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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Unemployment has shot up from 3.5% to 4.4%, according to the Bureau of Labor Statistics. CNBC reports 3 million people are out of work in a new report. What's not talked about is total underemployment, a measure known as U-6, which looks at the total amount of people who are working and earning less. U-6, which was at a low of 6.7% in December 2019, has shot up in March to 8.7%.
Source: https://fred.stlouisfed.org/series/U6RATE
Source: https://www.cnbc.com/2020/04/03/jobs-report-household-survey-shows-nearly-3-million-out-of-work.html
It's time for legislators and businesses around the world to put their thinking caps on and look at what would constitute a Digital New Deal. We know that this pandemic will truly last for about 18 months, until a vaccine is broadly available. With that backdrop, what can we do to copy FDR's New Deal, but for an environment where people must remain physically separated from others for extended periods of time? Plenty of businesses already have portions of operations - office work - operating remotely.
What's the Digital New Deal equivalent of the Civilian Conservation Corps (which hired people to plant trees, among other tasks, just to keep them employed)?
I can think of thousands of training tasks for things like AI and machine learning - having large numbers of people classifying content to build training libraries, having and recording natural language conversations to capture speech nuances, translating texts into multiple languages. We could hire people to do usability testing on government websites, providing UI and UX feedback. There's plenty of work even for unskilled laborers in creating and annotating digital content, enough to get and keep people hired with government funding, just like the 1930s.
Feel free to copy and paste the above to your elected officials.
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For every case of COVID19 detected, there are between 1.8 and 2.8 cases undetected globally, according to a new study in The Lancet. "We estimated that detection of exported cases from Wuhan worldwide is 38% (95% HPDI 22–64) as sensitive as it has been in Singapore. Put another way, this estimate implies that the true number of cases in travellers is at least 2·8 (95% HPDI 1·5–4·4) times the number that has been detected. Equivalently, for each detected exported case there are at least 1·8 (95% HPDI 0·5–3·4) undetected cases."
Source: https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(20)30229-2/fulltext
Detection is all about testing. Until we have massive, widespread testing, we will not be able to contain the pandemic. Keep pushing your elected officials to further fund and require large scale testing. Reach out to them weekly and remind them that we will not emerge from lockdowns without testing, tracing, and treating.
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Masks of any kind work at reducing the spreading of disease from infected individuals. A new study in Nature: "We detected coronavirus in respiratory droplets and aerosols in 3 of 10 (30%) and 4 of 10 (40%) of the samples collected without face masks, respectively, but did not detect any virus in respiratory droplets or aerosols collected from participants wearing face masks, this difference was significant in aerosols and showed a trend toward reduced detection in respiratory droplets."
Source: https://www.nature.com/articles/s41591-020-0843-2
This is why masks are so important - they protect the healthy from the ill. Given how many cases are asymptomatic, you don't know who is or isn't ill - so masks of any kind on, at all times in indoor public spaces, please. Outdoors - stay 10-20 feet away from others. In your own home, no protection necessary.
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An excellent roundup in JAMA of what powers in the United States federal, state, and local governments do or do not have. "Congress has the authority to restrict travel between states and territories if clearly needed to prevent the interstate transmission of a contagious disease. Presidential authority to do so is uncertain, absent clear legislative authorization. No city or state has erected a sanitary cordon, prohibiting exit from an area of active SARS-CoV-2 contagion. Nor has any city or state imposed a reverse cordon, completely barring entry from zones of substantial transmission (eg, New Orleans, Louisiana). Just as for stay-at-home orders, modern courts have not reviewed sanitary cordons. At the turn of the 19th century, a federal court struck down a San Francisco, California, cordon to control the bubonic plague. The judge ruled the geographic quarantine was ineffective because infected and uninfected individuals were congregated together, risking transmission."
Source: https://jamanetwork.com/journals/jama/fullarticle/2764283
For those friends outside the United States, this is one of the many reasons why the United States response to COVID19 has been so disastrously managed. Our laws provide different, heterogenous powers to different levels of government and acting in concert is difficult under the best circumstances. After the pandemic is over, we may need to rethink our laws, at least as they apply to public health.
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STAT News has excellent commentary on how long the lockdowns may last: much longer than anyone thinks. "“What the means is we have to be patient. By the end of April shouldn’t be anyone’s consideration at this point,” he said. “We have to assume at the very least this is going through May.” Others suggest it may be longer before stores and restaurants can reopen, before authorities can consider reopening schools and universities. Philanthropist Bill Gates warned in an appearance on “CBS This Morning” on Thursday that things like lifting bans on mass gatherings — public meetings or concerts — could be quite a way down the road. Some activities, like reopening schools, might be deemed low risk and of societal benefit, Gates said. But mass gatherings “may be, in a certain sense, more optional.” Until large numbers of people can be vaccinated against the virus “those may not come back at all,” he said. “We’re at the front end of what will be a pretty arduous few years of something. What the something looks like, we don’t fully know,” said Konyndyk."
Source: https://www.statnews.com/2020/04/03/americans-are-underestimating-how-long-coronavirus-disruptions-will-last-health-experts-say/
This speaks to the question many folks in the marketing space about how soon before conferences and events return. The answer isn't what people want to hear: it may be a long time, and some may not come back at all except in virtual form. One of the key provisions of insurance policies is not willfully exposing your attendees to known harm; until a vaccine exists or the vast majority of the population contracts and recovers from COVID19, an event cannot say they have appropriately protected attendees from known harm.
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JAMA also provides a legal perspective on healthcare liability if a provider has to withhold or withdraw ventilator support. As long as standards of care and triage protocols are met, liability may be limited. The AMA advocates for universal applicability of immunity as long as triage protocols are met.
Source: https://jamanetwork.com/journals/jama/fullarticle/2764239
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Myocardial injury is significantly associated with fatal outcomes of COVID19. "Myocardial injury is significantly associated with fatal outcome of COVID-19, while the prognosis of patients with underlying CVD but without myocardial injury is relatively favorable. Myocardial injury is associated with cardiac dysfunction and arrhythmias. Inflammation may be a potential mechanism for myocardial injury. Aggressive treatment may be considered for patients at high risk of myocardial injury."
Source: https://jamanetwork.com/journals/jamacardiology/fullarticle/2763845
Diabetes and heart conditions are two of the major comorbidities associated with severe COVID19 outcomes. If you or someone you know is at risk, make sure they continue to stay isolated.
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Don't like needles? A study in EBioMedicine, published by The Lancet, indicates that microneedle arrays deliver better results than traditional needles for vaccines that deal with the family of coronaviruses. "These studies demonstrate the rapid development and immunogenicity of novel microneedle array (MNA) delivered recombinant coronavirus (SARS-CoV-2) vaccines. MNA delivered MERS-S1 subunit vaccines induced potent and long-lasting antigen antigen-specific immune responses. Notably, MNA delivery of these vaccines generated significantly stronger immune responses than those administered by traditional subcutaneous needle injection, indicating the improved immunogenicity by skin-targeted delivery. These efforts with MNA MERS-S1 subunit vaccines enabled the rapid design and production of MNA SARS-CoV-2 vaccines, capable of eliciting potent virus-specific antibody responses that were evident as early as 2 weeks after immunization."
Source: https://www.thelancet.com/journals/ebiom/article/PIIS2352-3964(20)30118-3/fulltext
Let's hope that as vaccines eventually become available, this will be one of the delivery methods. Microneedles are less painful, too.
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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/