Friday, April 24, 2020
Communicating health information in a practical, truthful, and transparent manner is, I believe, an ethical imperative. People want to understand what their options are and what can be done. The problem is, data is messy, and, often, meaningful context takes time, thoughtfulness, and a range of perspectives. But, framing advice and actions in the context of knowns and unknowns is difficult. And, what we think we understand can change over time. This is why doing something is sometimes worse than doing nothing. And, when it comes to treating illness, this is a painfully difficult notion to live with, especially if you are sick right now.
------
Latest data
FT data (No change in the presentation)
https://www.ft.com/coronavirus-latest
Death vs. Cases in the US.
https://ourworldindata.org/grapher/daily-covid-cases-deaths?country=US
remember the reasons for variable daily reporting, look for the trends.
An estimate of the effective reproduction number by state (not updated daily)
https://rt.live/
What is this analysis about? http://systrom.com/topic/coronavirus/
A retrospective, not yet peer-reviewed study in the VA system looking at HCQ, HCQ+/-Azithro, or no HCQ found:
HCQ offered no reduction in risk for mechanical ventilation
HCQ offered a trend toward increased risk of mortality
Data must drive conclusions.
https://www.medrxiv.org/content/10.1101/2020.04.16.20065920v2
about the study:
https://www.medscape.com/viewarticle/929253?nlid=135188_5653&src=wnl_newsalrt_daily_200423_MSCPEDIT&uac=68144FY&impID=2357488&faf=1
Angiotensin-Converting Enzyme inhibitors (ACEi) and Angiotensin Receptor Blockers (ARBs) have been discussed as possibly "enhancing" COVID entry into cells. There is now more data indicating that ACE and ARB are safe in COVID, bolstering support for the consensus statements made in March by many professional societies about not stopping ACE/ARBs.
https://jamanetwork.com/journals/jamacardiology/fullarticle/2765049
On the Q&A call yesterday, I was asked about COVID-associated strokes. I have found a very comprehensive review of the wide variety of signs and symptoms of coronavirus infection, including the neurologic symptoms reported. This requires a Medscape login (which you should all have now).
https://www.medscape.com/viewarticle/929284
Take a moment to read this article. Close your eyes and envision the Boston Dynamics dogs roaming healthcare facilities for telehealth. Imagine if it had a stethoscope and ultrasound probe for remote examination. Even I, lover of technology, am unsettled. Cue - multiple bad storylines - two telehealth robots that fall in love but must fight to be free of their designated roles as telehealth sherpas. A robot dog, fighting against big corporations and red tap to save its human. Robot dogs sent back from the future to kill other robot dogs who became sentient. Enjoy.
https://www.wired.com/story/spot-the-coronavirus-doctor-robot-dog/
Here is an older article about the biologic anomaly that is the platypus. Perry, from Phineas and Ferb, is my favorite platypus, of course. I should not be surprised that more wonderment can emanate from this "hard to believe it is a real thing" animal.
https://www.bbc.com/news/world-australia-38153853
for contrast: https://en.wikipedia.org/wiki/Perry_the_Platypus
-------Bonus Round - Communicating about Science
Writing artistically and clearly about science is critical. Writing about science with poetry can be sublime. The Universe in Verse has been around a few years, but I learned that the program will be live-streamed this year - tomorrow Sat April 25th.
https://pioneerworks.org/programs/the-universe-in-verse-2020/
https://www.brainpickings.org/the-universe-in-verse/
See the 2019 recording:
https://vimeo.com/332096199
https://www.brainpickings.org/2020/04/14/universe-in-verse-2019/
Athanasius Kircher was a 17th-century scholar who investigated on a wide range of topics. He is compared to Da Vinci in his breadth and depth of topics explored. His study of the plague in Italy in the 1650's is a fascinating example of how people attempt to put events of the day in the context of their world view. He is known for many things, but the article below is a review of his Plague Study. (I apologize, worms come up again...)
https://publicdomainreview.org/essay/athanasius-kircher-study-of-the-plague
https://en.wikipedia.org/wiki/Athanasius_Kircher
Clean hands and sharp minds
-AW
Communicating health information in a practical, truthful, and transparent manner is, I believe, an ethical imperative. People want to understand what their options are and what can be done. The problem is, data is messy, and, often, meaningful context takes time, thoughtfulness, and a range of perspectives. But, framing advice and actions in the context of knowns and unknowns is difficult. And, what we think we understand can change over time. This is why doing something is sometimes worse than doing nothing. And, when it comes to treating illness, this is a painfully difficult notion to live with, especially if you are sick right now.
