Thursday, April 2, 2020, I have double-checked this data.
After a slew of articles regarding a high likelihood of CDC changing recommendations on the public use of face mask, I am thinking about the notion of change. There have been times in this country when politicians who changed their minds were vilified for "flip-flopping." Once my children learned the word hypocrite, they made the common error of using it to describe any inconsistency between 2 thoughts or a change in a plan, even if that change was reflective of new or improved information. But when it comes to science and public health, a change in a recommendation is more complicated. Beyond incorporating new data about the efficacy of therapy or an enhanced understanding of a disease mechanism, the disease prevalence plays a critical role in the utility of an action or activity. So, I find myself, yet again, writing about masks.
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The slope is going the wrong way again. Must avoid the temptation to pass judgement on each new data point. (for sanity if nothing else).
https://www.ft.com/coronavirus-latest
Here is a detailed update from a physician epidemiologist on the patterns of spread. It is well worth the time to read.
https://covid19-insights.squarespace.com/blog/covid19-insights-7
Insights from my colleague Joel Topf (@kidney_boy) on the need for volume management in COVID+ ESKD patients.
https://twitter.com/kidney_boy/status/1245156695308931072
Here is the latest, most unambiguous article on the evolving issue around masks for the general public.
https://www.forbes.com/sites/tarahaelle/2020/04/01/should-everyone-wear-a-mask-in-public-maybe-but-its-complicated/#455732a7a02f
The Chair of Surgery at Columbia University Medical Center in NY is blogging about their experience.
https://columbiasurgery.org/news/covid-19-update-dr-smith-33120
(NB: I have a bias for good physician writers.)
Here is a New Yorker article discussing the problems and implications of the data surrounding the French physician's report on Chloroquine. Again, premature judgment and incomplete data sets can lead us down the wrong path.
https://www.newyorker.com/news/daily-comment/a-new-study-questions-the-effectiveness-of-a-potential-game-changer-against-the-coronavirus
This Tweet regarding the uncanny resemblance between that French physician and the very odd physician Donald Trump used in NY before being president had me laughing for quite a while.
https://twitter.com/HeerJeet/status/1245034475739742208
Here is an outstanding interview on Medscape (again, you need to register!) between Dr. Verghese and one of his hospitalist colleagues on her observations from weeks of caring for inpatients at Stanford.
https://www.medscape.com/viewarticle/927296?src=WNL_trdalrt_200401_MSCPEDIT&uac=68144FY&impID=2330709&faf=1#vp_1
Bonus Round: People who changed their minds edition
William of Rubruck was a 13th-century monk who documented his mission to parlay with the Mongol emperor Mongke Kahn. His account is very detailed and remarkably objective, given his biases and the lack of organized reporting standards in 1253 AD. His report back to King Louis, the IX of France, reflects someone whose eyes were opened to a world beyond the Catholic-dominated Europe of the late middle ages. (Even if he didn't have a lot of positive things to say about other religions he encountered -Ahem, you know who you are Nestorian Christians!)
https://en.wikipedia.org/wiki/William_of_Rubruck
His report: https://depts.washington.edu/silkroad/texts/rubruck.html
A great article on his observations: https://publicdomainreview.org/essay/the-khans-drinking-fountain
My favorite in-depth history of the Kahns:
https://www.dancarlin.com/product/hardcore-history-wrath-of-the-khans-series/
Ole Kirk Christiansen was a Danish carpenter who made wooden toys in the 1930s and 1940s. In 1947, he decided that plastics were the way of the future and changed his company to produce molded plastic toys. These plastic toys were interlocking blocks initially designed by a child psychologist in the UK. Though Ole died 1958, and his business was then run by his son Godtfred, he had laid the pivotal strategic vision and groundwork for the success of the LEGO group.
https://astrumpeople.com/ole-kirk-christiansen-biography/
A very insightful book on How LEGO has adapted to the ever-changing world of children's interests
https://www.amazon.com/Brick-Rewrote-Innovation-Conquered-Industry/dp/B00DEK2PUQ/ref=sr_1_6?keywords=lego+history+book&qid=1585826107&sr=8-6
Clean Hands and Sharp Minds.
