Tuesday, July 28, 2020
(Date has been triple checked for freshness and quality)
In the last week, two physicians who served as mentors at various points in my training passed away. While I was intermittently in touch with one of them, the other one I had not spoken to in 20 years. More for the world at large than me, I am sad. Both were young and had much to offer.
Healthcare training is intense. At a large academic institution, you work with a group of doctors for a month or two, rotate to the next team, and on and on for 5-7 years (in the internal medicine specialties). What makes it different is the intensity. During those weeks (with so many new exposures to urgent, very sick, and intensely tragic events), you look to the senior physicians to navigate the complexity of intellectual curiosity, emotions, and simply GSD. The gratitude, the affinity, and the sense of comradery are powerful. I am sure many of us have people in our lives like this. All these interactions shape us a bit. The deaths of Drs. Costa and Foxwell remind me to reach out to a few more people who have had this kind of short-duration, high-intensity impact. Especially amid a pandemic.
https://www.baltimoresun.com/coronavirus/bs-md-ob-cv-costa-icu-doctor-mercy-coronavirus-20200727-qbb4ebvnizdvtpkk4octd27tda-story.html
https://www.myeasternshoremd.com/dorchester_star/obituaries/milford-mace-mickey-foxwell-jr-m-d/article_51bb39a9-5107-5a57-af59-f43416da5c3d.html
----Latest Data
http://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.
-------
Yesterday, several tweets and blogs discussed the abrupt flattening of the new case curve for the US that coincided with the data reporting change from CDC to HHS. The most provocative comments were from this YouTube video: https://www.youtube.com/watch?v=wsSwzVomWhU&feature=youtu.be
I am not sure if this is nefarious or only chaos from change. Please read the COVID tracking project blog from July 23rd (see hospitalizations section). https://covidtracking.com/blog/erratic-hospital-numbers-deaths-still-rising-this-week-in-covid-19-data-july
The problem I see is that states report data in different ways (hospitals -> HHS -> States in some cases; Hospitals -> States and HHS in others). I am not sure how to get to an understanding of "correct" data. The whole situation feels nebulous and non-transparent.
It looks like the courts are starting to get more involved with mask mandates.
https://twitter.com/BNODesk/status/1287771637220245504?s=20
Speaking of masks, here is an outstanding tweetorial on the masks with exhalation valves. These are not effective at protecting others from the asymptomatic patient spreading virus (which is the whole point of masking). DO NOT USE THESE MASKS.
Wired offers a compare and contrast to school openings in other parts of the world. Bottom line - if you have rapid testing, track and trace, and the ability to rapidly shift to distance learning, it is possible.
https://www.wired.com/story/some-countries-reopened-schools-what-did-they-learn-about-kids-and-covid/
Related: https://www.instagram.com/p/CDKBRbmn6Qn/?utm_source=ig_web_button_share_sheet - a loyal reader turned me on to the media company Now Simplified (https://nowsimplified.org/aboutus/) which produces bullet-point driven topic reviews: https://www.instagram.com/p/CDKBRbmn6Qn/
STAT news offers a glimmer of hope that Facebook seems to care about COVID misinformation and what that could mean when vaccines are available. https://www.statnews.com/2020/07/28/facebook-vaccine-misinformation-antivaxx-coronavirus-covid/?utm_campaign=rss
Here is an MMWR article from last week highlighting a telephone survey of COVID+ patients indicating that about 1/3 had not returned to "their usual state of health" within 2-3 weeks of testing. There are numerous limitations to this study (self-reported, low phone call response rate, selection against the sickest patients who would have been hospitalized, etc.) And, many viruses take weeks to recover from, I have seen. Either way, this is a reasonable indicator of how disruptive this illness can be.
https://www.cdc.gov/mmwr/volumes/69/wr/mm6930e1.htm?s_cid=mm6930e1_x
This tweet and replies summed up so much of the world in small bits of text. What a cultural biopsy. https://twitter.com/JohnJHarwood/status/1287817568896667649
Infographic of the day: The Flavor Hex
https://www.cuisinevault.com/wp-content/uploads/2020/06/Flavor-profile-infographic.jpg
from https://www.cuisinevault.com/flavor-profiles/
Infographic of the day #2 Plant Irritants!
https://twitter.com/compoundchem/status/1287829191279484928/photo/1
-----Bonus Round - Rough and tumble realities of protest and change
I have written about the overlapping, messy, and non-linear pathways of the civil rights movement and the women's suffrage movements. I found this article in the New Yorker that was, in part, a reflection on Representative Ocasio-Cortez's recent speech about the abuse by Ted Yoho. What I found most interesting is how difficult it was (and still is) to affect change that opposes social norms and assumptions. It is also a great reminder that history has a lot of nuance and detail often lost to the expediency of shorter history books, and the tendency to focus on prominent personalities.
https://www.newyorker.com/magazine/2020/08/03/protest-delivered-the-nineteenth-amendment
And, I offer this article on the angriest protester from Crosby, Stills, Nash, and Young - a review of Neil Young's recently released (but long-ago recorded) album, Homegrown.
https://www.newyorker.com/culture/culture-desk/a-neil-young-time-capsule
Clean hands and sharp minds,
-Adam
(Date has been triple checked for freshness and quality)
In the last week, two physicians who served as mentors at various points in my training passed away. While I was intermittently in touch with one of them, the other one I had not spoken to in 20 years. More for the world at large than me, I am sad. Both were young and had much to offer.
