Thursday, July 23, 2020
The notion of compromise is floating around my head this week. Where and when is it OK to deviate from the ideal? When do you say, "good enough is OK?" As a doctor, you spend a lot of time talking about optimal treatment and settling for good enough. And politics, at its best, is all about organized paths to compromise. It is much harder with larger gaps in ideas, or when data-free opinions come into the discussion. (How do you compromise between a "flat earther" and the reality of a spherical earth?) Education and critical thinking are the short answer, but not something you can quickly deliver, especially if there is a lack of insight or willingness. I know we all have a lot of work to do in fighting ignorance and fear.
-------------
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 - the second graph down now has state-level data - I suggest setting it to cases, per million, linear, and add your state to the highlighted list.
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/
COVID risk by US county: https://globalepidemics.org/key-metrics-for-covid-suppression/
Estimate your risk of exposure to a COVID positive person based on your county and the size of gathering: https://covid19risk.biosci.gatech.edu/
Each of the above sites reports its source data. Please review sources like https://covidtracking.com/ to understand the quality of that data.
---------
We had a great discussion on data, data integrity, and data consistency from state to state on yesterday's Q&A call. In response, I found this Science article from last week that enumerates the details of state data variability. It also ties in some thoughts on the shift in data reporting to an HHS contractor, bypassing the CDC.
https://www.sciencemag.org/news/2020/07/us-epidemiologists-say-data-secrecy-covid-19-cases-cripples-intervention-strategies
Here is a YouTube video demonstrating the impact of wearing different masks on exhalation using liquid nitrogen sublimation. While not the most rigorous of science, but an excellent visual.
https://www.youtube.com/watch?v=q99HwzAcR7k
Speaking of which, I found this press release about successful tests on anti-viral properties imbedded in surgical masks to help mitigate spread from by healthcare workers touching or adjusting their mask.
https://www.utoronto.ca/news/u-t-tests-show-canadian-made-mask-deactivates-99-sars-cov-2-virus
Here is one last item on masks today - a coherent review of the best data on using masks from an Australian government health promotion practitioner. He is open about the challenges - lots of unknowns, not great data, and the distraction of not focusing on other issues. It is a great example of public health problems - having a simple message that compresses the nuance into universal rules that may not be fully defendable based on the data. BUT - the data does tend to support mask use in areas of high COVID prevalence, indoors, and in large groups.
https://insidestory.org.au/weapons-of-mask-distraction/
I am finding numerous tragic stories from the current "hot spots" in Texas, Florida, etc. These stories seem to mimic, almost word for word, stories from Italy and New York from earlier in the year. It is disheartening to see that we cannot learn from experience.
https://www.texastribune.org/2020/07/08/houston-coronavirus-deaths-number/
or
https://foxbaltimore.com/news/coronavirus/denied-permission-to-work-from-home-md-public-health-worker-dies-after-covid-hits-office
Sadly, these are great examples of the special pleading logical fallacy - https://www.logicallyfallacious.com/logicalfallacies/Special-Pleading
Pfizer has gotten the 1st contract for high-volume US vaccine purchases. I am not sure how the 100 million doses will be distributed. It does appear the US is purchasing quantities from other vaccine makers as well.
https://www.bloomberg.com/news/articles/2020-07-22/pfizer-biontech-receive-u-s-order-for-covid-vaccine
Here is a twitter discussion of the decreased prevalence of flu due to masks, lockdown, and the like. The linked article is WSJ, behind a paywall. https://twitter.com/ScottGottliebMD/status/1286032031089131521
In response to Florian Krammer's detailed discussion of antibody waning and memory B-cells, Andy Watson, a self-described "Libertarian anarchist with a Taoist twist," decided to display his righteous ignorance. My favorite tweets of the day resulted:
https://twitter.com/florian_krammer/status/1285964357755637762?s=10
And the accumulating data on what hydroxychloroquine does not do (treat COVID) continues to mount. Given the current pace of negative data being published, I assume someone will eventually publish an article on how HCQ will not make me younger, have more hair, or make me more attractive to members of the opposite sex. With or without concomitant zinc use. Maybe if I take HCQ near a 5G tower, I can get different results?
https://twitter.com/GaetanBurgio/status/1285898063454724101
STATnews offers this overview of the NIH's Accelerating Covid-19 Therapeutic Interventions and Vaccines (ACTIV) effort. It is an interesting read on how government incentives could speed efforts at finding therapeutic options.
