June 3, 2020
Wednesday
I found myself focused on data in the last 24 hours. I have been unable to find voter turnout data on yesterday's primary elections in 9 states, but results are available. I have seen articles quantifying the differences in police use-of-force data. And there are several new articles on coronavirus-related data—all in all, lots of information to consider.
Elections coverage at the NY Times https://www.nytimes.com/interactive/2020/06/02/us/elections/results-iowa-new-mexico-pennsylvania-primaries.html?action=click&module=ELEX_results&pgtype=Interactive®ion=Navigation
Here is a BLM-associated campaign that offers an array of data and infographics on both Police violence and measures to mitigate police violence. Campaign Zero was first published in 2015.
http://useofforceproject.org/
https://www.joincampaignzero.org/
NY Times article on use-of-force in Minneapolis
https://www.nytimes.com/interactive/2020/06/03/us/minneapolis-police-use-of-force.html
----
State comparisons:
https://public.tableau.com/views/Coronavirus-ChangeovertimeintheUSA/2_Corona?:display_count=y&:origin=viz_share_link
Rt data
https://rt.live/
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 infographics - https://www.nytimes.com/interactive/2020/us/coronavirus-us-cases.html?referringSource=articleShare
Our world in data has interactive features.
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
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.
------------
In the medical world, when there are concerns about published data, letters (and possibly retractions) start. In response to a May 22 Lancet article (a meta-analysis on the use of HCQ), a number of scientists have written such letters. The letter highlights a number of concerns about the data analysis of the May 22 study. It is a good example of how bias needs to be accounted for and why peer review is so valuable. Peer review after publication (which is essentially what this is about) is far less useful since the article is "out there." Essentially, the meta-analysis muddies the waters on what is known about HCQ and makes getting to a meaningful consensus that much more challenging.
https://zenodo.org/record/3871094#.Xtd9M8Z7l-U
On the OCMO call last night, Dr. G brought up another meta-analysis from the Lancet about face masks, eye protection, and distancing. This topic is difficult (as we have discussed), and this study has flaws but is not without merit. The important takeaways are:
it appears all three interventions reduce the likelihood of viral transmission, with consistent data to support 6-foot (or 3 meters) distancing.
https://twitter.com/TheLancet/status/1267585465424719873/photo/1
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31142-9/fulltext
Temperature checks alone are not a very sensitive or specific screening tool for coronavirus infection. More robust screening (contact and symptom questions) is necessary. In places with high rates of infection, screening for overtly febrile patients may help identify who deserves testing. Still, temperature checks alone will miss a lot of positive cases and find people ill with other infections.
https://twitter.com/EricTopol/status/1267816542869131266
I recommend the discussion in this thread and Dr. Topol's reference to the SNOT-22 olfactory symptom grading scale.
Here is an interesting article on some theories about the mechanism of the pathophysiology of SARS-CoV-2. Bear in mind that this is a non-scientific study pulling data from several journal articles interwoven with some expert opinion. Nevertheless, it is a satisfying discussion on some ideas of what might be going on. As with any theorized model, it will likely be wrong in many ways but is a great example of how doctors think systemically about this infection.
https://elemental.medium.com/coronavirus-may-be-a-blood-vessel-disease-which-explains-everything-2c4032481ab2
Yesterday, I found this pre-release cohort study looking at combination Vitamin D, Magnesium, and Vitamin B12 (DMB) on progression to severe outcomes in older COVID-19 patients. It is interesting, but the number of treated patients is very small. The control and intervention groups are reasonably balanced. I do not believe they quantified how long the patients were infected before hospitalization, but they attempted to control for severity of illness once admitted. Given the costs and the limited downside risk of these supplements (at these doses), this topic is worthy of a deeper investigation. Nota Bene: DO NOT CONCLUDE THAT USING Mg, B12, and Vit D will prevent infection or mitigate response in your or your family.
https://www.medrxiv.org/content/10.1101/2020.06.01.20112334v1
Infographic of the day - mechanical ventilators!
https://tabletopwhale.com/2020/04/01/explaining-ventilators-for-covid-19.html
Infographic of the day #2 - the cost of getting off the earth, per kg by launch platform. You know how much you weigh, you can do the math.
https://i.redd.it/1e1starglk251.jpg
---Bonus Round - Stirring things up, but in an organized way.
Only one today, but I think he counts as two.
One of my favorite leaders from the 1960s civil rights movement was Bayard Rustin. He was one of the leaders of the March on Washington. He was heavily involved in numerous organizations fighting for civil rights, the labor movement, and gay rights (amongst many other causes). As a gay black man in mid-20th century America, he was not the public face of these movements but was a savvy and thoughtful organizer. More than the vision guys, I often think it is more inspirational to see talented people that can operationalize ideas into manageable steps that yield change. I am, admittedly, a fan. He is on my list of people I would have like to have lunch with, to be sure.
https://en.wikipedia.org/wiki/Bayard_Rustin
https://kinginstitute.stanford.edu/encyclopedia/rustin-bayard
Clean hands and sharp minds,
-AW
I found myself focused on data in the last 24 hours. I have been unable to find voter turnout data on yesterday's primary elections in 9 states, but results are available. I have seen articles quantifying the differences in police use-of-force data. And there are several new articles on coronavirus-related data—all in all, lots of information to consider.