Healthcare training is intense. At a large academic institution, you work with a group of doctors for a month or two, rotate to the next team, and on and on for 5-7 years (in the internal medicine specialties). What makes it different is the intensity. During those weeks (with so many new exposures to urgent, very sick, and intensely tragic events), you look to the senior physicians to navigate the complexity of intellectual curiosity, emotions, and simply GSD. The gratitude, the affinity, and the sense of comradery are powerful. I am sure many of us have people in our lives like this. All these interactions shape us a bit. The deaths of Drs. Costa and Foxwell remind me to reach out to a few more people who have had this kind of short-duration, high-intensity impact. Especially amid a pandemic.
https://www.baltimoresun.com/coronavirus/bs-md-ob-cv-costa-icu-doctor-mercy-coronavirus-20200727-qbb4ebvnizdvtpkk4octd27tda-story.html
https://www.myeasternshoremd.com/dorchester_star/obituaries/milford-mace-mickey-foxwell-jr-m-d/article_51bb39a9-5107-5a57-af59-f43416da5c3d.html
----Latest Data
http://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.
-------
Yesterday, several tweets and blogs discussed the abrupt flattening of the new case curve for the US that coincided with the data reporting change from CDC to HHS. The most provocative comments were from this YouTube video: https://www.youtube.com/watch?v=wsSwzVomWhU&feature=youtu.be
I am not sure if this is nefarious or only chaos from change. Please read the COVID tracking project blog from July 23rd (see hospitalizations section). https://covidtracking.com/blog/erratic-hospital-numbers-deaths-still-rising-this-week-in-covid-19-data-july
The problem I see is that states report data in different ways (hospitals -> HHS -> States in some cases; Hospitals -> States and HHS in others). I am not sure how to get to an understanding of "correct" data. The whole situation feels nebulous and non-transparent.
It looks like the courts are starting to get more involved with mask mandates.
https://twitter.com/BNODesk/status/1287771637220245504?s=20
Speaking of masks, here is an outstanding tweetorial on the masks with exhalation valves. These are not effective at protecting others from the asymptomatic patient spreading virus (which is the whole point of masking). DO NOT USE THESE MASKS.
Wired offers a compare and contrast to school openings in other parts of the world. Bottom line - if you have rapid testing, track and trace, and the ability to rapidly shift to distance learning, it is possible.
https://www.wired.com/story/some-countries-reopened-schools-what-did-they-learn-about-kids-and-covid/
Related: https://www.instagram.com/p/CDKBRbmn6Qn/?utm_source=ig_web_button_share_sheet - a loyal reader turned me on to the media company Now Simplified (https://nowsimplified.org/aboutus/) which produces bullet-point driven topic reviews: https://www.instagram.com/p/CDKBRbmn6Qn/
STAT news offers a glimmer of hope that Facebook seems to care about COVID misinformation and what that could mean when vaccines are available. https://www.statnews.com/2020/07/28/facebook-vaccine-misinformation-antivaxx-coronavirus-covid/?utm_campaign=rss
Here is an MMWR article from last week highlighting a telephone survey of COVID+ patients indicating that about 1/3 had not returned to "their usual state of health" within 2-3 weeks of testing. There are numerous limitations to this study (self-reported, low phone call response rate, selection against the sickest patients who would have been hospitalized, etc.) And, many viruses take weeks to recover from, I have seen. Either way, this is a reasonable indicator of how disruptive this illness can be.
https://www.cdc.gov/mmwr/volumes/69/wr/mm6930e1.htm?s_cid=mm6930e1_x
This tweet and replies summed up so much of the world in small bits of text. What a cultural biopsy. https://twitter.com/JohnJHarwood/status/1287817568896667649
Infographic of the day: The Flavor Hex
https://www.cuisinevault.com/wp-content/uploads/2020/06/Flavor-profile-infographic.jpg
from https://www.cuisinevault.com/flavor-profiles/
Infographic of the day #2 Plant Irritants!
https://twitter.com/compoundchem/status/1287829191279484928/photo/1
-----Bonus Round - Rough and tumble realities of protest and change
I have written about the overlapping, messy, and non-linear pathways of the civil rights movement and the women's suffrage movements. I found this article in the New Yorker that was, in part, a reflection on Representative Ocasio-Cortez's recent speech about the abuse by Ted Yoho. What I found most interesting is how difficult it was (and still is) to affect change that opposes social norms and assumptions. It is also a great reminder that history has a lot of nuance and detail often lost to the expediency of shorter history books, and the tendency to focus on prominent personalities.
https://www.newyorker.com/magazine/2020/08/03/protest-delivered-the-nineteenth-amendment
And, I offer this article on the angriest protester from Crosby, Stills, Nash, and Young - a review of Neil Young's recently released (but long-ago recorded) album, Homegrown.
https://www.newyorker.com/culture/culture-desk/a-neil-young-time-capsule
Clean hands and sharp minds,
-Adam
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