Wednesday, May 13, 2020
(This date is seared into my mind, it is wedding anniversary day.)
Good morning. Our Physician Experience Q&A yesterday sparked several thoughts, including the notion that we have had an 8-week, ongoing conversation around seven topics: epidemiologic data presentation, testing, vaccines, therapies, clinical impact, social/policy issues, and viral origins. These topics overlap, in many ways, with the physician's phone calls PEX runs - just the depth and technical detail vary. What is clear is that so many of us are looking for the right way to think through the problems - be it safely getting groceries, caring for our parents, or getting patients the dialysis they need. This categorization also gave me pause, since I am not an expert in any of these things, per se. I am just a kidney doctor trying to understand what is happening in a rational and organized fashion. Thanks for reading, thanks for the comments and support, and thanks for your trust.
------
Data Visualization Update
State comparisons:
https://public.tableau.com/views/Coronavirus-ChangeovertimeintheUSA/2_Corona?:display_count=y&:origin=viz_share_link
Rt data
https://public.tableau.com/shared/7FH637YGW?:display_count=y&:origin=viz_share_link
FT data is still the best visualization I have found for country comparisons.
https://ig.ft.com/coronavirus-chart/?areas=usa&areas=gbr&cumulative=0&logScale=1&perMillion=0&values=deaths
----------
Here is some discussion about an article about the genetic variations of the coronavirus, implying that it is very likely that HCov-19 is a natural (as opposed to engineered) occurrence.
https://twitter.com/MackayIM/status/1260179825509036032
Peer-reviewed article, in Cell https://www.cell.com/current-biology/fulltext/S0960-9822(20)30662-X
In light of our Q&A discussion on the antibody-based testing, here is an article reviewing the work of a lab from Mount Sinai in NY. It demonstrates that ELISA testing can be more specific and sensitive as we refine our knowledge of where to attach proteins that "light up" to the antibodies to coronavirus. Short story = the antibody testing will improve. Whether this particular set of testing is scalable and deployable as a point of care test is not clear to me, but the underlying technology is improving.
https://www.nature.com/articles/s41591-020-0913-5
Here is a broader conversation on testing from Eric Topol
https://twitter.com/EricTopol/status/1260226209297788929
Here is an interesting policy overview co-authored by Dr. Fauci. With lots of technical detail, it reviews the societal infrastructure needed to develop and deploy vaccines rapidly.
https://science.sciencemag.org/content/early/2020/05/12/science.abc5312
CUP OF COFFEE ARTICLE OF THE DAY
In follow up, here is a very readable article on herd immunity, vaccines, and related topics.
https://fivethirtyeight.com/features/without-a-vaccine-herd-immunity-wont-save-us/
Brave new work world. Here is an NYTimes article for your consideration:
https://www.nytimes.com/2020/05/06/technology/employee-monitoring-work-from-home-virus.html
and
https://www.ndtv.com/world-news/google-announces-company-holiday-to-address-coronavirus-work-from-home-burnout-2225845
Finally! Another way off the planet that is "safe enough." https://www.wired.com/story/how-nasa-certifies-new-spacecraft-safe-enough-for-humans/
And, remember, there is a price tag for everything, as this older article reminds us:
https://medicalfuturist.com/how-much-is-life-worth/
Here is a follow-up infographic (from a different source): https://i.redd.it/7l7ivv6fcey41.jpg
Infographic of the day - Reuters has a whole infographics department, I learned. I thought this one was neat.
https://graphics.reuters.com/HEALTH-CORONAVIRUS/PPE/rlgpdwxkavo/index.html
------Bonus Round - Doing more than you bargained for edition
Here are a few people who found themselves doing more than they anticipated.
Teddy Roosevelt Jr was TR's son. He had a long career as a businessman, government official, and General in WWII. I am not certain what drove this branch of the Roosevelts to take risks and seek glory, but the story of him leading the 1st wave of the assault on Omaha beach on D-day is like a movie script. And he had what sounds like congestive heart failure and angina. And he survived, at least for another 5 weeks post landing.
Here is the quick version: https://en.wikipedia.org/wiki/Theodore_Roosevelt_Jr.#D-Day
Longer version:
https://warfarehistorynetwork.com/2019/02/06/d-day-invasion-tales-teddy-roosevelt-jrs-bold-decision/
The problem of accurately positioning a ship with longitude is a complex story that requires its own discussion. John Harrison, an English clockmaker, solved many of the engineering problems underlying the issues faced by keeping clocks on ships in the 1700s. What is unique is that he spent 17+ years working on various models and developing solutions to problem after problem. I can only imagine what he was thinking in year 12 of his work.
https://en.wikipedia.org/wiki/History_of_longitude
https://en.wikipedia.org/wiki/John_Harrison
clean hands and sharp minds, team
-Adam
(This date is seared into my mind, it is wedding anniversary day.)