-Adam
After a slew of articles regarding a high likelihood of CDC changing recommendations on the public use of face mask, I am thinking about the notion of change. There have been times in this country when politicians who changed their minds were vilified for "flip-flopping." Once my children learned the word hypocrite, they made the common error of using it to describe any inconsistency between 2 thoughts or a change in a plan, even if that change was reflective of new or improved information. But when it comes to science and public health, a change in a recommendation is more complicated. Beyond incorporating new data about the efficacy of therapy or an enhanced understanding of a disease mechanism, the disease prevalence plays a critical role in the utility of an action or activity. So, I find myself, yet again, writing about masks.
----------
The slope is going the wrong way again. Must avoid the temptation to pass judgement on each new data point. (for sanity if nothing else).
https://www.ft.com/coronavirus-latest
Here is a detailed update from a physician epidemiologist on the patterns of spread. It is well worth the time to read.
https://covid19-insights.squarespace.com/blog/covid19-insights-7
Insights from my colleague Joel Topf (@kidney_boy) on the need for volume management in COVID+ ESKD patients.
https://twitter.com/kidney_boy/status/1245156695308931072
Here is the latest, most unambiguous article on the evolving issue around masks for the general public.
https://www.forbes.com/sites/tarahaelle/2020/04/01/should-everyone-wear-a-mask-in-public-maybe-but-its-complicated/#455732a7a02f
The Chair of Surgery at Columbia University Medical Center in NY is blogging about their experience.
https://columbiasurgery.org/news/covid-19-update-dr-smith-33120
(NB: I have a bias for good physician writers.)
Here is a New Yorker article discussing the problems and implications of the data surrounding the French physician's report on Chloroquine. Again, premature judgment and incomplete data sets can lead us down the wrong path.
https://www.newyorker.com/news/daily-comment/a-new-study-questions-the-effectiveness-of-a-potential-game-changer-against-the-coronavirus
This Tweet regarding the uncanny resemblance between that French physician and the very odd physician Donald Trump used in NY before being president had me laughing for quite a while.
https://twitter.com/HeerJeet/status/1245034475739742208
Here is an outstanding interview on Medscape (again, you need to register!) between Dr. Verghese and one of his hospitalist colleagues on her observations from weeks of caring for inpatients at Stanford.
https://www.medscape.com/viewarticle/927296?src=WNL_trdalrt_200401_MSCPEDIT&uac=68144FY&impID=2330709&faf=1#vp_1
Bonus Round: People who changed their minds edition
William of Rubruck was a 13th-century monk who documented his mission to parlay with the Mongol emperor Mongke Kahn. His account is very detailed and remarkably objective, given his biases and the lack of organized reporting standards in 1253 AD. His report back to King Louis, the IX of France, reflects someone whose eyes were opened to a world beyond the Catholic-dominated Europe of the late middle ages. (Even if he didn't have a lot of positive things to say about other religions he encountered -Ahem, you know who you are Nestorian Christians!)
https://en.wikipedia.org/wiki/William_of_Rubruck
His report: https://depts.washington.edu/silkroad/texts/rubruck.html
A great article on his observations: https://publicdomainreview.org/essay/the-khans-drinking-fountain
My favorite in-depth history of the Kahns:
https://www.dancarlin.com/product/hardcore-history-wrath-of-the-khans-series/
Ole Kirk Christiansen was a Danish carpenter who made wooden toys in the 1930s and 1940s. In 1947, he decided that plastics were the way of the future and changed his company to produce molded plastic toys. These plastic toys were interlocking blocks initially designed by a child psychologist in the UK. Though Ole died 1958, and his business was then run by his son Godtfred, he had laid the pivotal strategic vision and groundwork for the success of the LEGO group.
https://astrumpeople.com/ole-kirk-christiansen-biography/
A very insightful book on How LEGO has adapted to the ever-changing world of children's interests
https://www.amazon.com/Brick-Rewrote-Innovation-Conquered-Industry/dp/B00DEK2PUQ/ref=sr_1_6?keywords=lego+history+book&qid=1585826107&sr=8-6
Clean Hands and Sharp Minds.
-Adam
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