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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Convalescent plasma impact unclear. "Last week, just as the Food and Drug Administration was preparing to issue an emergency authorization for blood plasma as a Covid-19 treatment, a group of top federal health officials including Dr. Francis S. Collins and Dr. Anthony S. Fauci intervened, arguing that emerging data on the treatment was too weak, according to two senior administration officials.
The authorization is on hold for now as more data is reviewed, according to H. Clifford Lane, the clinical director at the National Institute of Allergy and Infectious Diseases. An emergency approval could still be issued in the near future, he said.
But clinical trials have not proved whether plasma can help people fighting the coronavirus.
Several top health officials — led by Dr. Collins, the director of the National Institutes of Health; Dr. Fauci, the government’s top infectious disease expert; and Dr. Lane — urged their colleagues last week to hold off, citing recent data from the country’s largest plasma study, run by the Mayo Clinic. They thought the study’s data to date was not strong enough to warrant an emergency approval.
“The three of us are pretty aligned on the importance of robust data through randomized control trials, and that a pandemic does not change that,” Dr. Lane said in an interview on Tuesday."
Source: https://www.nytimes.com/2020/08/19/us/politics/blood-plasma-covid-19.html
Commentary: A danger of cutting corners and racing too quickly is the situation we faced with hydroxychloroquine. Data that's inconclusive but presents potential harm is data we have to treat conservatively. Data that's inconclusive but presents no harm is data we can be more aggressive with. Masks' effectiveness early on was inconclusive, but there's no harm in wearing one, so the recommendation should have been yes, put one on for now until we have better data. I'm glad to see that federal health officials put the brakes on the emergency authorization for now in this instance.
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The United States still hasn't solved the PPE problem, almost 6 months after the start of the pandemic. "At the height of summer, temperatures climb to nearly 100 degrees most days in Pharr, a small city in South Texas. Nonetheless, nurse practitioner Oralia Martinez and her staff have set up a temporary exam room outside her small clinic.
This is their way of preserving masks and other personal protective equipment as they treat COVID-19 patients in the Rio Grande Valley, where infections are spiking. While Martinez and her colleagues sweat in full gear outside, the staffers and other patients inside the clinic aren't exposed and don't need as much PPE.
"It's been very challenging for me, you know, seeing patients outside in this kind of heat, running my own practice, trying to keep employees, trying to keep them safe," Martinez said. "Here in Texas, it has hit really, really hard, and we don't have enough PPE to go around."
Six months into the coronavirus pandemic, some schools are reopening. Dentists and family doctors are seeing patients again. More businesses are getting back to work.
And they're all confronting a familiar problem: Masks and other personal protective equipment can still be hard to come by.
Now it's not just hospitals, states and federal officials vying for the same PPE. Smaller operations without a lot of buying power — from cash-strapped school districts to independent medical practices — are entering the market.
"The dramatically increased demand is not going away anytime soon," says Dr. Susan Bailey, president of the American Medical Association. "Churches, schools, businesses, everyone that's trying to reopen needs PPE, and we're all competing for the same small supply.""
Source: https://www.npr.org/2020/08/19/903612006/yep-masks-and-protective-gear-are-still-hard-get-especially-for-small-buyers
Commentary: If you're working for an organization that needs PPE, you may need to source overseas supplies yourself or form a consortium with other organizations if the minimum order quantity is too high for your budget alone.
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New Zealand flu deaths this year during their winter (now): none. "Data from overseas showed death rates rose alongside air pollution, Wilson said. New Zealand's air quality increased markedly during lockdown.
While the hypotheses were speculation at this stage, it was “pretty informed speculation”, Wilson said, based on data from New Zealand's regular health surveillance.
That data show the flu (specifically, influenza) has been nearly non-existent in New Zealand. In fact, you can count the number of confirmed flu cases in New Zealand over recent months on one hand.
The flu is connected to around 500 deaths per year, and predominantly affects older people.
According to the most recent report from Flutracking, a system that tracks influenza, 0.6 per cent of people reported flu-like symptoms from a survey of more than 50,000 people.
At the same time last year, that figure was four times higher. In 2018, it was more than six times higher."
Source: https://www.stuff.co.nz/national/health/coronavirus/122476223/coronavirus-while-covid19-takes-lives-around-the-world-new-zealands-response-has-led-to-fewer-deaths-from-all-causes
Commentary: As mentioned yesterday, COVID-19 precautions are also flu precautions, and New Zealand nuked their flu out of existence by strong adherence to COVID-19 precautions. Wash your hands, watch your distance, wear a mask, withdraw from indoor spaces will stop COVID-19 AND influenza. For those folks who still incorrectly insist that COVID-19 is no worse than the flu, treat this as a golden opportunity to stop both with the same countermeasures.
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No school tracking. "Coronavirus cases are already surfacing in K-12 schools that have reopened, but the federal government is not tracking these outbreaks, and some states are not publicly reporting them, making it more difficult to determine how the virus is spreading, experts say.
Scores of students and staff members have been quarantined because of potential COVID-19 exposure in Georgia, Alabama, Mississippi and Indiana, among other states.
But there is no official national tally of school-linked COVID-19 cases, and some states are not reporting how many outbreaks have occurred or how many students and staff members have been infected. Instead, they are leaving it up to local officials to decide which information to make public and which information to share more narrowly with affected students and families. Researchers say the absence of a comprehensive accounting is hampering efforts to identify which safety practices can best prevent cases in schools from spreading.
“Without good data that tracks cases over time — and shows how one case turns into many cases — there's just no way to answer that question,” said Emily Oster, an economist at Brown University and co-founder of COVID Explained, a team of researchers studying the pandemic. “In January, we'll be in the same position that we are in now, and kids still won't be in school.”"
Source: https://www.nbcnews.com/news/us-news/coronavirus-spreading-schools-no-one-tracking-all-outbreaks-n1236964
Commentary: You can't manage what you don't measure. This has been a management axiom forever, and for good reason. If we fail to track school-related outbreaks, we don't know how good or bad the problem is, and that means we can't make informed decisions about whether to close a school or not.
For anyone living in any nation where the national government has abdicated its responsibilities for public health, you will likely be suffering longer and worse under the pandemic. If a regime change is unlikely (such as Russia), then it might be time to start planning to live somewhere else.
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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, 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.
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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.