https://www.statnews.com/2020/07/23/nih-to-start-flurry-of-large-studies-of-potential-covid-19-treatments/?utm_campaign=rss
Infographic of the day - You probably woke up this morning saying to yourself, "Today is the day I will attempt to learn all there is to know about succulents." I feel you. And I can help expedite your dry, desert-like path to cactal enlightenment. (And yes, cactal is a word!)
https://i2mag.com/wp-content/uploads/2014/07/Visual-Comendium-of-Succulents.jpg
http://definition.org/define/cactal/
The cactuspedia for the deeper dive: http://www.cactuspedia.info/
(Not an) infographic of the day #2
You will be happy to know that Bill Gates has publically stated he will not be using the COVID-19 vaccine to microchip people. (My read: he will use the next pandemic and 6- or 7G since the tech will be better. This is a technical issue, not a lack of desire to chip people. I mean, look at his blinking pattern when he talks.) Kudos to these Australians who dared to ask these questions to "the man" directly.
https://www.sbs.com.au/news/bill-gates-confirms-he-won-t-use-a-covid-19-vaccine-to-microchip-people
---Bonus Round -- Get in the Way and Good Trouble
Last night I found a few documentaries on John Lewis and chose to watch the 2017 PBS documentary Get In the Way. It is a biographical sketch that highlights how diverse and complex the civil rights movement was. Various groups had different takes on the tradeoffs of the Freedom Rides, the sit-ins, the militancy of speeches, and the appearance of being the "lead" organization. Lewis (and others) made mistakes they regretted; they were often scared, and, of course, did not know how history would play out. It is about an hour to watch and is, I think, very well done as it captures so much nuance in such a short time. And, John Lewis was a remarkable person who was clearly called to a life of public service. You can see how he lived the philosophies he studied - specifically the books I mentioned from his backpack earlier in the week. A model for what elected officials can and should be like.
https://www.pbs.org/show/john-lewis-get-in-the-way/
I found this one too - https://www.johnlewisgoodtrouble.com/
Clean hands and sharp minds,
Adam
The notion of compromise is floating around my head this week. Where and when is it OK to deviate from the ideal? When do you say, "good enough is OK?" As a doctor, you spend a lot of time talking about optimal treatment and settling for good enough. And politics, at its best, is all about organized paths to compromise. It is much harder with larger gaps in ideas, or when data-free opinions come into the discussion. (How do you compromise between a "flat earther" and the reality of a spherical earth?) Education and critical thinking are the short answer, but not something you can quickly deliver, especially if there is a lack of insight or willingness. I know we all have a lot of work to do in fighting ignorance and fear.
-------------
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 - the second graph down now has state-level data - I suggest setting it to cases, per million, linear, and add your state to the highlighted list.
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/
COVID risk by US county: https://globalepidemics.org/key-metrics-for-covid-suppression/
Estimate your risk of exposure to a COVID positive person based on your county and the size of gathering: https://covid19risk.biosci.gatech.edu/
Each of the above sites reports its source data. Please review sources like https://covidtracking.com/ to understand the quality of that data.
---------
We had a great discussion on data, data integrity, and data consistency from state to state on yesterday's Q&A call. In response, I found this Science article from last week that enumerates the details of state data variability. It also ties in some thoughts on the shift in data reporting to an HHS contractor, bypassing the CDC.
https://www.sciencemag.org/news/2020/07/us-epidemiologists-say-data-secrecy-covid-19-cases-cripples-intervention-strategies
Here is a YouTube video demonstrating the impact of wearing different masks on exhalation using liquid nitrogen sublimation. While not the most rigorous of science, but an excellent visual.
https://www.youtube.com/watch?v=q99HwzAcR7k
Speaking of which, I found this press release about successful tests on anti-viral properties imbedded in surgical masks to help mitigate spread from by healthcare workers touching or adjusting their mask.
https://www.utoronto.ca/news/u-t-tests-show-canadian-made-mask-deactivates-99-sars-cov-2-virus
Here is one last item on masks today - a coherent review of the best data on using masks from an Australian government health promotion practitioner. He is open about the challenges - lots of unknowns, not great data, and the distraction of not focusing on other issues. It is a great example of public health problems - having a simple message that compresses the nuance into universal rules that may not be fully defendable based on the data. BUT - the data does tend to support mask use in areas of high COVID prevalence, indoors, and in large groups.
