org/give/
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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.