Coronavirus Tidbits #72 8/9/20
Quick links
News Diagnostics Drugs Devices Epidemiology/Infection control Tips Politics Feel good du jour Comic relief Perspective/Poem Bits of beauty
Announcements:
First, there is now a Resources Page here for the most commonly asked questions I’m getting.
Happy to continue to answer your questions/concerns as best I can, so don’t be shy about that.
News
As a result of threats and harassment, at least 27 public health officers in 13 states have resigned or been fired since the pandemic started.
https://jamanetwork.com/journals/jama/fullarticle/2769291
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Study: Most (77%) Americans don’t have enough assets to withstand 3 months at least poverty-level status without income
https://www.eurekalert.org/
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Nearly 30 million Americans told the Census Bureau they didn’t have enough to eat last week
https://www.cnn.com/2020/07/31/us/food-insecurity-30-million-census-survey/index.html
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Still a problem
People of America! I want to talk about two photos that tell the story of food in our country in this moment…two different, painful realities that we are experiencing, and the opportunity we must seize to make sure food is not the problem but the solution 1/ pic.twitter.com/LUUS4jcMgr
— Please wear a mask! Do it for USA, please… (@chefjoseandres) April 30, 2020
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The high price of long hauling:
If 20% of the U.S. population contracts the coronavirus, the one-year post-hospitalization costs would be at least $50 billion Without a vaccine, if 80% of the pop. became infected, that cost would balloon to $204 billion
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15 hospitalized with methanol poisoning after ingesting hand sanitizers
Do not drink hand sanitizer, no matter what certain people might say.
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Hi. The Trump-supporting company that owns Motel 6, a chain that illegally sold its guest lists to U.S. Immigration and Customs Enforcement (ICE) without a warrant, just bought our DNA. https://t.co/FNrs5yhvMm
— Marquita Harris (@mar_har) August 5, 2020
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Large Salmonella outbreak from ONIONS
https://twitter.com/chrishendel/status/1291821464434417665?s=20
Diagnostics:
still an incredible, negligent lack of testing.
a simpler, faster Covid-19 test
LAMP, or loop-mediated isothermal amplification.
https://www.statnews.com/2020/08/06/better-simpler-faster-covid-19-test/?
Some others are being designed like a home pregnancy test, using saliva. Maybe not as accurate, but good screen and only costs $1
https://www.vox.com/2020/6/3/21277347/covid-19-testing-at-home-accuracy
Drugs:
Important news about aggressive Hydroxychloroquine disninformation campaign. Rec whole thread:
The report itself is a case study in Humpty-Dumpty's "When I use a word, it means just what I choose it to mean—neither more nor less."
— Carl T. Bergstrom (@CT_Bergstrom) August 7, 2020
The fact that different countries used different treatment approaches is referred to as a randomized controlled trial. pic.twitter.com/rCA62W4TyR
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Do You Want to Be a Vaccine Volunteer?
How do you sign up for a trial? Who is eligible? Will you be paid? Could an experimental shot protect you? Could you get sick? Who covers the costs if you do?
A number of sites maintain lists of coronavirus vaccine trials. The Covid-19 Prevention Network site, created by the National Institute of Allergy and Infectious Diseases at the National Institutes of Health, helps connect volunteers to Phase 3 studies.
ClinicalTrials.gov also lists Covid-19 vaccine studies at different phases and COVID Dash, a portal managed by a group of doctors, clinical trial professionals and students who want to encourage people to volunteer, features studies across the world.
https://www.nytimes.com/2020/08/05/health/volunteer-coronavirus-vaccine-trial.html
[If you want to know more about drug/vaccine development, incl ethics, see my Conducting Clinical Research guide, free on my website].
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Obesity and vaccines: Scientists know that vaccines engineered to protect the public from influenza, hepatitis B, tetanus and rabies can be less effective in obese adults than in the general population, leaving them more vulnerable to infection and illness. There is little reason to believe, obesity researchers say, that COVID-19 vaccines will be any different.
