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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The weekly talk show circuit was something. Dr. Scott Gottlieb on Face the Nation, on the dearth of clinical data: "this infection is not just an infection that's causing severe outcomes in older Americans, as was originally initially put forward. A lot of young people are having bad outcomes or intubated right now in the ICU with no comorbidities no otherwise, no risk factors that would predict the bad outcome. There's pregnant women intubated, and in hospitals right now, we need to understand that there's been no publication serious publication by the CDC of the collective clinical experience in this United States In the United States right now. So doctors are making decisions based on anecdote and their own clinical experience. There's really no excuse for that right now. We need to start getting literature out right away to inform providers on what's working and what's not."
Source:
Unofficial transcript: https://otter.ai/s/eMuMzo0uS8ukdLxgXVKzPw
Dr. Anthony Fauci reminds us that because people aren't taking mitigation seriously, the week ahead is going to be a bad one: "Well, this is going to be a bad week, Margaret. Unfortunately, if you look at the projection of the curves of the kinetics of the curves, we're going to continue to see an escalation. Also, we should hope that within a week, maybe a little bit more, we'll start to see a flattening out of the curve and coming down. The mitigation that we're talking about that you just mentioned is absolutely key to the success of that. So on the one hand, things are going to get bad and we need to be prepared for that. It is going to be shocking to Some, it certainly is really disturbing to see that. But that's what's going to happen before it turns around. So just buckle down, continue to mitigate continue to do the physical separation, because we got to get through this week that's coming up because it is going to be a bad week. We are struggling to get it under control. And that's the issue that's at hand right now."
Source:
Unofficial transcript: https://otter.ai/s/DbTdT2A0SAmBMgR30HYy-g
Here's the thing: this disease has a course of 4-6 weeks. We aren't at the hard weeks yet. We still have a massive amount of work to do on containment, on keeping people in their homes, away from others. Protect yourself, protect those around you, and minimize the time you spend near other people in person. When you look at the charts over at FT, it's clear we are not turning any corners anytime soon.
A look at the charts in Our World in Data reveals that we're now at a doubling time in the United States of roughly every 3 days, up from every 2 days. This is still a far, far cry from where we need to be.
Source: ECDC and https://ourworldindata.org/coronavirus#all-charts-preview
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Another great point by Dr. Jeremy Faust on hydroxychloroquine: many people are already taking it, and it's not preventing them from contracting COVID-19.
Source:
And another paper in Science Direct asserting the same: no evidence supports a clinical benefit of hydroxychloroquine and azithromycin with COVID-19. Despite what politicians are saying, there's no evidence it has any impact.
Source: https://www.sciencedirect.com/science/article/pii/S0399077X20300858
If a politician is giving you medical advice about taking a specific drug and they're not an MD, probably ignore them. The science thus far shows no clinical evidence.
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Airflow and enclosed spaces matter. A new paper from the CDC shows an infection pattern in a restaurant that mirrors the HVAC system's airflow. "Virus transmission in this outbreak cannot be explained by droplet transmission alone. Larger respiratory droplets (>5 Ī¼m) remain in the air for only a short time and travel only short distances, generally <1 m (2,3). The distances between patient A1 and persons at other tables, especially those at table C, were all >1 m. However, strong airflow from the air conditioner could have propagated droplets from table C to table A, then to table B, and then back to table C (Figure)."
Source: https://wwwnc.cdc.gov/eid/article/26/7/20-0764_article
This is why social distancing needs to be greater than 6 feet in enclosed airspaces, OR you need to be using additional protective gear. If you distance and you have a mask with decent filtration, you will be better off than distancing with no mask. Wear protective gear wherever possible when near other humans indoors, and give yourself wide latitude outdoors - 20-30 feet. There's absolutely no harm in staying further away from people than the minimum distance.
And to the folks who are saying a cloth mask only reduces particles by 18-50%... well yeah. Of course. That's 18-50% more protection than you have without it. If I asked you if you'd like to have an 18% greater chance to win at the slot machine, would you take it? I should hope so.
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A Houston hospital reports its ICUs filled, despite low reported testing numbers of COVID-19. "Dr. Peter Hotez, an infectious disease expert and dean of the National School of Tropical Medicine at the Baylor College of Medicine in Houston, said the disconnect between the number of positive test results and the number of people hospitalized for COVID-19 suggests that a significant majority of coronavirus cases are going undetected here. āWe know that about 1 in 5 or 1 in 10 COVID-19 patients needs to be hospitalized, so what youāre seeing in hospital admissions would suggest that the actual number of cases could be 5 to 10 times higher in Texas than whatās been reported to this point,ā he said."
Source: https://www.nbcnews.com/news/us-news/houston-hasn-t-reported-surge-coronavirus-cases-its-hospitals-tell-n1175291
This may well end up being the case for a majority of the United States. Because testing is still not scaled up, we may have to rely on ICU and mortality data to ultimately judge how widespread the pandemic is.
CDC influenza-like illness surveillance correlates strongly with this. Reported illnesses have spiked sharply since February.
Source: https://www.cdc.gov/coronavirus/2019-ncov/covid-data/covidview.html
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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/