Monday, June 29, 2020
The ramifications of the uncoordinated national response to the pandemic were more evident in the data from the weekend. Death rates are rising now. Hospitals are filling up. And the degree of alarm seems muted. I do not fully understand the disconnect between the data and the responses to the data. As of this morning, only six states still had declining cases per capita. And any policy we implement now will take 14+ days to start reducing new infections.
--------
Latest Data
https://ourworldindata.org/coronavirus-data-explorer?yScale=log&zoomToSelection=true&time=2020-04-16..&country=USA~GBR~CAN~BRA~AUS~IND~DEU~FRA~ITA~SWE&deathsMetric=true&dailyFreq=true&aligned=true&perCapita=true&smoothing=7
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 NY Times has hotspot map is an excellent quick glace of rolling 2-week case change https://www.nytimes.com/interactive/2020/us/coronavirus-us-cases.html
State Details:
https://public.tableau.com/views/Coronavirus-ChangeovertimeintheUSA/2_Corona?:display_count=y&:origin=viz_share_link
Rt data
https://rt.live/
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.
------
Here is a starting point: CNBC published JP Morgan data indicating that Chase credit card spending, by state, was correlated with rising infection rates at the +3 week mark. They even did a sub-analysis for in-person vs. takeout dining. Supermarket spending associated with declining infection rates. Based on the comments in the article, the National Restaurant Association (and I) want to remind you that correlation and causation should not be confused.
https://www.cnbc.com/amp/2020/06/26/this-chart-shows-the-link-between-restaurant-spending-and-new-coronavirus-cases.html
How Texas lost control of the pandemic
https://www.bloomberg.com/news/articles/2020-06-28/texas-governor-hobbled-houston-leaders-losing-control-of-virus
Here are some words of wisdom from Florian Krammer, a virologist from NY:
https://twitter.com/florian_krammer/status/1276326535901970432
A loyal reader forwarded the NY Times article describing the coronavirus-mediated mechanisms of T-cell depletion. T-cell depletion may account for one of the factors driving death in older patients.
https://www.nytimes.com/2020/06/26/health/coronavirus-immune-system.html
The notion of pooled testing came up over the weekend as a more efficient means of screening for and then honing in upon positive patients. Here is a concise and helpful Twitter thread by a Brigham doc on the topic:
https://twitter.com/AbraarKaran/status/1276499530943475712
Some leaders have, perhaps, started to say the right words and put some life-sparing policies in place. Nevertheless, many still seem to be wrestling with how to interpret data proactively. We may see the impact of these changes (lower new case rates) in 2-3 weeks.
https://www.aikenstandard.com/coronavirus/gov-mcmaster-declares-new-state-of-emergency-s-c-surpasses-30-000-covid-19-cases/article_1171bf2c-b7e8-11ea-93cf-eb7f1f219e33.html
or
https://www.wptv.com/news/state/broward-county-to-close-beaches-for-july-4-weekend
or
https://www.texastribune.org/2020/06/26/greg-abbott-texas-bars-regret/
or
https://www.pghcitypaper.com/pittsburgh/allegheny-county-closing-bars-and-on-site-alcohol-consumption-in-result-to-spike-in-covid-19-cases/Content?oid=17538719
or
https://www.youtube.com/watch?v=zVIWqOQugho&pbjreload=101
Here is a thoughtful article on why transparency and trust-worthy data is critical in times of emergency. https://theconversation.com/can-i-trust-this-map-4-questions-to-ask-when-you-see-a-map-of-the-coronavirus-pandemic-141131
As an aside, we may also be facing a compounding shortage of physicians and research scientists, due to new rules regarding work visas. It takes 4-6 years of higher education to prepare to take a medical researcher or physician training job, as a point of reference.
https://www.medscape.com/viewarticle/933063
And another loyal reader introduced me to the concept of "Doomscrolling." I have come to accept and continue to love myself for who I am, despite my doomscrolling tendencies. And, while there are always cat videos, that feels like switching to intellectual decaf. I am the type of person that likes me a big slice of fear and a side of outrage before bed, I guess.
https://www.wired.com/story/stop-doomscrolling/#intcid=recommendations_wired-homepage-right-rail_5c6ced51-7162-443d-81a9-2f7ede884ade_popular4-1
Infographic of the day: Since we are all doing outdoor things now, it feels appropriate to remind ourselves how to fight wild animals MMA style. I would be interested in any outcomes data associated with employing these techniques, especially if attacked by Colorado's mountain kangaroos.
