Lunchtime Pandemic Reading, 19-Mar-2020
Lunchtime COVID-19/SARSCoV2 (coronavirus) 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 laiety. ALWAYS prioritize advice from qualified healthcare experts over some person on Facebook.
This is also available as an email newsletter at https://lunchtimepandemic.substack.com if you prefer the update in your inbox.
You are welcome to share this.
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On the economy front, initial jobless claims surged to 281,000 according to the Federal Reserve of St. Louis database. This is a surge of 33% in just one week.
Source: https://fred.stlouisfed.org/series/ICSA
Now comes the most difficult leadership calculus of all. How do you balance the different, competing priorities - those of livelihoods versus lives? Someone starving to death is just as deceased as someone contracting a life-threatening illness. How do you weigh and measure different lives? These are questions facing leaders around the world. The answers will shape the world for the next generation or two, much as the Great Depression shaped America for decades after.
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The CDC published an important piece of research showing that people under 60 are by no means immune to the harmful effects of COVID-19. "Among 508 (12%) patients known to have been hospitalized, 9% were aged ≥85 years, 26% were aged 65–84 years, 17% were aged 55–64 years, 18% were 45–54 years, and 20% were aged 20–44 years. Less than 1% of hospitalizations were among persons aged ≤19 years (Figure 2). The percentage of persons hospitalized increased with age, from 2%–3% among persons aged ≤9 years, to ≥31% among adults aged ≥85 years. (Table)."
Source: https://www.cdc.gov/mmwr/volumes/69/wr/mm6912e2.htm
Hospitalization means your lung functions have been impaired enough to need treatment. When people ages 20-44 are hospitalized at a rate of 1 in 5, that's reason to stay home and self-isolate, not go to the bar or beach.
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From the file of events that should have been cancelled: Mardi Gras. New Orleans and Orleans Parish now has the third highest COVID-19 per capita in the country.
Source:
A friend pegged this event back in February as a key milestone for COVID-19 in the US, and they were right.
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Via MedXriv, serological assays are being developed for COVID19. These are important because we need to identify healthcare workers who have had the disease and recovered; these workers will be able to be on the frontlines with far less protective equipment than workers who have not contracted the disease. The sooner these tests are available, the better.
Source: https://www.medrxiv.org/content/10.1101/2020.03.17.20037713v1
This will be a key strategy as the pandemic goes on. Who is immune? Those folks can re-enter the workforce immediately.
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A paper by Dr. Florian Krammer highlights the challenges of a COVID-19/SARS-CoV-2 vaccine. "The development of vaccines for human use can take years, especially when novel technologies are used that have not been extensively tested for safety or scaled up for mass production. Since no coronavirus vaccines are on the market and no large scale manufacturing capacity for these vaccines exists yet."
Source: https://marlin-prod.literatumonline.com/pb-assets/journals/research/immunity/SARS-CoV-2%20vaccines%20status%20report.pdf
Anyone saying there will be a working, scaled, full-production vaccine in less than a year is delusional.
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Foreign Policy magazine speculates that a full lockdown is coming and needed for America. "Whether you are reading this in your living room in Vancouver, office in London, or on a subway in New York City, you need to think hard, and fast, about two crucial questions: Where, and with whom, do you want to spend the next six to 12 weeks of your life, hunkered down for the epidemic duration? And what can you do to make that place as safe as possible for yourself and those around you? Your time to answer those questions is very short—a few days, at most. Airports will close, trains will shut down, gasoline supplies may dwindle, and roadblocks may be set up. Nations are closing their borders, and as the numbers of sick rise, towns, suburbs, even entire counties will try to shut the virus out by blocking travel. Wherever you decide to settle down this week is likely to be the place in which you will be stuck for the duration of your epidemic. Plan now for your state of siege. Don’t delay. Choose where you want to survive the pandemic, with whom, and how. Your window of opportunity to act is shrinking, very fast."
Source: https://foreignpolicy.com/2020/03/18/america-united-states-lockdown-coming/
Wherever you are, there you'll be. Get where you need to be.
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Via Dr. Scott Gottlieb, what needs to happen at the federal level to mitigate the impact of the pandemic, from their new pre-print working paper. "To reduce the risk of severe disease and death and mitigate the virus’ impact, therapeutics are urgently needed to treat severely ill patients, as is prophylaxis that can be used to reduce the risk of infection for front line healthcare workers and those at significant risk of poor outcomes (e.g., the elderly, those with impaired heart and lung function, those who are immunocompromised) . Potentially effective therapeutic strategies could include antibodies, immune globulins, anti- inflammatory drugs that mitigate severe disease, and direct acting antiviral drugs."
Source: https://healthpolicy.duke.edu/sites/default/files/atoms/files/covid-19_tx_working_paper.pdf
Therapeutics and prophylactics are the essential tools we'll need to combat COVID-19 until vaccines are available. Thankfully, research is proceeding at record pace; Dr. Anthony Fauci said in his testimonial to Congress that we could be 3-6 months away from a solid array of working therapeutics to blunt the impact.
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The State Department has essentially flagged America itself as a Level 4 travel advisory, warning Americans overseas to shelter in place or immediately come home.
Source: https://www.politico.com/news/2020/03/19/coronavirus-travel-advisory-level-four-137227
Wherever you are, there you'll be.
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On a positive note, lockdowns have created a fascinating side-effect: nature rebounding. Canals in Venice are clear and schools of dolphins, swans, and fish have returned.
Source: https://www.nbcnews.com/science/environment/coronavirus-shutdowns-have-unintended-climate-benefits-n1161921
Something for us all to think about. COVID-19 is one giant reboot button for our entire civilization. We'll have a short period of time afterwards to decide what changes we want to keep, and what we want to go back to. Hopefully, reduced CO2 emissions, waste, and needless consumption will stick.
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A first-person perspective from Kelsey Coronado on her experience with COVID-19, and a message that anyone with any symptoms should self-isolate immediately, since it may not be immediately apparent you have COVID-19, especially if your symptoms are not severe.
Source: https://www.facebook.com/shawnacoronado/videos/10157256578038250/
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A reminder of the simple daily habits we should all be taking.
1. Wash/sanitize your hands often. Have a bottle of hand sanitizer on your belt, bag, purse, whatever and use it when out and about in public every 15 minutes whether you need it or not.
2. Wash/sanitize before touching any part of your face for any reason.
3. Avoid large crowds. Period. Any group over 25. Stay home as much as practical.
4. Avoid in-person interaction with anyone at risk, without exception. Video call instead of visit.