Elections coverage at the NY Times https://www.nytimes.com/interactive/2020/06/02/us/elections/results-iowa-new-mexico-pennsylvania-primaries.html?action=click&module=ELEX_results&pgtype=Interactive®ion=Navigation
Here is a BLM-associated campaign that offers an array of data and infographics on both Police violence and measures to mitigate police violence. Campaign Zero was first published in 2015.
http://useofforceproject.org/
https://www.joincampaignzero.org/
NY Times article on use-of-force in Minneapolis
https://www.nytimes.com/interactive/2020/06/03/us/minneapolis-police-use-of-force.html
----
State comparisons:
https://public.tableau.com/views/Coronavirus-ChangeovertimeintheUSA/2_Corona?:display_count=y&:origin=viz_share_link
Rt data
https://rt.live/
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 infographics - https://www.nytimes.com/interactive/2020/us/coronavirus-us-cases.html?referringSource=articleShare
Our world in data has interactive features.
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
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.
------------
In the medical world, when there are concerns about published data, letters (and possibly retractions) start. In response to a May 22 Lancet article (a meta-analysis on the use of HCQ), a number of scientists have written such letters. The letter highlights a number of concerns about the data analysis of the May 22 study. It is a good example of how bias needs to be accounted for and why peer review is so valuable. Peer review after publication (which is essentially what this is about) is far less useful since the article is "out there." Essentially, the meta-analysis muddies the waters on what is known about HCQ and makes getting to a meaningful consensus that much more challenging.
https://zenodo.org/record/3871094#.Xtd9M8Z7l-U
On the OCMO call last night, Dr. G brought up another meta-analysis from the Lancet about face masks, eye protection, and distancing. This topic is difficult (as we have discussed), and this study has flaws but is not without merit. The important takeaways are:
it appears all three interventions reduce the likelihood of viral transmission, with consistent data to support 6-foot (or 3 meters) distancing.
https://twitter.com/TheLancet/status/1267585465424719873/photo/1
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31142-9/fulltext
Temperature checks alone are not a very sensitive or specific screening tool for coronavirus infection. More robust screening (contact and symptom questions) is necessary. In places with high rates of infection, screening for overtly febrile patients may help identify who deserves testing. Still, temperature checks alone will miss a lot of positive cases and find people ill with other infections.
https://twitter.com/EricTopol/status/1267816542869131266
I recommend the discussion in this thread and Dr. Topol's reference to the SNOT-22 olfactory symptom grading scale.
Here is an interesting article on some theories about the mechanism of the pathophysiology of SARS-CoV-2. Bear in mind that this is a non-scientific study pulling data from several journal articles interwoven with some expert opinion. Nevertheless, it is a satisfying discussion on some ideas of what might be going on. As with any theorized model, it will likely be wrong in many ways but is a great example of how doctors think systemically about this infection.
https://elemental.medium.com/coronavirus-may-be-a-blood-vessel-disease-which-explains-everything-2c4032481ab2
Yesterday, I found this pre-release cohort study looking at combination Vitamin D, Magnesium, and Vitamin B12 (DMB) on progression to severe outcomes in older COVID-19 patients. It is interesting, but the number of treated patients is very small. The control and intervention groups are reasonably balanced. I do not believe they quantified how long the patients were infected before hospitalization, but they attempted to control for severity of illness once admitted. Given the costs and the limited downside risk of these supplements (at these doses), this topic is worthy of a deeper investigation. Nota Bene: DO NOT CONCLUDE THAT USING Mg, B12, and Vit D will prevent infection or mitigate response in your or your family.
https://www.medrxiv.org/content/10.1101/2020.06.01.20112334v1
Infographic of the day - mechanical ventilators!
https://tabletopwhale.com/2020/04/01/explaining-ventilators-for-covid-19.html
Infographic of the day #2 - the cost of getting off the earth, per kg by launch platform. You know how much you weigh, you can do the math.
https://i.redd.it/1e1starglk251.jpg
---Bonus Round - Stirring things up, but in an organized way.
Only one today, but I think he counts as two.
One of my favorite leaders from the 1960s civil rights movement was Bayard Rustin. He was one of the leaders of the March on Washington. He was heavily involved in numerous organizations fighting for civil rights, the labor movement, and gay rights (amongst many other causes). As a gay black man in mid-20th century America, he was not the public face of these movements but was a savvy and thoughtful organizer. More than the vision guys, I often think it is more inspirational to see talented people that can operationalize ideas into manageable steps that yield change. I am, admittedly, a fan. He is on my list of people I would have like to have lunch with, to be sure.
https://en.wikipedia.org/wiki/Bayard_Rustin
https://kinginstitute.stanford.edu/encyclopedia/rustin-bayard
Clean hands and sharp minds,
-AW
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