Thursday, June 4, 2020
Last evening a female red-wing blackbird flew into my garage. Watching it try to find its way out felt like a metaphor for the news. Chaotic, frustrating, and lost. And yet, the garage door was open.
Here is some data to keep in mind as you watch the news:
Despite an evident drop in violent crime over the last 30 years, perceptions of crime do not align with this data.
https://www.pewresearch.org/fact-tank/2019/10/17/facts-about-crime-in-the-u-s/
Bias and injustice is a public health issue. There is correlative data on the relationship between being killed by the police and age, race/ethnicity, and gender. This article is from August 2019.
https://www.pnas.org/content/116/34/16793
----
State comparisons:
https://public.tableau.com/views/Coronavirus-ChangeovertimeintheUSA/2_Corona?:display_count=y&:origin=viz_share_link
Rt data
https://rt.live/
North Carolina's Rt seems to be very high. A brief review of various resources does seem to indicate higher testing volumes, with a stable % positive rate. Not sure what is going on there.
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.
------------
A well-done study on using Hydroxychloroquine demonstrates that it is NOT useful in post-exposure prophylaxis. Thus far, we have mounting data that 1) not helpful in severe COVID, 2) not helpful in mild/moderate COVID, and does not prevent infection after exposure.
https://www.nejm.org/doi/full/10.1056/NEJMoa2016638?query=featured_home#.XtgSPYeCao0.twitter
Commentary: https://twitter.com/GidMK/status/1268291611689017344
Data is messy, and the best we often get in healthcare is a preponderance of data across numerous studies. There are also steps back. Here is some more in-depth information on the letters of concern in the Lancet and NEJM. It appears that an overlapping set of authors mining databases are behind both papers. This STAT News article covers a lot of fo good ground on study design and avoiding bias.
https://www.statnews.com/2020/06/02/top-medical-journals-raise-concerns-about-data-in-two-studies-related-to-covid-19/
Here are some interesting comments from Sweden's architect of their "no lockdown" strategy. It seems he feels a bit differently about his thoughts 2-3 months into the viral spread.
https://www.bloomberg.com/news/articles/2020-06-03/man-behind-sweden-s-virus-strategy-says-he-got-some-things-wrong
Here is a summary of data from Medscape addressing the notion that "the virus is weakening." At this point, there is no evidence that the virus is weakening (or mutating enough to be clinically different).
https://www.medscape.com/viewarticle/931670
Here is an interesting potential early indicator of problems: ICU bed capacity. I think there are some problems with baseline data, but it is another variable to keep in mind as we look across the dashboards.
https://www.politico.com/news/2020/05/28/rising-icu-bed-use-red-flag-287552
Commentary of value: https://twitter.com/charlesornstein/status/1268261362867884032
Bad infographic of the day:
In 2014, Reuters attempted to create an infographic that looked like dripping blood in response to the Florida stand-your-ground law. However, they created confusion. The Y-axis on this graph is reversed. The data demonstrates INCREASED gun deaths, but it is not obvious.
https://i.redd.it/s8qym4n6aq251.jpg
There are more successful attempts at this technique of data display
https://eagereyes.org/wp-content/uploads/2014/06/scarr-iraqs-bloody-toll.jpg
-----Bonus Round - Darkness and Light
Vaclav Havel was one of the many intellectual and political leaders of Eastern Europe's long struggle against Soviet totalitarianism. He started life in the theater and as a playwright, who found himself leading the democracy movement in Czechoslovakia. As we know, he helped transition his country to a democratic, multiparty democracy and oversaw the split between the Czech Republic and Slovakia. Persistence over 40+ years in the face of large oppressive forces is truly a light in dark times.
https://en.wikipedia.org/wiki/V%C3%A1clav_Havel
https://www.nytimes.com/2011/12/19/world/europe/vaclav-havel-dissident-playwright-who-led-czechoslovakia-dead-at-75.html
Roy Cohn was a lawyer who became famous as the advisor to Senator Joseph McCarthy in the 1950s during the hearings he held looking for communists. Cohn went on to a broad career representing numerous unsavory characters and was involved in numerous high-profile events. He was known for being unrelenting, underhanded, and unethical. He was disbarred later in life. He died at NIH in 1984 while receiving AZT for HIV, which he claimed was liver cancer. He was the intellectual mentor to several current political figures.
https://en.wikipedia.org/wiki/Roy_Cohn
Here is a Washington Post profile from 2016:
https://www.washingtonpost.com/investigations/former-mccarthy-aide-showed-trump-how-to-exploit-power-and-draw-attention/2016/06/16/e9f44f20-2bf3-11e6-9b37-42985f6a265c_story.html
Clean hands and sharp minds,
Adam
Last evening a female red-wing blackbird flew into my garage. Watching it try to find its way out felt like a metaphor for the news. Chaotic, frustrating, and lost. And yet, the garage door was open.