https://9gag.com/gag/aYxeLPN
https://www.outtherecolorado.com/pretend-youre-a-zookeeper-at-this-colorado-kangaroo-farm/
------- Bonus Round - Some first-person perspectives
Over the weekend, while clearing off some bookshelves, I came upon a book I purchased a while back, Weevils in the Wheat, analysis of interviews of former Virginia slaves by African American academics in the 1920s and 1930s. Online, I found that the Library of Congress offers 1930s-era audio interviews with former slaves recorded under the Works Project Administration during the Great Depression. While there is an overlap between the book and the website, the book offers more analysis; the website is more accessible.
https://www.amazon.com/Weevils-Wheat-Interviews-Virginia-Ex-Slaves/dp/0813913705
https://www.loc.gov/collections/voices-remembering-slavery/about-this-collection/?loclr=blogloc
About the Library of Congress site:
http://www.openculture.com/2020/06/hear-the-voices-of-americans-born-in-slavery.html
For the decade I spent in inner-city Baltimore for medical school, residency, and fellowship, I was overwhelmed by the pernicious socio-economics enveloping my patients. The interwoven complexities of poor education, lack of employment, lack of familial structure/support, the war on drugs, untreated mental illness, untreated chronic disease, violence, and the lack of access to capital all amplified the situation. Many of my patients frequently often made necessary short-term choices at the expense of any long-term plans. And I was being asked to treat my patients for preventative and primary care concerns. Sometimes, it felt like a charade. It is hard to write about this topic succinctly. The Corner (David Simon's book on the sociology of this) did a masterful job of explaining how all these factors combine and play out.
https://en.wikipedia.org/wiki/The_Corner:_A_Year_in_the_Life_of_an_Inner-City_Neighborhood
https://www.independent.co.uk/news/people/profiles/how-we-met-fran-boyd-donnie-andrews-1780688.html
https://www.chicagoreader.com/Bleader/archives/2012/08/06/cause-of-death-poverty
https://baltimorefishbowl.com/stories/donnie-andrews-the-real-life-omar-died-at-58/
Clean hands and sharp minds,
Adam
The ramifications of the uncoordinated national response to the pandemic were more evident in the data from the weekend. Death rates are rising now. Hospitals are filling up. And the degree of alarm seems muted. I do not fully understand the disconnect between the data and the responses to the data. As of this morning, only six states still had declining cases per capita. And any policy we implement now will take 14+ days to start reducing new infections.
--------
Latest Data
https://ourworldindata.org/coronavirus-data-explorer?yScale=log&zoomToSelection=true&time=2020-04-16..&country=USA~GBR~CAN~BRA~AUS~IND~DEU~FRA~ITA~SWE&deathsMetric=true&dailyFreq=true&aligned=true&perCapita=true&smoothing=7
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 NY Times has hotspot map is an excellent quick glace of rolling 2-week case change https://www.nytimes.com/interactive/2020/us/coronavirus-us-cases.html
State Details:
https://public.tableau.com/views/Coronavirus-ChangeovertimeintheUSA/2_Corona?:display_count=y&:origin=viz_share_link
Rt data
https://rt.live/
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.
------
Here is a starting point: CNBC published JP Morgan data indicating that Chase credit card spending, by state, was correlated with rising infection rates at the +3 week mark. They even did a sub-analysis for in-person vs. takeout dining. Supermarket spending associated with declining infection rates. Based on the comments in the article, the National Restaurant Association (and I) want to remind you that correlation and causation should not be confused.
https://www.cnbc.com/amp/2020/06/26/this-chart-shows-the-link-between-restaurant-spending-and-new-coronavirus-cases.html
How Texas lost control of the pandemic
https://www.bloomberg.com/news/articles/2020-06-28/texas-governor-hobbled-houston-leaders-losing-control-of-virus
Here are some words of wisdom from Florian Krammer, a virologist from NY:
https://twitter.com/florian_krammer/status/1276326535901970432
A loyal reader forwarded the NY Times article describing the coronavirus-mediated mechanisms of T-cell depletion. T-cell depletion may account for one of the factors driving death in older patients.
