Tuesday, June 9, 2020
Yesterday, some comments and data on coronavirus were released by the World Health Organization (WHO), spawning much confusion. Words like asymptomatic now have to be parsed with care. What does this all mean - does this change our guidance on masks? Why can't health officials coordinate their messaging and vocabulary? And, what should we, the public, do differently? It is bad enough we have a pandemic coupled to protests for needed social and policy change. But adding highly nuanced messaging to the mix of this story is not a recipe for confidence or compliance. It appears that a myriad of agencies, in both public safety and healthcare, are challenged to communicate clearly and act on their best values. I am baffled and frustrated by the seeming inability to perceive the impact of their words and actions.
----
Numerous reports in the media that the South East US is seeing increasing cases. This is in the context of a national trend of decreasing deaths and steady new case rates. For the US, it is more a collection of local and regional outbreaks. I was pleasantly surprised by the seeming lack of impact from the Ozarks over memorial day.
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.
--------
Here is an article on the WHO statement.
https://www.cnbc.com/2020/06/08/asymptomatic-coronavirus-patients-arent-spreading-new-infections-who-says.html
Excellent comments, backed by data, from thoughtful physicians on the WHO announcement:
https://twitter.com/ASlavitt/status/1270135499659923458
https://twitter.com/Bob_Wachter/status/1270190621869789184
https://twitter.com/EricTopol/status/1270178612457598976
Here is my best understanding:
-WHO data indicated that when contact tracing, it is difficult for people to remember when symptoms started (recall bias).
-Therefore, WHO was attempting to distinguish between true asymptomatic COVID+ patients (those who never experience symptoms) vs. pre-symptomatic patients (those who were symptomatic at some point).
-Using these definitions, data they cited could be interpreted to mean that asymptomatic (never had symptoms) account for a low volume of spread.
-This doesn't change guidance on mask-wearing or the possibility that pre-symptomatic people can spread the disease.
What a communications cluster!
One more interesting tidbit for follow up on some real-world mask-wearing outcomes. I wouldn't make too much of this data but certainly points to the value of masks.
https://twitter.com/tmprowell/status/1270228490848264193
Bob Wachter from UCSF on COVID testing. This is what clear communication can look like.
https://medium.com/@Bob_Wachter/interpreting-covid-19-test-results-a-bayesian-approach-df058dad2ade
Here is an article from the NY Times OpEd page on the correlation between wealth and health. This piece has some excellent graphics demonstrating the disparity in the prevalence of various chronic diseases by wealth, across numerous US cities. Again, illustrating the overlap of poverty and public health.
https://www.nytimes.com/interactive/2020/06/04/opinion/coronavirus-health-race-inequality.html?smid=tw-share
Here is an article estimating the impact of the quarantine. Across six countries, the authors estimate that 62 million cases of COVID were avoided or delayed.
https://twitter.com/tmprowell/status/1270035584237670402
I found this interesting article about when people step in to help others. It turns out that people are more likely to render assistance when danger is present, when perpetrators are present, and when physical (as opposed to non-physical) action was required. Interesting.
https://pubmed.ncbi.nlm.nih.gov/21534650/
My favorite random fact encountered yesterday
https://twitter.com/tmprowell/status/1270160094173564931
Infographic of the day - Terms of Venery
https://i.redd.it/3jphs0a8at351.jpg
Of course, there is a website exploring the collective nouns.
www.collectivenounslist.com
I thought I was all clever by asking, "And what is the collective noun for collective nouns?" Google says it is the a collection of collective nouns. And Google, through the passive display of others asking this question, informed me I am not so clever.
https://en.wikipedia.org/wiki/Collective_noun
---Bonus Round - Subversion through humor
There was a period of my life when I had both hair and could routinely get haircuts. I had haircuts in a manly barbershop, where, back in the early 1980s, there was a [Gaggle? Horde? Host? Pack?] of man-focused magazines such as Guns and Ammo, Car and Driver, Field and Stream, and MAD. Even then, MAD was a humor magazine that was a waning cultural icon but introduced me to the power and the art of political satire. Much of it was above my head, but Al Jaffee and Sergio Aragones were two of the artists I came to admire. I just learned that Jaffee retired last week - at age 99! His story is well worth reading.
http://www.openculture.com/2020/06/al-jaffee-iconic-mad-magazine-cartoonist-retires-at-age-99.html
https://www.washingtonpost.com/arts-entertainment/2020/06/06/al-jaffee-mad-magazine-retires/
BTW - I did not find much interest in the "noun-and-noun" -titled magazines, but I suspect you could deduce that—no ghillie suits or duck blinds for Adam.
