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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Today, we crossed 10 million cumulative cases worldwide and 500,000 deaths worldwide. In the United States, we have exceeded 125,000 dead, greater than the total number of people who died in World War 1.
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Major epidemics are underway. Dr. Scott Gottlieb: "Well, these are major epidemics that are underway underway in the south and southeast right now. You look at Texas with almost 6000 cases California and with 6000 cases, Georgia is getting hot with 2000 cases. Florida with almost 10,000 cases right now in Texas with about 5500 people hospitalized. This is community spread that's been underway for some time, it's going to be hard to extinguish. We're going to have many weeks ahead of us have continued growth in these cases at least two or three weeks, even if we take aggressive actions right now, which across the board we're not doing. I know a lot of the discussion right now is that these cases are clustered in younger people. So deaths are Coming down, but that's not likely to stay that way. This spread is likely to seep into more vulnerable communities and we're likely to see total daily death start to go back up again.
New York implemented the stay at home order on March 20. It was a Friday went into effect on Sunday. They peaked in terms of the number of daily cases that they were reporting on April 7, so almost three weeks after they implemented the stay at home order, the cases continued to build, and then they start to slowly decline. We're implementing measures in the States, the governors have taken action, but the action is much weaker than a stay at home order. And so even if it does have some impact on the continued spread, it's going to be a marginal impact and can take more time to flow through. So I think that these states have some difficult weeks ahead, you look at states like Florida, which might be in the worst shape right now. It looks like they may be tipping over into Xfinity Job growth. And so they're going to see perhaps rapid acceleration number of cases. So it's a difficult situation right now. I think over the next week, we're going to know just how pervasive the spread is, but it looks pretty widespread right now.
One, we opened against the backdrop of a lot of spread. And so it was only going to go in one direction, there was already a lot of infection around to continue building new cases. And these epidemics take time to build. And the other thing was the speed of the opening. And some of these states, they didn't really pause in between steps of their reopening for a sufficient amount of time to see if it was having an untoward effect. And so as they reopened parts of their economies, they should have taken two week pauses in between. That's what states like Maryland, Massachusetts, New York, New Jersey, Connecticut, Michigan did, and did it successfully so that they can measure the impact of their actions."
Source:
Commentary: Opened too soon, didn't use data to guide the opening. That's where we are and why things are so bad - and this is happening all over. There's an old cliche, "the price of freedom is eternal vigilance". What's happened is that people opted for freedom without the vigilance, and that freedom is being revoked out of necessity. It's not difficult to wear some form of protective equipment to stop spreading germs.
Does it have to be a cloth mask? No, absolutely not. The panic buying that occurred at the beginning of the pandemic has largely subsided, and MANY different options now exist. I personally don't like cloth masks, so I wear a P100 respirator. These are available on Amazon right now, and they leave your nose and mouth relatively unobstructed. You can get heavy duty welding gear that covers your whole face with a protective glass shield - that will work as well or better than most masks. Heck, you can get powered HAZMAT hoods if you really want to go wild or have absolutely nothing touching your nose and mouth while still being safe.
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There's a big undercounting problem. "CDC has received results from the Western Washington State region; the New York City metro region; south Florida; and all of Connecticut, Missouri, and Utah from blood samples collected by commercial laboratories as part of routine patient care. This survey will help us better understand the percentages of people who were previously infected with SARS-CoV-2 in the areas studied (that is called seroprevalence). CDC also will use this information to estimate the number of people in the areas sampled who have been previously infected with SARS-CoV-2, including those that may not have been reported in official case counts. Some of those people may not have been counted because they had mild illness or no symptoms and did not get medical care or testing."
Source: https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/commercial-lab-surveys.html
Commentary: Here's the stunner. In all of the surveys collected, we are drastically under-identifying cases of COVID-19, by as much as 11x. For every 1 case we test and find, there are 6-11 cases we're not finding. That's why we're having such massive outbreaks right now - there are a lot of people out there walking around, infecting others.
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Former CDC Director Tom Frieden on what must be done. "Start smarter with the three W’s: wear a mask, wash your hands, watch your distance. And box it in with strengthening public health: be able to test, isolate, contact trace and quarantine.
If your number of cases is increasing and your tests are stable or increasing and the percent positivity is increasing, you have an expanding outbreak — period. But where is it coming from? Are we doing investigations to figure out the settings where it’s spreading? This is really important so that we can be more granular in our control measures.
If you do those things really carefully, yeah, we’re not going to be reopening bars anytime soon. And we’re not going to be having big indoor gatherings with thousands of people. But there’s a lot else that we can do in our economy that isn’t like that.
Anyone who tells you with confidence what’s going to happen with this virus more than three or four weeks into the future doesn’t know enough about this virus. But there’s no reason to think it’s going to magically or miraculously go away."
Source: https://www.nytimes.com/2020/06/25/us/politics/tom-frieden-coronavirus.html
Commentary: The last paragraph is the key. We don't know what's going to happen. Right now, we need to put out the fire before worrying about how bad the fire damage is.
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NBER on the Black Lives Matter protests. "Sparked by the killing of George Floyd in police custody, the 2020 Black Lives Matter protests have brought a new wave of attention to the issue of inequality within criminal justice. However, many public health officials have warned that mass protests could lead to a reduction in social distancing behavior, spurring a resurgence of COVID-19. This study uses newly collected data on protests in 315 of the largest U.S. cities to estimate the impacts of mass protests on social distancing and COVID-19 case growth. Event-study analyses provide strong evidence that net stay-at-home behavior increased following protest onset, consistent with the hypothesis that nonprotesters’ behavior was substantially affected by urban protests. This effect was not fully explained by the imposition of city curfews. Estimated effects were generally larger for persistent protests and those accompanied by media reports of violence. Furthermore, we find no evidence that urban protests reignited COVID-19 case growth during the more than three weeks following protest onset. We conclude that predictions of broad negative public health consequences of Black Lives Matter protests were far too narrowly conceived."
Source: https://www.nber.org/papers/w27408.pdf
Commentary: The protests had no impact on COVID-19 cases. Anyone claiming otherwise probably has an agenda and an ax to grind.
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John Oliver on evictions. "With evictions on the rise due to coronavirus, John Oliver discusses the long struggle with housing in the US, why it’s gotten worse in recent months, and how to prevent an impending crisis."
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Commentary: Watch the video. It's informative; then contact your elected officials and let them know protections for renters should be extended as much as practical to avoid a massive homelessness crisis. Recall that in several cities, homeless shelters are MASSIVE breeding grounds for the spread of COVID-19. The last thing we want is to permanently entrench the virus in shelters any more than it already is.
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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.
2. Wear gloves and a mask when out of your home. Consider wearing a face shield if you can't breathe at all through a mask.
3. Stay home as much as possible. Minimize your contact with others and maintain physical distance of at LEAST 6 feet / 2 meters. Avoid indoor places as much as you can.
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.