Good morning. Our Physician Experience Q&A yesterday sparked several thoughts, including the notion that we have had an 8-week, ongoing conversation around seven topics: epidemiologic data presentation, testing, vaccines, therapies, clinical impact, social/policy issues, and viral origins. These topics overlap, in many ways, with the physician's phone calls PEX runs - just the depth and technical detail vary. What is clear is that so many of us are looking for the right way to think through the problems - be it safely getting groceries, caring for our parents, or getting patients the dialysis they need. This categorization also gave me pause, since I am not an expert in any of these things, per se. I am just a kidney doctor trying to understand what is happening in a rational and organized fashion. Thanks for reading, thanks for the comments and support, and thanks for your trust.
------
Data Visualization Update
State comparisons:
https://public.tableau.com/views/Coronavirus-ChangeovertimeintheUSA/2_Corona?:display_count=y&:origin=viz_share_link
Rt data
https://public.tableau.com/shared/7FH637YGW?:display_count=y&:origin=viz_share_link
FT data is still the best visualization I have found for country comparisons.
https://ig.ft.com/coronavirus-chart/?areas=usa&areas=gbr&cumulative=0&logScale=1&perMillion=0&values=deaths
----------
Here is some discussion about an article about the genetic variations of the coronavirus, implying that it is very likely that HCov-19 is a natural (as opposed to engineered) occurrence.
https://twitter.com/MackayIM/status/1260179825509036032
Peer-reviewed article, in Cell https://www.cell.com/current-biology/fulltext/S0960-9822(20)30662-X
In light of our Q&A discussion on the antibody-based testing, here is an article reviewing the work of a lab from Mount Sinai in NY. It demonstrates that ELISA testing can be more specific and sensitive as we refine our knowledge of where to attach proteins that "light up" to the antibodies to coronavirus. Short story = the antibody testing will improve. Whether this particular set of testing is scalable and deployable as a point of care test is not clear to me, but the underlying technology is improving.
https://www.nature.com/articles/s41591-020-0913-5
Here is a broader conversation on testing from Eric Topol
https://twitter.com/EricTopol/status/1260226209297788929
Here is an interesting policy overview co-authored by Dr. Fauci. With lots of technical detail, it reviews the societal infrastructure needed to develop and deploy vaccines rapidly.
https://science.sciencemag.org/content/early/2020/05/12/science.abc5312
CUP OF COFFEE ARTICLE OF THE DAY
In follow up, here is a very readable article on herd immunity, vaccines, and related topics.
https://fivethirtyeight.com/features/without-a-vaccine-herd-immunity-wont-save-us/
Brave new work world. Here is an NYTimes article for your consideration:
https://www.nytimes.com/2020/05/06/technology/employee-monitoring-work-from-home-virus.html
and
https://www.ndtv.com/world-news/google-announces-company-holiday-to-address-coronavirus-work-from-home-burnout-2225845
Finally! Another way off the planet that is "safe enough." https://www.wired.com/story/how-nasa-certifies-new-spacecraft-safe-enough-for-humans/
And, remember, there is a price tag for everything, as this older article reminds us:
https://medicalfuturist.com/how-much-is-life-worth/
Here is a follow-up infographic (from a different source): https://i.redd.it/7l7ivv6fcey41.jpg
Infographic of the day - Reuters has a whole infographics department, I learned. I thought this one was neat.
https://graphics.reuters.com/HEALTH-CORONAVIRUS/PPE/rlgpdwxkavo/index.html
------Bonus Round - Doing more than you bargained for edition
Here are a few people who found themselves doing more than they anticipated.
Teddy Roosevelt Jr was TR's son. He had a long career as a businessman, government official, and General in WWII. I am not certain what drove this branch of the Roosevelts to take risks and seek glory, but the story of him leading the 1st wave of the assault on Omaha beach on D-day is like a movie script. And he had what sounds like congestive heart failure and angina. And he survived, at least for another 5 weeks post landing.
Here is the quick version: https://en.wikipedia.org/wiki/Theodore_Roosevelt_Jr.#D-Day
Longer version:
https://warfarehistorynetwork.com/2019/02/06/d-day-invasion-tales-teddy-roosevelt-jrs-bold-decision/
The problem of accurately positioning a ship with longitude is a complex story that requires its own discussion. John Harrison, an English clockmaker, solved many of the engineering problems underlying the issues faced by keeping clocks on ships in the 1700s. What is unique is that he spent 17+ years working on various models and developing solutions to problem after problem. I can only imagine what he was thinking in year 12 of his work.
https://en.wikipedia.org/wiki/History_of_longitude
https://en.wikipedia.org/wiki/John_Harrison
clean hands and sharp minds, team
-Adam
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