Wednesday, April 15, 2020
Nuance is on my mind today. Living in a world of complexity means it takes time and energy to understand what is happening. Allowing others to interpret data for you is convenient, but fraught with trade-offs. And yet, spending time gathering and interpreting data is exhausting. Though I find comfort in details, I can see why disconnecting and finding serenity is so appealing. As such, I tried to seek such peace in a broader range of non-COVID information today.
-----
Today is projected to be a near peak day of deaths per day and resource needs in the U.S., per IHME models:
https://covid19.healthdata.org/united-states-of-america
FT data (No change in the presentation)
https://www.ft.com/coronavirus-latest
And another way to look at this data
https://ourworldindata.org/grapher/daily-covid-cases-deaths?country=USA
In doing a little more exploring for comparative data, the NYT has some state to state comparison graphs that are unique amongst data visualizations.
https://www.nytimes.com/interactive/2020/03/21/upshot/coronavirus-deaths-by-country.html
Maryland has released zip-code level data, which is both enlightening and scary: https://coronavirus.maryland.gov/
The need for testing continues to be a high priority. A variety of new tests are entering the market. Each test type has trade-offs. That is to say, no one type of test is 100% sensitive (a positive is a true positive) nor specific (a negative is a true negative). The technology (ELISA antibody, PCR, or direct antigen in the blood), the timing relative to exposure, the frequency of testing, and the handling of the test kit all matter. And, all tests require an understanding of the patient's clinical context. What makes this illness so troubling is the possibility of asymptomatic patients and the extended timeline to being clinically ill. And, to be sure, testing availability has been a big hurdle in this pandemic.
Here is an article from ProPublica that outlines the concerns. Beware: There is a "the world is filled with nefarious actors doing bad things" tone to this article that feels alarmist, but the description of the testing approval process and the need for clinicians to understand the clinical context of the patient are useful.
https://www.propublica.org/article/coronavirus-tests-are-being-fast-tracked-by-the-fda-but-its-unclear-how-accurate-they-are
more on the topic of testing for coronavirus
https://www.statnews.com/2020/03/31/covid-19-overcoming-testing-challenges/
Background on sensitivity and specificity
https://www.verywellhealth.com/sensitivity-and-specificity-in-medical-testing-overview-4777799
The degree of personal responsibility and desire to aid others is a highlight of being a physician. Here is a poignant and articulate description of the internal conversation many physicians have with themselves regarding COVID.
https://www.nejm.org/doi/full/10.1056/NEJMp2009027
The critical quote in this article is "everything is about probability." A very thoughtfully written article on the data (or lack thereof) behind social distancing.
https://www.nytimes.com/2020/04/14/health/coronavirus-six-feet.html?action=click&module=Top%20Stories&pgtype=Homepage
Matt Brill enlightened me to the essential nature of World Wrestling Entertainment. I can only hope that such a crucial business is conducted with appropriate PPE and at a minimum of 6-foot spacing.
https://thehill.com/homenews/state-watch/492627-florida-mayor-says-wwe-deemed-essential-business-during-coronavirus
While I may not appreciate the criticality of this sport, I was curious about the shift in name from World Wrestling Federation (WWF) to WWE.
https://www.quora.com/What-is-the-difference-between-the-WWE-and-WWF
Taneytown, Maryland, is a rural community that has had some problems with a resident's choice of attire. I have not seen such targeted use of Facebook for police enforcement, but social distancing demands modern techniques, I suppose.
https://www.wmar2news.com/news/local-news/taneytown-police-remind-residents-to-wear-pants-while-checking-mailbox
My favorite infographic of the day
https://i.redd.it/kud55fa6dfs41.jpg
RYAN - We should put together a Physician Experience culinary bingo game that involves finding, taking pictures of, and consuming these different kinds of pasta. Which of our programmers wants to write a script that will create 5x5 tables of a random selection of pasta types?
Source data on Wikipedia https://en.wikipedia.org/wiki/List_of_pasta
-----Bonus Round - Pirates! edition -
In celebration of the latest LEGO set in my house https://brickset.com/article/49422/lego-ideas-pirates-of-barracuda-bay-revealed!
Jan Janszoon was a 16th/17th-century Dutch privateer who converted to Islam and became the elected leader of a pirate council that ran the Republic of Salé, a breakaway port city, ultimately recognized by the Sultan of Morocco (from whom the city broke away). He is known for many raids on various European cities and was, for a time, imprisoned by the Knights of Malta. Like other stories that glamorize criminal lifestyles (Ahem, Goodfellas), I imagine his day-to-day was a bit more mundane. But he was and hung out with the Barbary Pirates that were part of the impetus for forming the US Navy (a little more than 100 years later).
Jans Janszoon
https://en.wikipedia.org/wiki/Jan_Janszoon
Barbary Pirates
https://en.wikipedia.org/wiki/Barbary_pirates
US Naval History
https://history.state.gov/milestones/1801-1829/barbary-wars
Sid Meier is a computer programmer who founded MircroProse in the early 1980s. His games occupied a substantial amount of my early teenage time on an Apple IIe. Of course, my favorite was Sid Meir's Pirates! Interestingly, he lives near my childhood home, but I have never met him. The astounding catalog of games he has developed or produced must account for an enormous amount of entertainment (and loss of world-wide GDP).