https://www.nytimes.com/2020/06/26/health/coronavirus-immune-system.html
The notion of pooled testing came up over the weekend as a more efficient means of screening for and then honing in upon positive patients. Here is a concise and helpful Twitter thread by a Brigham doc on the topic:
https://twitter.com/AbraarKaran/status/1276499530943475712
Some leaders have, perhaps, started to say the right words and put some life-sparing policies in place. Nevertheless, many still seem to be wrestling with how to interpret data proactively. We may see the impact of these changes (lower new case rates) in 2-3 weeks.
https://www.aikenstandard.com/coronavirus/gov-mcmaster-declares-new-state-of-emergency-s-c-surpasses-30-000-covid-19-cases/article_1171bf2c-b7e8-11ea-93cf-eb7f1f219e33.html
or
https://www.wptv.com/news/state/broward-county-to-close-beaches-for-july-4-weekend
or
https://www.texastribune.org/2020/06/26/greg-abbott-texas-bars-regret/
or
https://www.pghcitypaper.com/pittsburgh/allegheny-county-closing-bars-and-on-site-alcohol-consumption-in-result-to-spike-in-covid-19-cases/Content?oid=17538719
or
https://www.youtube.com/watch?v=zVIWqOQugho&pbjreload=101
Here is a thoughtful article on why transparency and trust-worthy data is critical in times of emergency. https://theconversation.com/can-i-trust-this-map-4-questions-to-ask-when-you-see-a-map-of-the-coronavirus-pandemic-141131
As an aside, we may also be facing a compounding shortage of physicians and research scientists, due to new rules regarding work visas. It takes 4-6 years of higher education to prepare to take a medical researcher or physician training job, as a point of reference.
https://www.medscape.com/viewarticle/933063
And another loyal reader introduced me to the concept of "Doomscrolling." I have come to accept and continue to love myself for who I am, despite my doomscrolling tendencies. And, while there are always cat videos, that feels like switching to intellectual decaf. I am the type of person that likes me a big slice of fear and a side of outrage before bed, I guess.
https://www.wired.com/story/stop-doomscrolling/#intcid=recommendations_wired-homepage-right-rail_5c6ced51-7162-443d-81a9-2f7ede884ade_popular4-1
Infographic of the day: Since we are all doing outdoor things now, it feels appropriate to remind ourselves how to fight wild animals MMA style. I would be interested in any outcomes data associated with employing these techniques, especially if attacked by Colorado's mountain kangaroos.
https://9gag.com/gag/aYxeLPN
https://www.outtherecolorado.com/pretend-youre-a-zookeeper-at-this-colorado-kangaroo-farm/
------- Bonus Round - Some first-person perspectives
Over the weekend, while clearing off some bookshelves, I came upon a book I purchased a while back, Weevils in the Wheat, analysis of interviews of former Virginia slaves by African American academics in the 1920s and 1930s. Online, I found that the Library of Congress offers 1930s-era audio interviews with former slaves recorded under the Works Project Administration during the Great Depression. While there is an overlap between the book and the website, the book offers more analysis; the website is more accessible.
https://www.amazon.com/Weevils-Wheat-Interviews-Virginia-Ex-Slaves/dp/0813913705
https://www.loc.gov/collections/voices-remembering-slavery/about-this-collection/?loclr=blogloc
About the Library of Congress site:
http://www.openculture.com/2020/06/hear-the-voices-of-americans-born-in-slavery.html
For the decade I spent in inner-city Baltimore for medical school, residency, and fellowship, I was overwhelmed by the pernicious socio-economics enveloping my patients. The interwoven complexities of poor education, lack of employment, lack of familial structure/support, the war on drugs, untreated mental illness, untreated chronic disease, violence, and the lack of access to capital all amplified the situation. Many of my patients frequently often made necessary short-term choices at the expense of any long-term plans. And I was being asked to treat my patients for preventative and primary care concerns. Sometimes, it felt like a charade. It is hard to write about this topic succinctly. The Corner (David Simon's book on the sociology of this) did a masterful job of explaining how all these factors combine and play out.
https://en.wikipedia.org/wiki/The_Corner:_A_Year_in_the_Life_of_an_Inner-City_Neighborhood
https://www.independent.co.uk/news/people/profiles/how-we-met-fran-boyd-donnie-andrews-1780688.html
https://www.chicagoreader.com/Bleader/archives/2012/08/06/cause-of-death-poverty
https://baltimorefishbowl.com/stories/donnie-andrews-the-real-life-omar-died-at-58/
Clean hands and sharp minds,
Adam
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