Coronavirus Tidbits #42 5/2/20

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Announcements:

First, there is now a Resources Page here for the most commonly asked questions I’m getting.

Tidbits will likely be a bit shorter and a little less frequent for the next little bit. I have been immersed in it and I need to spend a little more time on self-care, which for me means seeing the spring flowers emerge and digging in the dirt.

Happy to continue to answer your questions/concerns as best I can, so don’t be shy about that.

News 

Dr Fauci blocked from testifying to the House on US response

to Coronavirus; White House said it would be “counterproductive.”

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Yesterday I mentioned the Internet Archive was providing access to library books free for now as part of their response to the national emergency.

Today, I learned how many view this as piracy. It’s an interesting discussion and I can see the arguments on both sides. It may come as a shock that as an author with a recently released book, Resilience: One Family’s Story…, I would still support the Internet Archive sharing my book during this period.

https://slate.com/culture/2020/04/internet-archive-national-emergency-library-controversy.html

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Suicides in health care workers – 2 this week in NYC

“Having to choose your own safety over offering comfort to the dying because your hospital or health care system doesn’t have enough personal protective equipment to go around inflicts moral injury. When facing the reality of constrained resources and unthinkable choices, working to exhaustion, and caring for patients at great personal risk, the only way to get through each shift is to do what is immediately at hand…

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Thousands of patients suffered needlessly, and far too many of them died. At the same time, frontline health care workers felt betrayed by institutions that made them choose between their own safety and patient well-being.

Failing to prepare properly for the mental health aftermath of the pandemic would be another structural betrayal of frontline health care workers, exposing them to needless suffering and possibly death. We must choose to be ready.”

by Wendy Dean, MD

https://www.statnews.com/2020/04/30/suicides-two-health-care-workers-hint-at-covid-19-mental-health-crisis-to-come/

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Coronavirus takes outsized toll on Filipino-Am nurses

https://www.statnews.com/2020/04/28/coronavirus-taking-outsized-toll-on-filipino-american-nurses/

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2nd trimester miscarriage w/ maternal COVID-19 “appears related to placental infection with SARS-CoV-2,

supported by virological findings in the placenta” Infection of maternal side of placenta inducing placental insufficiency seen in 40% of MERS or SARS https://jamanetwork.com/journals/jama/fullarticle/2765616

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More on the DPA and Executive Order to keep Meat packing plants open:

“Magaly Licolli, executive director of Venceremos, an Arkansas workers’ rights group that focuses on the poultry industry, said invoking the DPA to keep plants humming during an outbreak constitutes a “direct attack to our workers and their communities, knowing that the majority of them are immigrants, refugees, people of color—the most vulnerable people in society.”…

here’s a theory. Already, 20 meatpacking and food-processing workers have died from COVID-19, and more than 5,000 have contracted the disease, according to the United Food and Commercial Workers International Union. What if workers and their families start suing, claiming that the companies’ practices made them sick? Already, one worker—at a Smithfield plant in Milan, Mo.—filed a lawsuit claiming management was not sufficiently protecting workers from the risk of COID-19, and demanding that it follow Centers for Disease Control and Prevention guidelines.

A president invoking the Defense Production Act to require meatpacking firms to keep their plants running during outbreaks would provide a “solid basis” for shielding the firms from suits like this, said Jennifer Zwagerman, director of Drake University’s Agricultural Law Center.

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Armed “protesters” are allowed in Michigan state house but placards are not…and Trump calls them “very good people.”

the second amendment isn’t a license to terrorize or to subvert democratic deliberation with threats of violence. people can own all the guns they want but this stuff has no place in a democracy https://t.co/wPTVcXE7QD

— b-boy bouiebaisse (@jbouie) May 1, 2020

“Deal with the angry militants barricading your office with assault weapons???” No. https://t.co/s70riUrhU4

— Jeremy TEST/TRACE/ISOLATE Konyndyk (@JeremyKonyndyk) May 1, 2020

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Leadership on a major health threat:

PM Justin Trudeau just announced a ban on 1,500 makes and models of military-grade “assault-style” weapons in Canada, effective immediately.

“Enough is enough. Banning these firearms will save Canadian lives,” Public Safety Minister Bill Blair said.

“Because of gun violence, people are dying, families are grieving, and communities are suffering. It must end. Assault-style firearms designed for military use have no place in Canada. By removing them from our streets, we will limit the devastating effects of gun-related violence and help make our country safer.” – Justin Trudeau.

 

Diagnostics:

Pathetic:

MD Governor Hogan says he made sure the plane with (diagnostic) tests landed at BWI instead of Dulles, with a large presence of Maryland National Guard and Maryland State police, bc the tests were valuable and Massachusetts Gov. Baker said his plane load of masks was basically confiscated by the feds… and now, despite buying the kits and the elaborate cat-and-mouse game to keep them from the feds, “Maryland was missing critical testing components [swabs, reagents] and had only enough supplies on hand to conduct 3,200 tests in state-directed labs,” ~ ~ ~ More on inaccuracies of diagnostic tests: https://www.nytimes.com/2020/04/28/opinion/coronavirus-testing.html?referringSource=articleShare

Drugs:

Gilead’s Remdesivir

Also, leaked trial data boosted by STAT

Look, I’m just recapping published events here:

– Former Gilead lobbyist joins White House
– Gilead drug achieves modest effect against #COVID19
– Gliead drug announced as “standard of care” and basis of future trials
– Former Gilead lobbyist announces is leaving White House pic.twitter.com/AeAxFEUe0U

— Maryn McKenna (@marynmck) April 30, 2020

 

Gary Schwitzer’s Health News Review noted:

“the study’s primary endpoint was time to recovery. Yes, that has been the primary endpoint for the last two weeks. But not before that.The trial started February 21.

