Lunchtime Pandemic Reading, 25-Mar-2020
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 laiety. ALWAYS prioritize advice from qualified healthcare experts over some person on Facebook.
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The Centre for Mathematical Modeling of Infectious Diseases has a very helpful ongoing dashboard that models how progress in fighting the pandemic is going, by country. The stunning number to me, based on today's data, is the United States effective reproduction number. That number, R0, indicates how many people an infected person will subsequently infect. The United States number range is from 1.9 to 5.9 - far, far above any other nation in the world.
Source: https://cmmid.github.io/topics/covid19/current-patterns-transmission/global-time-varying-transmission.html
What does this mean? It means the situation in the United States is dire, and it means you should be going out in public in full protective gear. Assume every person around you is infected, because at this point, with testing still not caught up, we don't know save to know it's very, very bad.
What I do - put on a sweatshirt or hoodie, gloves, respirator, and then head out. When I return home:
- Spray with homemade disinfectant (3 parts 91% alcohol, 1 part 3% peroxide) my respirator and shoes, plus anything I bought while I was out.
- I toss the gloves and clothes into the laundry immediately.
- Spray down the interior of the car with the disinfectant.
- Spray down my face (CAREFULLY) and any other exposed skin.
Once you've sanitized, you can then operate normally around your household. You don't need to wash your hands every 15 minutes if you haven't left to the outside world. Sanitize before coming back in - treat your home like a clean room laboratory.
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Stanford Medicine Anesthesia Informatics Lab reports that N95 masks can be reused if sterilized, and the most effective methods are 70C hot air ovens for 30 minutes or ultraviolet light for 30 minutes, followed by hot water vapor. Hydrogen peroxide is also noted as effective. They advise avoiding alcohol and bleach as it damages the static charges in the mask fibers and causes respiratory irritation, respectively, and heat over 70C as normal autoclaves melt the masks.
Source: https://stanfordmedicine.app.box.com/v/covid19-PPE-1-1
If you've got a mask you're reusing, follow Stanford's recommendations. If you know a healthcare worker, give this advice to them.
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The Financial Times has an excellent set of visualizations for growth rates of infections and deaths. Worth a look.
Source: https://www.ft.com/coronavirus-latest
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Italy's estimated "crude" case fatality rate, due to hospitals being overwhelmed, is estimated by a study in The Lancet to be 4%. "All other European countries appear to be in a similar situation, with just a short time-lag of a couple of weeks (figure). We urge all countries to acknowledge the Italian lesson and to immediately adopt very restrictive measures to limit viral diffusion, ensure appropriate health-system response, and reduce mortality, which appears to be higher than previously estimated, with a crude case-fatality rate of almost 4%."
Source: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30690-5/fulltext
This is what we desperately must avoid by staying home. There is truth that the disease is not inherently that bad under normal circumstances; Singapore managed to contain its case fatality rates to something like 0.6% because they locked down vigorously, completely, and immediately. South Korea tested, traced, and isolated immediately, and their case fatality rate is equally low because they didn't let their healthcare system get overwhelmed.
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Co-infection may also be a problem. Stanford Medicine scientists identified that 22% of COVID19 infections had co-infections, mostly the common cold, but also influenza.
Source: https://medium.com/@nigam/higher-co-infection-rates-in-covid19-b24965088333
Comorbidity outcomes for COVID19 have been bad. Staying home also means reducing your exposure to other germs too. Stay home, stay safe.
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NYU is following the Italian lesson and graduating students from its medical school early to help out.
Source:
Every medical school around the US should be considering the same, as should any country impacted. Italy did the right thing early and fast to get extra hands on deck. If this were war, this would be the draft.
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Debunking the rumor mill, the United States military still cannot operate domestically save for the Insurrection Act, and federalizing the National Guard then reduces its scope according to JustSecurity. Martial law is not on the horizon. "As of this writing, the federal government is paying for National Guard deployments in New York, California, and Washington state while keeping them under state control. This is both a wise legal and policy decision,"
Source: https://www.justsecurity.org/69353/militarys-response-to-the-coronavirus-crisis-top-10-principles/
Keep calm and stick to the facts. The state National Guards remain in the chain of command to states' governors, and are helping out where manpower is short, primarily on logistics.
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On a lighter note, Israel's rabbinical court has issued a halakhic ruling permitting the use of Zoom teleconferencing for the Passover Seder.
Source: http://www.israelnationalnews.com/News/News.aspx/277764
Probably the first time a piece of software has been denoted such? I was going to say kosher, but that specifically refers to food, I think. It's brilliant, and I hope that all religions take heed and make exceptions to doctrine to protect their adherents. Mazel tov!
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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/