Lunchtime Pandemic Reading, 27-April-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 laity. ALWAYS prioritize advice from qualified healthcare experts over some person on Facebook.
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From the Sunday talk show roundup, Dr. Scott Gottlieb says Georgia and other locations are jumping the gun. "It does up the risk of infection, Georgia, certainly not out of the words they're only testing about 1% of the total population, they have 23,000 cases. They may have plateaued in their epidemic maybe but they're still accruing. A lot of cases and they certainly aren't coming down in terms of the number of new cases each day. This slope up in terms of cases that got us to the point of this epidemic was a rapid slope, it was a rapid progression up that up that epidemic curve, the slope down is going to be far more gradual. So it's going to take some time until we see sustained declines in new cases and get to the point where there's a low enough, low enough level of spread in the country that we could feel comfortable about opening up parts of the country. It's going to be probably mid May, maybe late main parts of parts of this nation. Georgia, certainly jumping the gun I think here getting getting started too early relative to where they are in their epidemic."
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We are nowhere close to opening up, and the places that are, will see the consequences of failing to listen to scientists and experts. Put your faith in people who know what they're talking about, not politicians.
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Investor Barry Diller on the economic impact. "I think that the established businesses, I mean, Expedia, which went which had basically a $10 billion cost base went from a day when it would have 250 million dollars in sales to basically zero. What Expedia did and many other companies have done. We've topped the private markets for close to $4 billion, which wouldn't get us through, we think, almost any worst case scenario. But of course, you're going to have, you're going to have a massive amount of businesses that can't return businesses that go bankrupt. It's inevitable, and, and hopefully the government will, so to speak, pick up the tab, because this is an existential crisis. And we shouldn't worry so much about doing it in a neat way. It ought to be sloppy to get that money out to everybody who needs it."
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Diller points out later in the interview that there will be no "bounce". A bounce assumes that things will just turn right back on, that the economy is a piece of machinery that simply whirs back to life. It's not. It's more like a field in a farm. If the field incurs enough damage - drought, wildfire, pests, etc. - it will take a long time to regrow. It will regrow, but it will take longer than we think.
Do whatever you can to help your friends and family adjust to the new economic reality as well. There ARE places still hiring. Do as much as you can to connect people to resources. As my friend Jennifer Iannolo says, no one is coming to help you, so it's up to us to help each other.
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A new pre-print paper suggests that for each reported case of COVID-19, we have been drastically undercounting the non-reported cases; for every 1 reported case, we may have 25 unreported cases. "Reverse transcription-polymerase chain reaction (RT-PCR) assays are used to test patients and key workers for infection with the causative SARS-CoV-2 virus. RT-PCR tests are highly specific and the probability of false positives is low, but false negatives can occur if the sample contains insufficient quantities of the virus to be successfully amplified and detected. The amount of virus in a swab is likely to vary between patients, sample location (nasal, throat or sputum) and through time as infection progresses. Here, we analyse publicly available data from patients who received multiple RT-PCR tests and were identified as SARS-CoV-2 positive at least once. We identify that the probability of a positive test decreases with time after symptom onset, with throat samples less likely to yield a positive result relative to nasal samples."
Source: https://www.medrxiv.org/content/10.1101/2020.04.05.20053355v2.full.pdf
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The implications of this are obvious: treat EVERYONE outside your household as infected. Assume they are infected. Do not interact with others without a mask and gloves; when you return home, decontaminate.
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An interesting perspective on why early models of COVID-19 failed. "Outbreak predictions can influence the final number of cases. If a model suggests the outbreak is a genuine threat, it may trigger a major response from health agencies. And if this brings the outbreak under control, it means the original forecast will be wrong. It's therefore easy to confuse a useless forecast... with a useful one."
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Virologist Adam Kurcharski makes the excellent point that we're not in a controlled laboratory setting. We're all winging it, and having an understanding of what could happen is essential to improving our models. That said, I'm VERY glad that thus far, the early models of COVID-10 fatalities were so wrong. I would prefer no loss of life, but I'll take reducing the number of deaths by an extra zero any day.
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NextStrains' visualizations of SARS-CoV-2 are an incredibly useful way to see how the virus has traveled the world, from a single starting point in China.
Source: https://nextstrain.org/ncov/global?c=clade_membership
These genomic maps clearly show several things. First, this virus started in China in December 2019. There was no such thing as a hidden circulation in the fall, ever. Second, it shows that once the virus started to spread to other nations, it rapidly created new (functionally identical) variations that let genomic detectives see where each outbreak came from previously. As time goes on, we'll see further changes that will help us understand its spread better.
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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.
2. Wear gloves and a mask when out of your home.
3. Stay home as much as possible.
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:
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There is no evidence SARS-CoV-2 was engineered.
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