Researchers on Twitter have posted this excerpt from the online history of changes for this study:

…For the general public, this is somewhat akin to the football field being shrunk so that the goal line is not 100 yards away but only 50 yards away – after the game has already begun.

 

Devices:

Epidemiology/Infection control:

@WADeptHealth

points out that the first confirmed case in the U.S. was detected 101 days ago. In the 100 days that followed, +1M people in the US have been diagnosed with the infection. So far. So fast.

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Nice explainer from Dr. Craig Spencer, on transmission of the virus:

https://threadreaderapp.com/thread/1256389762296025088.html

Tips, general reading for public:

StayAtHome

Wash your hands.

Rinse and repeat.

Politics:

We’re all Zelensky now – 

by Catherine Rampell

“Do us a favor though: Before we provide lifesaving equipment, praise the president.

Do us a favor though: Before we rescue the U.S. Postal Service, raise postage prices on the president’s perceived political enemies.

Do us a favor though: Before we assist states in fiscal crisis, reopen your economies when we say so. Oh, and hand over your immigrants…

In late March, for instance, he suggested that provision of medical supplies to states would be conditional on praise from governors. “It’s a two-way street,” he said on Fox News. “They have to treat us well, also. They can’t say, ‘Oh, gee, we should get this, we should get that.’ ”

Days later, in a White House press briefing, he urged Vice President Pence not to call governors who were insufficiently “appreciative”: “If they don’t treat you right, I don’t call.”

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And in NYC, de Blasio makes an apparent faux pas.

While justifiably criticizing Hasidic Jews in Williamsburg for not maintaining social distancing during a rabbi’s funeral, de Blasio went on, “My message to the Jewish community…,” ignoring that the people doing this were from a specific and relatively small sect. So he’s being criticized by some for tarring all Jews for the actions of this sect.

https://www.cityandstateny.com/articles/politics/new-york-city/everyones-mad-de-blasio-wrong-reason.html

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Want a mask contract or some ventilators? A White House connection helps

Trump and his top aides have played favorites in awarding coronavirus contracts and allocating scarce resources. Much of the flexibility in who gets supplies comes from a secretive “adjudication” process in which senior political appointees have the power to circumvent formulas designed to apportion test kits, ventilators, masks, gloves, gowns and other personal protective equipment based on evolving needs… At the same time, front-line responders in big cities and in some Democratic states, from Phoenix to Detroit to New York, are scrambling to put together homemade gear because they can’t get government-issued equipment and the masks, gloves and gowns they’re trying to buy on the private market are often being delayed or rerouted.

 

Feel good du jour:

A 1,000-year-old water mill in southwest England, which previously witnessed global pandemics such as the plague in the 17th century and the 1918 influenza pandemic, has resumed production to meet demand for flour during the current coronavirus outbreak https://cnn.it/35jEayF

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2 college students made an app to match essential workers with products that might be helpful to them from donors. Read more https://www.huffpost.com/entry/app-help-essential-workers-supplies_n_5ea84cf6c5b6c3055e0bd3b0 or sign up: https://giveessential.org/

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Perspective:

I complained to my mom about feeling confined in our apartment. She then sent me this pic of how she and my dad ate dinner in their manhattan studio apartment when I was a baby and they had nowhere to go when I slept. I take back my complaint. pic.twitter.com/B9Ev4dZ4b4

— Emily C. Singer (@CahnEmily) April 30, 2020

Comic relief:

Mike Pence outraged both parties by defying rule to wear mask at Mayo.

“My solution was the Grim Reaper in a MAGA hat throwing away his mask,” says McKee, a conservative commentator. “And that’s exactly what I think will happen. Pence just gave this chunk of society already disinclined to wear a mask a license not to.”

 

Perspective

Thoughtful read by Keren Landman, MD

Georgia Went First. And It Screwed Up.

Here’s what other states can learn from our inept reopening.

Key points:

“we have yet to demonstrate the coordination needed to identify emerging hot spots in real time.

It’s not just about having favorable data, or even enough testing. It’s about having the right infrastructure to assess it and ensure sustained decreases in cases.

Don’t punish small businesses by treating their decision to reopen — or not — as a purity test.

Somehow, we’ve reached the point where caring about public health has become a progressive issue, while the nation’s economy has become a conservative one. This division is false; no one should have to choose between financial annihilation and helping to spread a deadly disease. But thanks to unforgivable failures of political leadership, business owners in Georgia are bearing the burden of that choice — and the same will happen in every state that follows our lead.

We have dangerous tensions between our state and local governments.

The governor’s decision came as a surprise to our mayors, who were not consulted or informed about his executive order in advance — and were barred by one of its clauses from issuing local orders more or less restrictive than his.

Many felt the choice was the wrong one for their communities.

 

Bits of beauty:

 

It’s #NationalGardeningWeek

But you don’t need a garden to experience the enormous mental health benefits that gardening can bring.

So here’s a two minute video tour of a garden I made in my tiny, rented flat. I call it ‘Borneo in a bookcase’.

Turn on the sound for narration. pic.twitter.com/2whsbrr0z1

— James Wong (@Botanygeek) April 30, 2020

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