Learn about Sid! https://en.wikipedia.org/wiki/Sid_Meier
An interview from 2015 https://www.theguardian.com/technology/2015/feb/27/civilization-sid-meier-interview-starships
Play Pirates! on Steam
https://store.steampowered.com/app/3920/Sid_Meiers_Pirates/
Clean Hands and Sharp Minds
-Adam
Nuance is on my mind today. Living in a world of complexity means it takes time and energy to understand what is happening. Allowing others to interpret data for you is convenient, but fraught with trade-offs. And yet, spending time gathering and interpreting data is exhausting. Though I find comfort in details, I can see why disconnecting and finding serenity is so appealing. As such, I tried to seek such peace in a broader range of non-COVID information today.
-----
Today is projected to be a near peak day of deaths per day and resource needs in the U.S., per IHME models:
https://covid19.healthdata.org/united-states-of-america
FT data (No change in the presentation)
https://www.ft.com/coronavirus-latest
And another way to look at this data
https://ourworldindata.org/grapher/daily-covid-cases-deaths?country=USA
In doing a little more exploring for comparative data, the NYT has some state to state comparison graphs that are unique amongst data visualizations.
https://www.nytimes.com/interactive/2020/03/21/upshot/coronavirus-deaths-by-country.html
Maryland has released zip-code level data, which is both enlightening and scary: https://coronavirus.maryland.gov/
The need for testing continues to be a high priority. A variety of new tests are entering the market. Each test type has trade-offs. That is to say, no one type of test is 100% sensitive (a positive is a true positive) nor specific (a negative is a true negative). The technology (ELISA antibody, PCR, or direct antigen in the blood), the timing relative to exposure, the frequency of testing, and the handling of the test kit all matter. And, all tests require an understanding of the patient's clinical context. What makes this illness so troubling is the possibility of asymptomatic patients and the extended timeline to being clinically ill. And, to be sure, testing availability has been a big hurdle in this pandemic.
Here is an article from ProPublica that outlines the concerns. Beware: There is a "the world is filled with nefarious actors doing bad things" tone to this article that feels alarmist, but the description of the testing approval process and the need for clinicians to understand the clinical context of the patient are useful.
https://www.propublica.org/article/coronavirus-tests-are-being-fast-tracked-by-the-fda-but-its-unclear-how-accurate-they-are
more on the topic of testing for coronavirus
https://www.statnews.com/2020/03/31/covid-19-overcoming-testing-challenges/
Background on sensitivity and specificity
https://www.verywellhealth.com/sensitivity-and-specificity-in-medical-testing-overview-4777799
The degree of personal responsibility and desire to aid others is a highlight of being a physician. Here is a poignant and articulate description of the internal conversation many physicians have with themselves regarding COVID.
https://www.nejm.org/doi/full/10.1056/NEJMp2009027
The critical quote in this article is "everything is about probability." A very thoughtfully written article on the data (or lack thereof) behind social distancing.
https://www.nytimes.com/2020/04/14/health/coronavirus-six-feet.html?action=click&module=Top%20Stories&pgtype=Homepage
Matt Brill enlightened me to the essential nature of World Wrestling Entertainment. I can only hope that such a crucial business is conducted with appropriate PPE and at a minimum of 6-foot spacing.
https://thehill.com/homenews/state-watch/492627-florida-mayor-says-wwe-deemed-essential-business-during-coronavirus
While I may not appreciate the criticality of this sport, I was curious about the shift in name from World Wrestling Federation (WWF) to WWE.
https://www.quora.com/What-is-the-difference-between-the-WWE-and-WWF
Taneytown, Maryland, is a rural community that has had some problems with a resident's choice of attire. I have not seen such targeted use of Facebook for police enforcement, but social distancing demands modern techniques, I suppose.
https://www.wmar2news.com/news/local-news/taneytown-police-remind-residents-to-wear-pants-while-checking-mailbox
My favorite infographic of the day
https://i.redd.it/kud55fa6dfs41.jpg
RYAN - We should put together a Physician Experience culinary bingo game that involves finding, taking pictures of, and consuming these different kinds of pasta. Which of our programmers wants to write a script that will create 5x5 tables of a random selection of pasta types?
Source data on Wikipedia https://en.wikipedia.org/wiki/List_of_pasta
-----Bonus Round - Pirates! edition -
In celebration of the latest LEGO set in my house https://brickset.com/article/49422/lego-ideas-pirates-of-barracuda-bay-revealed!
Jan Janszoon was a 16th/17th-century Dutch privateer who converted to Islam and became the elected leader of a pirate council that ran the Republic of Salé, a breakaway port city, ultimately recognized by the Sultan of Morocco (from whom the city broke away). He is known for many raids on various European cities and was, for a time, imprisoned by the Knights of Malta. Like other stories that glamorize criminal lifestyles (Ahem, Goodfellas), I imagine his day-to-day was a bit more mundane. But he was and hung out with the Barbary Pirates that were part of the impetus for forming the US Navy (a little more than 100 years later).
Jans Janszoon
https://en.wikipedia.org/wiki/Jan_Janszoon
Barbary Pirates
https://en.wikipedia.org/wiki/Barbary_pirates
US Naval History
https://history.state.gov/milestones/1801-1829/barbary-wars
Sid Meier is a computer programmer who founded MircroProse in the early 1980s. His games occupied a substantial amount of my early teenage time on an Apple IIe. Of course, my favorite was Sid Meir's Pirates! Interestingly, he lives near my childhood home, but I have never met him. The astounding catalog of games he has developed or produced must account for an enormous amount of entertainment (and loss of world-wide GDP).
Learn about Sid! https://en.wikipedia.org/wiki/Sid_Meier
An interview from 2015 https://www.theguardian.com/technology/2015/feb/27/civilization-sid-meier-interview-starships
Play Pirates! on Steam
https://store.steampowered.com/app/3920/Sid_Meiers_Pirates/
Clean Hands and Sharp Minds
-Adam
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