What Adam is Reading - 5-26-2020

Tuesday, May 26, 2020

Memorial day weekend is the start of beach season on Maryland's Eastern Shore. Traffic backups and crowds in my area typically mark the summer weekends. On my few errands, I saw a surprising adherence to masks and distancing. I will be interested to see how well my community maintains this discipline. On Sunday, I was notified by one of my transplant patients that they were exposed to a COVID+ family member at a Saturday gathering. That family member, who was having a cough from "allergies" on Saturday, chose to attend the family gathering (including my patient, her children, and her older family members), despite having a known COVID exposure, symptoms, and a pending PCR test. We (both my patient and our country) are not out of the woods on this, by a long shot.

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Latest Data
Weekend/holiday data is not as up-to-date due to the reporting pathways.

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

The tableau data is from The COVID Tracking Project, which compiles and rates state-reported data. Please review https://covidtracking.com/ to understand the quality of the data.
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Data integrity is now full-on in the spotlight.
https://www.nbcnews.com/politics/politics-news/i-m-looking-truth-states-face-criticism-covid-19-data-n1202086

What does this look like for the typical person? A loyal reader and friend offered two observations on FL data that seemed spot-on and a great example of how data presentation can be manipulated:

1. The Florida dashboard appears to be minimizing the most recent deaths by
- delayed reporting (making the newest data always look like it is trending down and then updating older data)
- defining the population by "Residents of FL" (Perhaps excluding non-residents? This is unclear.)
- only using "confirmed" COVID-19 deaths (as opposed to offering suspected and confirmed).

See "Resident Deaths by Date of Death"
*The Deaths by Day chart shows the total number of Florida residents with confirmed COVID-19 that died on each calendar day (12:00 AM - 11:59 PM). Death data often have significant delays in reporting, so data within the past two weeks will be updated frequently
https://experience.arcgis.com/experience/96dd742462124fa0b38ddedb9b25e429
vs. MD "Confirmed and Probable Deaths, Totals by Date of Death"
https://coronavirus.maryland.gov/datasets/md-covid-19-data-dashboard?fullScreen=true
vs. NYT "New Deaths Reported"
https://www.nytimes.com/interactive/2020/us/florida-coronavirus-cases.html

2. FL appears not to report typical metrics other states may be benchmarking by, such as hospitalizations (a surrogate measure of resource utilization). Florida offers no data on hospitalizations (unlike many other states). It's also a number that is increasing or holding steady.
https://covidtracking.com/data/state/florida
Compare to Maryland: https://coronavirus.maryland.gov/
Or Wyoming https://health.wyo.gov/publichealth/infectious-disease-epidemiology-unit/disease/novel-coronavirus/covid-19-map-and-statistics/

Bottom line - it appears the data are not false, just not meaningful, or appropriately contextualized to convey the reality of the situation.


The Atlantic had an article on the CDC's conflation of PCR and antibody testing data. Once again, critical thinking is crucial to understanding data:
https://www.theatlantic.com/health/archive/2020/05/cdc-and-states-are-misreporting-covid-19-test-data-pennsylvania-georgia-texas/611935/

Family gatherings and group events are still a likely venue for COVID transmission. Here is a report from Oregon.
https://www.registerguard.com/news/20200525/spike-in-coronavirus-cases-in-oregon-traced-to-gatherings

For healthcare workers, the risks of exposure are related to PPE and the types of medical procedures they are engaged in. Here is a peer-reviewed meta-analysis.
https://www.acpjournals.org/doi/10.7326/M20-1632

In follow up to some of the Vitamin D comments I have found, a number of scientists have published a consensus statement that Vit D offers no benefit in treating or preventing COVID-19.
https://www.surrey.ac.uk/news/high-doses-vitamin-d-supplementation-has-no-current-benefit-preventing-or-treating-covid-19
Here is the article: https://nutrition.bmj.com/content/early/2020/05/15/bmjnph-2020-000089

We continue to see a wide range of systemic impacts of this coronavirus. Here is some data regarding pathology reports on placental injury ONLY noticed after successful delivery in COVID+ patients. There are some interesting comments in the article about how this issue may be under-appreciated in other infectious illnesses.
https://eurekalert.org/pub_releases/2020-05/nu-pfc052220.php

Infographic of the day - thinking long-term. I am looking forward to the year 21,000 AD for a safe trip to Chernobyl. Invest now for the inevitable tourist trade that is sure to blossom.
https://www.informationisbeautiful.net/visualizations/timeline-of-the-far-future/

My favorite Twitter thread of yesterday: May 25, 1977 (and 1983), was a momentous day in the lives of us that grew up in the 80s. Pew pew pew.
https://twitter.com/HamillHimself/status/1264933411661082626


Bonus Round --- People behind the scenes who we know but don't know

I found the story of Care Torry, the vocalist on Pink Floyd's Great Gig in the Sky. Remarkably, vocals without words can be both impactful and controversial.
http://www.openculture.com/2020/05/clare-torrys-rare-live-performances-of-great-gig-in-the-sky-with-pink-floyd.html

And, to round out today's bonus round, I offer the compelling story of Mary Clayton, who was the vocalist on the Rolling Stone's Gimme Shelter. [This is unequivocally my favorite Stone's song, so I am biased here].
http://www.openculture.com/2018/07/merry-clayton-tells-story-amazing-backing-vocal-rolling-stones-gimme-shelter.html

As a result of these two articles, I found https://twentyfeetfromstardom.com/ - a documentary on the backup singers in music history. (Currently on sale of $2.99 rental on Amazon Prime!)

Clean hands and sharp minds

-AW

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