Here is some data to keep in mind as you watch the news:
Despite an evident drop in violent crime over the last 30 years, perceptions of crime do not align with this data.
https://www.pewresearch.org/fact-tank/2019/10/17/facts-about-crime-in-the-u-s/
Bias and injustice is a public health issue. There is correlative data on the relationship between being killed by the police and age, race/ethnicity, and gender. This article is from August 2019.
https://www.pnas.org/content/116/34/16793
----
State comparisons:
https://public.tableau.com/views/Coronavirus-ChangeovertimeintheUSA/2_Corona?:display_count=y&:origin=viz_share_link
Rt data
https://rt.live/
North Carolina's Rt seems to be very high. A brief review of various resources does seem to indicate higher testing volumes, with a stable % positive rate. Not sure what is going on there.
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.
------------
A well-done study on using Hydroxychloroquine demonstrates that it is NOT useful in post-exposure prophylaxis. Thus far, we have mounting data that 1) not helpful in severe COVID, 2) not helpful in mild/moderate COVID, and does not prevent infection after exposure.
https://www.nejm.org/doi/full/10.1056/NEJMoa2016638?query=featured_home#.XtgSPYeCao0.twitter
Commentary: https://twitter.com/GidMK/status/1268291611689017344
Data is messy, and the best we often get in healthcare is a preponderance of data across numerous studies. There are also steps back. Here is some more in-depth information on the letters of concern in the Lancet and NEJM. It appears that an overlapping set of authors mining databases are behind both papers. This STAT News article covers a lot of fo good ground on study design and avoiding bias.
https://www.statnews.com/2020/06/02/top-medical-journals-raise-concerns-about-data-in-two-studies-related-to-covid-19/
Here are some interesting comments from Sweden's architect of their "no lockdown" strategy. It seems he feels a bit differently about his thoughts 2-3 months into the viral spread.
https://www.bloomberg.com/news/articles/2020-06-03/man-behind-sweden-s-virus-strategy-says-he-got-some-things-wrong
Here is a summary of data from Medscape addressing the notion that "the virus is weakening." At this point, there is no evidence that the virus is weakening (or mutating enough to be clinically different).
https://www.medscape.com/viewarticle/931670
Here is an interesting potential early indicator of problems: ICU bed capacity. I think there are some problems with baseline data, but it is another variable to keep in mind as we look across the dashboards.
https://www.politico.com/news/2020/05/28/rising-icu-bed-use-red-flag-287552
Commentary of value: https://twitter.com/charlesornstein/status/1268261362867884032
Bad infographic of the day:
In 2014, Reuters attempted to create an infographic that looked like dripping blood in response to the Florida stand-your-ground law. However, they created confusion. The Y-axis on this graph is reversed. The data demonstrates INCREASED gun deaths, but it is not obvious.
https://i.redd.it/s8qym4n6aq251.jpg
There are more successful attempts at this technique of data display
https://eagereyes.org/wp-content/uploads/2014/06/scarr-iraqs-bloody-toll.jpg
-----Bonus Round - Darkness and Light
Vaclav Havel was one of the many intellectual and political leaders of Eastern Europe's long struggle against Soviet totalitarianism. He started life in the theater and as a playwright, who found himself leading the democracy movement in Czechoslovakia. As we know, he helped transition his country to a democratic, multiparty democracy and oversaw the split between the Czech Republic and Slovakia. Persistence over 40+ years in the face of large oppressive forces is truly a light in dark times.
https://en.wikipedia.org/wiki/V%C3%A1clav_Havel
https://www.nytimes.com/2011/12/19/world/europe/vaclav-havel-dissident-playwright-who-led-czechoslovakia-dead-at-75.html
Roy Cohn was a lawyer who became famous as the advisor to Senator Joseph McCarthy in the 1950s during the hearings he held looking for communists. Cohn went on to a broad career representing numerous unsavory characters and was involved in numerous high-profile events. He was known for being unrelenting, underhanded, and unethical. He was disbarred later in life. He died at NIH in 1984 while receiving AZT for HIV, which he claimed was liver cancer. He was the intellectual mentor to several current political figures.
https://en.wikipedia.org/wiki/Roy_Cohn
Here is a Washington Post profile from 2016:
https://www.washingtonpost.com/investigations/former-mccarthy-aide-showed-trump-how-to-exploit-power-and-draw-attention/2016/06/16/e9f44f20-2bf3-11e6-9b37-42985f6a265c_story.html
Clean hands and sharp minds,
Adam
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