------
Latest data
FT data (No change in the presentation)
https://www.ft.com/coronavirus-latest
Death vs. Cases in the US.
https://ourworldindata.org/grapher/daily-covid-cases-deaths?country=US
remember the reasons for variable daily reporting, look for the trends.
An estimate of the effective reproduction number by state (not updated daily)
https://rt.live/
What is this analysis about? http://systrom.com/topic/coronavirus/
A retrospective, not yet peer-reviewed study in the VA system looking at HCQ, HCQ+/-Azithro, or no HCQ found:
HCQ offered no reduction in risk for mechanical ventilation
HCQ offered a trend toward increased risk of mortality
Data must drive conclusions.
https://www.medrxiv.org/content/10.1101/2020.04.16.20065920v2
about the study:
https://www.medscape.com/viewarticle/929253?nlid=135188_5653&src=wnl_newsalrt_daily_200423_MSCPEDIT&uac=68144FY&impID=2357488&faf=1
Angiotensin-Converting Enzyme inhibitors (ACEi) and Angiotensin Receptor Blockers (ARBs) have been discussed as possibly "enhancing" COVID entry into cells. There is now more data indicating that ACE and ARB are safe in COVID, bolstering support for the consensus statements made in March by many professional societies about not stopping ACE/ARBs.
https://jamanetwork.com/journals/jamacardiology/fullarticle/2765049
On the Q&A call yesterday, I was asked about COVID-associated strokes. I have found a very comprehensive review of the wide variety of signs and symptoms of coronavirus infection, including the neurologic symptoms reported. This requires a Medscape login (which you should all have now).
https://www.medscape.com/viewarticle/929284
Take a moment to read this article. Close your eyes and envision the Boston Dynamics dogs roaming healthcare facilities for telehealth. Imagine if it had a stethoscope and ultrasound probe for remote examination. Even I, lover of technology, am unsettled. Cue - multiple bad storylines - two telehealth robots that fall in love but must fight to be free of their designated roles as telehealth sherpas. A robot dog, fighting against big corporations and red tap to save its human. Robot dogs sent back from the future to kill other robot dogs who became sentient. Enjoy.
https://www.wired.com/story/spot-the-coronavirus-doctor-robot-dog/
Here is an older article about the biologic anomaly that is the platypus. Perry, from Phineas and Ferb, is my favorite platypus, of course. I should not be surprised that more wonderment can emanate from this "hard to believe it is a real thing" animal.
https://www.bbc.com/news/world-australia-38153853
for contrast: https://en.wikipedia.org/wiki/Perry_the_Platypus
-------Bonus Round - Communicating about Science
Writing artistically and clearly about science is critical. Writing about science with poetry can be sublime. The Universe in Verse has been around a few years, but I learned that the program will be live-streamed this year - tomorrow Sat April 25th.
https://pioneerworks.org/programs/the-universe-in-verse-2020/
https://www.brainpickings.org/the-universe-in-verse/
See the 2019 recording:
https://vimeo.com/332096199
https://www.brainpickings.org/2020/04/14/universe-in-verse-2019/
Athanasius Kircher was a 17th-century scholar who investigated on a wide range of topics. He is compared to Da Vinci in his breadth and depth of topics explored. His study of the plague in Italy in the 1650's is a fascinating example of how people attempt to put events of the day in the context of their world view. He is known for many things, but the article below is a review of his Plague Study. (I apologize, worms come up again...)
https://publicdomainreview.org/essay/athanasius-kircher-study-of-the-plague
https://en.wikipedia.org/wiki/Athanasius_Kircher
Clean hands and sharp minds
-AW
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