Clean hands and sharp minds,
-Adam
Yesterday, some comments and data on coronavirus were released by the World Health Organization (WHO), spawning much confusion. Words like asymptomatic now have to be parsed with care. What does this all mean - does this change our guidance on masks? Why can't health officials coordinate their messaging and vocabulary? And, what should we, the public, do differently? It is bad enough we have a pandemic coupled to protests for needed social and policy change. But adding highly nuanced messaging to the mix of this story is not a recipe for confidence or compliance. It appears that a myriad of agencies, in both public safety and healthcare, are challenged to communicate clearly and act on their best values. I am baffled and frustrated by the seeming inability to perceive the impact of their words and actions.
----
Numerous reports in the media that the South East US is seeing increasing cases. This is in the context of a national trend of decreasing deaths and steady new case rates. For the US, it is more a collection of local and regional outbreaks. I was pleasantly surprised by the seeming lack of impact from the Ozarks over memorial day.
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.
--------
Here is an article on the WHO statement.
https://www.cnbc.com/2020/06/08/asymptomatic-coronavirus-patients-arent-spreading-new-infections-who-says.html
Excellent comments, backed by data, from thoughtful physicians on the WHO announcement:
https://twitter.com/ASlavitt/status/1270135499659923458
https://twitter.com/Bob_Wachter/status/1270190621869789184
https://twitter.com/EricTopol/status/1270178612457598976
Here is my best understanding:
-WHO data indicated that when contact tracing, it is difficult for people to remember when symptoms started (recall bias).
-Therefore, WHO was attempting to distinguish between true asymptomatic COVID+ patients (those who never experience symptoms) vs. pre-symptomatic patients (those who were symptomatic at some point).
-Using these definitions, data they cited could be interpreted to mean that asymptomatic (never had symptoms) account for a low volume of spread.
-This doesn't change guidance on mask-wearing or the possibility that pre-symptomatic people can spread the disease.
What a communications cluster!
One more interesting tidbit for follow up on some real-world mask-wearing outcomes. I wouldn't make too much of this data but certainly points to the value of masks.
https://twitter.com/tmprowell/status/1270228490848264193
Bob Wachter from UCSF on COVID testing. This is what clear communication can look like.
https://medium.com/@Bob_Wachter/interpreting-covid-19-test-results-a-bayesian-approach-df058dad2ade
Here is an article from the NY Times OpEd page on the correlation between wealth and health. This piece has some excellent graphics demonstrating the disparity in the prevalence of various chronic diseases by wealth, across numerous US cities. Again, illustrating the overlap of poverty and public health.
https://www.nytimes.com/interactive/2020/06/04/opinion/coronavirus-health-race-inequality.html?smid=tw-share
Here is an article estimating the impact of the quarantine. Across six countries, the authors estimate that 62 million cases of COVID were avoided or delayed.
https://twitter.com/tmprowell/status/1270035584237670402
I found this interesting article about when people step in to help others. It turns out that people are more likely to render assistance when danger is present, when perpetrators are present, and when physical (as opposed to non-physical) action was required. Interesting.
https://pubmed.ncbi.nlm.nih.gov/21534650/
My favorite random fact encountered yesterday
https://twitter.com/tmprowell/status/1270160094173564931
Infographic of the day - Terms of Venery
https://i.redd.it/3jphs0a8at351.jpg
Of course, there is a website exploring the collective nouns.
www.collectivenounslist.com
I thought I was all clever by asking, "And what is the collective noun for collective nouns?" Google says it is the a collection of collective nouns. And Google, through the passive display of others asking this question, informed me I am not so clever.
https://en.wikipedia.org/wiki/Collective_noun
---Bonus Round - Subversion through humor
There was a period of my life when I had both hair and could routinely get haircuts. I had haircuts in a manly barbershop, where, back in the early 1980s, there was a [Gaggle? Horde? Host? Pack?] of man-focused magazines such as Guns and Ammo, Car and Driver, Field and Stream, and MAD. Even then, MAD was a humor magazine that was a waning cultural icon but introduced me to the power and the art of political satire. Much of it was above my head, but Al Jaffee and Sergio Aragones were two of the artists I came to admire. I just learned that Jaffee retired last week - at age 99! His story is well worth reading.
http://www.openculture.com/2020/06/al-jaffee-iconic-mad-magazine-cartoonist-retires-at-age-99.html
https://www.washingtonpost.com/arts-entertainment/2020/06/06/al-jaffee-mad-magazine-retires/
BTW - I did not find much interest in the "noun-and-noun" -titled magazines, but I suspect you could deduce that—no ghillie suits or duck blinds for Adam.
Clean hands and sharp minds,
-Adam
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