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Italy becomes first country to require pharma to disclose public funding for R&D costs
https://www.statnews.com/pharmalot/2020/08/06/italy-transparency-rnd-drug-prices/ (Paywalled)
Devices:
Pulse oximeters are a crucial tool for COVID patients: to determine when to go to the ER and when to administer oxygen, yet systematic errors on dark-skinned patients could be resulting in worse care
— Rachel Thomas (@math_rachel) August 6, 2020
Incredibly thorough article: https://t.co/RzD13lr9uv pic.twitter.com/3wHEyITQRz
Most hospital protocols now recommend starting oxygen at 90. Below that threshold damage to the heart, brain, lungs, & kidneys becomes an immediate danger. Black patients, in crisis at 88, would get an [erroneous] average reading of 91—just above the intervention threshold.
At a pulse oxygen reading of 88 or 89, Medicare will reimburse for oxygen at home, but at 90 it won’t. This means people with darker skin may have to be sicker in order to qualify for the same treatment as people with white skin.
Related: The inaccuracy of Fitbits & other heart rate trackers on people with dark skin is particularly concerning given that Fitbits are currently being used in over 300 clinical medical research trials, most of which do not take skin tone into account. https://statnews.com/2019/07/24/fitbit-accuracy-dark-skin/
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Mask mandates:
Fascinating chart from @maddow! #Kansas Governor issued mask mandate but each county got to decide whether to adopt it. 15 counties adopted it (red line) & 90 didn’t (blue line). Look at how much #COVID19 cases declined in the counties that mandated masks! Wow! pic.twitter.com/aKhX78kNzR
— Tracy (@TweetingTracy) August 7, 2020
Epidemiology/Infection control:
Georgia's North Paulding High School hit the student, 15-year-old Hannah Waters, with a 5-day suspension for posting that photo — a shot she took out of concern for her safety … as well as her classmates'. pic.twitter.com/PKOir7fXv8
— Jonathan Webers (@JWeber988) August 6, 2020
Four days later, North Paulding High School has 6 students and 3 staff test positive for coronavirus….
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Nearly 100,000 children tested positive for the coronavirus in the last two weeks of July,
a new report from the American Academy of Pediatrics finds. Out of almost 5 million reported COVID-19 cases in the U.S., the group found that more than 338,000 were children.
Why are we sending kids back to school? Why are Trump and DeVos threatening schools that don’t open with loss of funding?
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Viral shedding and infectiousness
Many individuals with SARS-CoV-2 infection remained asymptomatic for a prolonged period. Viral load was similar in asymptomatic and symptomatic patients; therefore, isolation of infected persons should be performed regardless of symptoms.
https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2769235?
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Minority children in US shoulder large COVID-19 burden
About 46% of Hispanic children (adjusted odds ratio [aOR], 6.3; 95% confidence interval [CI], 3.3 to 11.9) and 30% of black children (aOR, 2.3; 95% CI, 1.2 to 4.4) tested positive for coronavirus, versus only 7% of white children.
When the investigators used data from the American Families Survey to analyze the group by income level, 38% of children in the lowest-income group were positive for COVID-19, compared with only 9% of those in the highest-income group.
https://www.cidrap.umn.edu/
Tips, general reading for public:
StayAtHome
Wash your hands.
Rinse and repeat.
Michelle Obama Says Hypocrisy Of Trump Admin And Racial Unrest Have Contributed To Her ‘Low-Grade Depression’
The former first lady said she has been working on her mental health by working out and learning to pamper herself.
Politics:
Over the last seven days, one person died every 80 seconds from the coronavirus in America.
https://nbcnews.to/30t99aW
Trump’s response: “It is what it is.”
Trump's America: First to worst. "It is what it is" https://t.co/Ah2kExiAfw pic.twitter.com/sQcroKTKOz
— JD Crowe (@CroweJam) August 7, 2020
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The Navajo Nation now has more COVID deaths than 13 states combined.
— Robert Reich (@RBReich) August 4, 2020
13 states.
“We have 13 supermarkets for 27,000 square miles, so people have to travel a long way to get food,” … Diabetes, which affects more than one-fifth of its residents.