https://insidestory.org.au/weapons-of-mask-distraction/
I am finding numerous tragic stories from the current "hot spots" in Texas, Florida, etc. These stories seem to mimic, almost word for word, stories from Italy and New York from earlier in the year. It is disheartening to see that we cannot learn from experience.
https://www.texastribune.org/2020/07/08/houston-coronavirus-deaths-number/
or
https://foxbaltimore.com/news/coronavirus/denied-permission-to-work-from-home-md-public-health-worker-dies-after-covid-hits-office
Sadly, these are great examples of the special pleading logical fallacy - https://www.logicallyfallacious.com/logicalfallacies/Special-Pleading
Pfizer has gotten the 1st contract for high-volume US vaccine purchases. I am not sure how the 100 million doses will be distributed. It does appear the US is purchasing quantities from other vaccine makers as well.
https://www.bloomberg.com/news/articles/2020-07-22/pfizer-biontech-receive-u-s-order-for-covid-vaccine
Here is a twitter discussion of the decreased prevalence of flu due to masks, lockdown, and the like. The linked article is WSJ, behind a paywall. https://twitter.com/ScottGottliebMD/status/1286032031089131521
In response to Florian Krammer's detailed discussion of antibody waning and memory B-cells, Andy Watson, a self-described "Libertarian anarchist with a Taoist twist," decided to display his righteous ignorance. My favorite tweets of the day resulted:
https://twitter.com/florian_krammer/status/1285964357755637762?s=10
And the accumulating data on what hydroxychloroquine does not do (treat COVID) continues to mount. Given the current pace of negative data being published, I assume someone will eventually publish an article on how HCQ will not make me younger, have more hair, or make me more attractive to members of the opposite sex. With or without concomitant zinc use. Maybe if I take HCQ near a 5G tower, I can get different results?
https://twitter.com/GaetanBurgio/status/1285898063454724101
STATnews offers this overview of the NIH's Accelerating Covid-19 Therapeutic Interventions and Vaccines (ACTIV) effort. It is an interesting read on how government incentives could speed efforts at finding therapeutic options.
https://www.statnews.com/2020/07/23/nih-to-start-flurry-of-large-studies-of-potential-covid-19-treatments/?utm_campaign=rss
Infographic of the day - You probably woke up this morning saying to yourself, "Today is the day I will attempt to learn all there is to know about succulents." I feel you. And I can help expedite your dry, desert-like path to cactal enlightenment. (And yes, cactal is a word!)
https://i2mag.com/wp-content/uploads/2014/07/Visual-Comendium-of-Succulents.jpg
http://definition.org/define/cactal/
The cactuspedia for the deeper dive: http://www.cactuspedia.info/
(Not an) infographic of the day #2
You will be happy to know that Bill Gates has publically stated he will not be using the COVID-19 vaccine to microchip people. (My read: he will use the next pandemic and 6- or 7G since the tech will be better. This is a technical issue, not a lack of desire to chip people. I mean, look at his blinking pattern when he talks.) Kudos to these Australians who dared to ask these questions to "the man" directly.
https://www.sbs.com.au/news/bill-gates-confirms-he-won-t-use-a-covid-19-vaccine-to-microchip-people
---Bonus Round -- Get in the Way and Good Trouble
Last night I found a few documentaries on John Lewis and chose to watch the 2017 PBS documentary Get In the Way. It is a biographical sketch that highlights how diverse and complex the civil rights movement was. Various groups had different takes on the tradeoffs of the Freedom Rides, the sit-ins, the militancy of speeches, and the appearance of being the "lead" organization. Lewis (and others) made mistakes they regretted; they were often scared, and, of course, did not know how history would play out. It is about an hour to watch and is, I think, very well done as it captures so much nuance in such a short time. And, John Lewis was a remarkable person who was clearly called to a life of public service. You can see how he lived the philosophies he studied - specifically the books I mentioned from his backpack earlier in the week. A model for what elected officials can and should be like.
https://www.pbs.org/show/john-lewis-get-in-the-way/
I found this one too - https://www.johnlewisgoodtrouble.com/
Clean hands and sharp minds,
Adam
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