Lunchtime Pandemic Reading, 27-Mar-2020
86,012 cases
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.
This is also available as an email newsletter at https://lunchtimepandemic.substack.com if you prefer the update in your inbox.
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13 minutes of no comedy, all facts with Trevor Noah and Dr. Anthony Fauci. "So people say arbitrarily. "Well, in two weeks, we're going to be okay"". It depends on the kinetics of the outbreak. Right now, take New York City. They are getting hit really hard and the kinetics of the outbreak is going there. You can't predict when it will make that turn around and start coming down. In general, if you look historically, at at countries that have been through the whole cycle, in China, it was about eight weeks or so before it went way up, and then way down in Korea, the same thing."
Source:
Transcript: https://otter.ai/s/9Xd6R3xKSKKEPBcG07pgQw
How long will this last? Dr. Fauci's answer is eight weeks from the start of it really ramping up. That said, other countries did a much, much better job of enacting containment measures than the US has. 29 states still haven't enacted lockdowns, including two of the most populous: Texas and Florida.
The interview also addresses things like Amazon packages: worry less about that and more about contact surfaces like door knobs and shopping carts. They're much higher risk. Wear gloves in public and wash them promptly on your return to home.
The United States has 86,000 cases of COVID-19 now, more than any other nation.
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Via the Centre for Mathematical Modeling of Infectious Diseases, summer weather may not matter to the coronavirus. "The ability of SARS-CoV-2 to effectively spread globally, including in warm and humid climates, suggests that seasonality cannot be considered a key modulating factor of SARS-CoV-2 transmissibility. While warmer weather may slightly reduce transmission of SARS-CoV-2, there is no evidence to suggest that warmer conditions in northern hemisphere summer months will reduce the effectiveness of SARS-CoV-2 transmission to an extent that few additional interventions are needed to curb its spread. Further studies on the impact of climate variability, air pollution and other extrinsic factors on COVID-19 transmission will need to consider connectivity from locations with a high incidence, population susceptibility and surveillance for respiratory infections. For the time being, policy makers must focus on contact reducing interventions and any COVID-19 risk predictions based on climate information alone should be interpreted with caution."
Source: https://cmmid.github.io/topics/covid19/current-patterns-transmission/role-of-climate.html
Summer is unlikely to make a dent in the pandemic. Warmer weather was not shown to reduce SARS-CoV-2's capabilities. Only distancing and staying home will do that.
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Via the Lancet, a look at 36 childrens' cases of COVID-19. "By contrast with findings in adults, children with COVID-19 had milder clinical manifestations; nearly half of paediatric patients were asymptomatic (ie, no fever and no cough). This asymptomatic condition is relevant if community-acquired transmission becomes the primary mode; identification of paediatric patients without presenting symptoms will become a great challenge. Fortunately, the number of children infected with SARS-CoV-2 accounted for a small proportion of total people infected, and paediatric patients also had clear epidemiological information. Devising measures to protect children from infection with SARS-CoV-2 is very important."
Source: https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(20)30198-5/fulltext
No play dates of any kind. None. Children of any age may be carriers, even without symptoms, and their general hygiene isn't as good as adults. Keep your kids away from all other kids except virtually, period. No exceptions.
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What we do and don't know about COVID19 and SARS-CoV-2, via Stat News. "How much this type of transmission is driving the pandemic is unclear but it could be significant. Gabriel Leung, dean of medicine at the University of Hong Kong, has estimated about 40% of cases transmit before symptoms develop. A recent preprint — a study that has not yet been peer-reviewed — from China pooled data from seven countries and estimated a very similar 43%."
Source: https://www.statnews.com/2020/03/26/what-weve-learned-about-the-coronavirus-and-what-we-still-need-to-know/
An excellent overall read, highlighting that this virus is extremely slippery. When you do go out, take serious precautions.
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Stories from the front lines. An ER doctor describes what's happening in NYC now.
Source: https://www.reddit.com/r/CoronavirusUS/comments/fp6pla/er_dr_colleen_smith_from_front_lines_of_nyc/ (originally created by the NY Times)
Expect many more stories like this. We're already receiving similar from Detroit, and Atlanta is saying its ICUs are at capacity.
We will also need to have a countrywide discussion and program for PTSD for healthcare workers, because this is going to severely impact an entire generation, just as doctors who went to war in World War II came home traumatized. The difference is the war is on our soil this time, with an enemy you can't see without a microscope.
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Speaking of Florida, an outstanding visualization of where one group of beachgoers at Spring Break end up after Spring Break ends. Spoiler alert: everywhere.
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Mardi Gras. Spring Break. Major conferences. These events, which should have been suspended when the outbreak became apparent in late January, have gotten us to where we are now.
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A woman in Allegheny County died of COVID19 because of fears about the healthcare bills.
Source: https://www.pennlive.com/coronavirus/2020/03/pa-woman-who-died-of-coronavirus-refused-to-go-to-hospital-because-she-worried-about-bills-son-says.html
Expect to hear more of these stories as well. A colleague forwarded me a GoFundMe for one of her friends who is in the ICU and has no health insurance.
If you're in America, contact your legislators about federal funding for COVID-19 care, otherwise the economic damage of the pandemic will be magnified greatly by individuals bankrupted by medical bills. That any of our citizens choose death over bills is a testament to how badly broken our healthcare system is. We're worse than many so-called "developing" nations.
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All four medical schools will early graduate their fourth year students to get them on the front lines.
Source:
This is the equivalent of the draft, rushing soldiers to the front lines. It's the right move, but it's also a one-shot chance. There are no reserves that will be ready in time for a second wave of staff, so protecting healthcare workers is essential. They're limited resources and all we have to mitigate the damage of the virus.
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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/