One in three households doesn’t have indoor plumbing, and decades of uranium mining has contaminated existing water supplies, adding to health problems. Families are also more likely to live in multigenerational homes, making quarantining more difficult.
although Native Americans are only 9 percent of New Mexico’s population, they account for 57 percent of its Covid-19 deaths. Many of these inequities stem from the US government’s breaking of treaty obligations…
Jonathan Nez, President of Navaho Nation:
We framed it within our cultural teaching: We teach that we have fought monsters, but today we also have modern monsters, like alcoholism, depression, suicide, and disease. In our society, we value our elders and we let people know they are warriors, and they are supposed to protect their families — in this case, to shield their elders, who have traditional and cultural knowledge for the future of our people…
the failure and slowness of the federal government to give us our share of the Cares Act …
While all states got money right away, we had no federal money until long after we hit our surge. Of course we’re grateful, but this money was intended for US citizens. Tribal people are US citizens, and we had to wait and wait for our fair share.
https://www.vox.com/2020/7/28/21344969/covid-19-masks-arizona-new-mexico-utah-navajo-nation
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Protesters in Utah face life in prison for alleged vandalism, after the DA they were protesting gave them gang-related charging enhancements. It's the latest incidence of prosecutors ratcheting up charges against activists: https://t.co/1MSgV1hU0v
— Kelly Weill (@KELLYWEILL) August 7, 2020
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On systemic racism:
I was taking care of a patient the other day who was very seriously injured. And I stepped out to talk to his family briefly and give them an update. For context, he was Black. I told them what was going on quickly and asked if they had any questions. And this is what they said.
— Esther Choo, MD MPH (@choo_ek) August 7, 2020
They told me that he worked for [well known company] And that he was a [respected role] at that company That he was on his way to work That he is loved in the community A good brother and son That he was well dressed before the blood soaked his clothes
Nothing in recent memory has broken my heart as much as gradually realizing that a family of a shattered man whose chief concerns should have been – when can i see him, when does he get out of surgery, do you know his meds and allergies, his mama gets to go in first…
…had to worry that the racism inherent in the system and in people everywhere meant they had to spend their few moments with me putting him in a favorable light, shifting any possible implicit negative frame I had (e.g., “hoodlum” or “criminal”) to get him the care he deserved.
What is the goal of all our anti-racist pledges over the past summer? It’s that this family can walk in with full confidence that their loved one is valued and cherished here and that we will fight for his life with everything we have, no questions asked.
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Study finds racial bias in the government’s formula for distributing Covid-19 aid to hospitals
The inequities resulted from a formula that allocated large chunks of a $175 billion relief package based on hospital revenue rather than Covid-19 cases.
https://www.statnews.com/2020/08/07/racial-bias-in-government-covid19-hospital-aid-formula/?
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Worth watching the video
https://twitter.com/AynRandPaulRyan/status/1291412757540044800?s=20
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The White House is considering directing the postal service not to deliver mail in ballots. 23 postal execs were sacked this week. If this doesn’t scare you, democracy must be optional to you. https://t.co/Dm4oTgcdWI via @politico
— Joe Lockhart (@joelockhart) August 8, 2020
Feel good du jour:
https://twitter.com/TJ_Knight/status/1291371460473294848?s=20
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Here’s a turtle playing with a ball. Happiness lies in the simple things in life. pic.twitter.com/rRPgFxpx6E
— Life on Earth (@planetpng) July 28, 2020
Comic relief:
https://twitter.com/SlenderSherbet/status/1290720938187726850?s=20
Perspective/Poem
Thinking today about this famous quote from Macbeth: "It is a tale, told by an idiot, full of sound and fury, signifying nothing."
— Dan Rather (@DanRather) August 4, 2020
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This @MaryLTrump quote at the end of her book stopped me in my tracks:
— Zerlina Maxwell (@ZerlinaMaxwell) August 4, 2020
“If he can in any way profit off your death, he will facilitate it and then he’ll ignore the fact that you died.”
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“Americans be so proud of working themselves to the bone, right into an early grave. Meanwhile other countries take naps in the middle of the day.”
Bits of beauty:
