December 3, 2020
One of the many novelties of moving from a rural to a suburban area is the availability of services. We have access to all the fantastic benefits the internet can deliver to our new house - literally. I now need a word that describes the guilt I feel for ordering something delivered early on a Sunday morning. And, how do you know if your Instacart shopper really tried hard enough? I am amused by and don't feel prepared for the emotional ambiguities of these newly available (to us) internet services. But I am very grateful people are willing to deliver stuff in the middle of a pandemic.
-----Latest Data---
I note both deaths and cases (7-day rolling average) have stopped decreasing.
Global-View:
https://www.ft.com/content/a2901ce8-5eb7-4633-b89c-cbdf5b386938
Nationally:
https://ig.ft.com/coronavirus-chart/?areas=usa&areas=gbr&areasRegional=usny&areasRegional=usca&areasRegional=usfl&areasRegional=ustx&areasRegional=usco&cumulative=0&logScale=0&perMillion=1&values=cases
Also, look at https://covidtracking.com/data
The US Regionally - NY. Times:
https://www.nytimes.com/interactive/2020/us/coronavirus-us-cases.html
About the data:
https://covidtracking.com/about-data/visualization-guide is the best resource to understand data visualization and data integrity.
-----
I found the CDC's latest document entitled, "What Long-Haul Truck Driver Employees Need to Know about COVID-19," was clear, concise, and easily applicable to a broader audience.
https://www.cdc.gov/coronavirus/2019-ncov/community/organizations/long-haul-trucking-employees.html
Here is a pre-release article on case rates in Florida's public schools when >60% of students returned to in-person instruction. Some counties' case rates were higher than community case rates, and high school students were more likely to be infected than younger students.
https://www.medrxiv.org/content/10.1101/2020.11.30.20241224v1.full.pdf+html
Despite the CDC decreasing some recommendations for post-exposure isolation, there are some new data that immunocompromised patients may be contagious for much longer than 14 days.
https://brief19.com/2020/12/01/brief
CDC recommendations: https://www.cdc.gov/coronavirus/2019-ncov/hcp/duration-isolation.html
There continues to be discussion over vitamin D levels and outcomes in COVID patients. I found this review paper this morning that is not yet peer-reviewed. In aggregating data from 11 articles, there continue to be signs that patients who are Vitamin D deficient (25(OH)D levels below 12-25 ng/mL, depending on the study) do not do as well when infected with SARS-CoV-2. These data are a correlation, not reflective of causation. It does not mean you should go out and get Vitamin D. It does not mean Vitamin D will prevent infection. It MAY mean having adequate Vitamin D stores offers some advantage IF you become infected. I believe it is safest to take enough vitamin D to maintain a goal 25(OH)D level around 30-40 ng/mL. It is the advice I offer many of my patients (but not all). I strongly suggest speaking with your physician before changing your regimen.
https://www.medrxiv.org/content/10.1101/2020.12.01.20242313v1
Infographic of the day: Compound Interest's Chemistry Advent calendar
Your (at least) second favorite Jewish nephrologist (me) is offering you an advent calendar about science topics. I'll let you unpack the issues here.
https://www.compoundchem.com/2020/11/30/chemadvent2020/
---Bonus Round --- The OG of Self-affirming Media
Poking around my various reading spots, I came across this article about the book Temperance Stories and Sketches from 1879.
https://publicdomainreview.org/collection/temperance-stories-and-sketches
The author is Edward Carswell, a Canadian who traveled throughout North America, delivering speeches about alcohol's evils. It seems he built a career around this.
https://oshawamuseum.wordpress.com/2017/12/22/where-the-streets-get-their-names-carswell-avenue/
As one voice in the Temperance movement, Carswell's work, in part, ultimately lead to the Volstead Act, the 18th Amendment to the constitution - aka prohibition.
https://www.archives.gov/education/lessons/volstead-act
What occurred to me is that this book's audience was likely purchasing it to "convert" someone or affirm their existing beliefs. An analog version of the crazy uncle who shares conspiracy posts on Facebook and algorithms that feed your brainstem with dopamine. Just slower and a lot more effort.
Check out page 30 of the book - there is a poem about an old apple tree that looks disturbingly like Shel Silverstein's The Giving Tree mixed with Leaving Las Vegas. I hate preachy apple trees.
https://archive.org/details/temperancestorie00cars/page/30/mode/2up
Clean hands and sharp minds, team
Adam
I'll be back on Monday.
-----------------------------------------------------------------------------
Adam Weinstein, MD
VP Medical Affairs Clinical IT Services DaVita Inc. • Cell 443-527-6333
Nephrologist - Kidney Health Center of Maryland • www.khcmd.com <http://www.khcmd.com/> • (P) 410-820-9823
CONFIDENTIALITY NOTICE: THIS MESSAGE IS CONFIDENTIAL, INTENDED FOR THE NAMED RECIPIENT(S) AND MAY CONTAIN INFORMATION THAT IS (I) PROPRIETARY TO THE SENDER, AND/OR, (II) PRIVILEGED, CONFIDENTIAL, AND/OR OTHERWISE EXEMPT FROM DISCLOSURE UNDER APPLICABLE STATE AND FEDERAL LAW, INCLUDING, BUT NOT LIMITED TO, PRIVACY STANDARDS IMPOSED PURSUANT TO THE FEDERAL HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT OF 1996 ("HIPAA"). IF YOU ARE NOT THE INTENDED RECIPIENT, OR THE EMPLOYEE OR AGENT RESPONSIBLE FOR DELIVERING THE MESSAGE TO THE INTENDED RECIPIENT, YOU ARE HEREBY NOTIFIED THAT ANY DISSEMINATION, DISTRIBUTION OR COPYING OF THIS COMMUNICATION IS STRICTLY PROHIBITED. IF YOU HAVE RECEIVED THIS TRANSMISSION IN ERROR, PLEASE (I) NOTIFY US IMMEDIATELY BY REPLY E-MAIL OR BY TELEPHONE AT (855.472.9822), (II) REMOVE IT FROM YOUR SYSTEM, AND (III) DESTROY THE ORIGINAL TRANSMISSION AND ITS ATTACHMENTS WITHOUT READING OR SAVING THEM. THANK YOU.
One of the many novelties of moving from a rural to a suburban area is the availability of services. We have access to all the fantastic benefits the internet can deliver to our new house - literally. I now need a word that describes the guilt I feel for ordering something delivered early on a Sunday morning. And, how do you know if your Instacart shopper really tried hard enough? I am amused by and don't feel prepared for the emotional ambiguities of these newly available (to us) internet services. But I am very grateful people are willing to deliver stuff in the middle of a pandemic.
-----Latest Data---
I note both deaths and cases (7-day rolling average) have stopped decreasing.
Global-View:
https://www.ft.com/content/a2901ce8-5eb7-4633-b89c-cbdf5b386938
Nationally:
https://ig.ft.com/coronavirus-chart/?areas=usa&areas=gbr&areasRegional=usny&areasRegional=usca&areasRegional=usfl&areasRegional=ustx&areasRegional=usco&cumulative=0&logScale=0&perMillion=1&values=cases
Also, look at https://covidtracking.com/data
The US Regionally - NY. Times:
https://www.nytimes.com/interactive/2020/us/coronavirus-us-cases.html
About the data:
https://covidtracking.com/about-data/visualization-guide is the best resource to understand data visualization and data integrity.
-----
I found the CDC's latest document entitled, "What Long-Haul Truck Driver Employees Need to Know about COVID-19," was clear, concise, and easily applicable to a broader audience.
https://www.cdc.gov/coronavirus/2019-ncov/community/organizations/long-haul-trucking-employees.html
Here is a pre-release article on case rates in Florida's public schools when >60% of students returned to in-person instruction. Some counties' case rates were higher than community case rates, and high school students were more likely to be infected than younger students.
https://www.medrxiv.org/content/10.1101/2020.11.30.20241224v1.full.pdf+html
Despite the CDC decreasing some recommendations for post-exposure isolation, there are some new data that immunocompromised patients may be contagious for much longer than 14 days.
https://brief19.com/2020/12/01/brief
CDC recommendations: https://www.cdc.gov/coronavirus/2019-ncov/hcp/duration-isolation.html
There continues to be discussion over vitamin D levels and outcomes in COVID patients. I found this review paper this morning that is not yet peer-reviewed. In aggregating data from 11 articles, there continue to be signs that patients who are Vitamin D deficient (25(OH)D levels below 12-25 ng/mL, depending on the study) do not do as well when infected with SARS-CoV-2. These data are a correlation, not reflective of causation. It does not mean you should go out and get Vitamin D. It does not mean Vitamin D will prevent infection. It MAY mean having adequate Vitamin D stores offers some advantage IF you become infected. I believe it is safest to take enough vitamin D to maintain a goal 25(OH)D level around 30-40 ng/mL. It is the advice I offer many of my patients (but not all). I strongly suggest speaking with your physician before changing your regimen.
https://www.medrxiv.org/content/10.1101/2020.12.01.20242313v1
Infographic of the day: Compound Interest's Chemistry Advent calendar
Your (at least) second favorite Jewish nephrologist (me) is offering you an advent calendar about science topics. I'll let you unpack the issues here.
https://www.compoundchem.com/2020/11/30/chemadvent2020/
---Bonus Round --- The OG of Self-affirming Media
Poking around my various reading spots, I came across this article about the book Temperance Stories and Sketches from 1879.
https://publicdomainreview.org/collection/temperance-stories-and-sketches
The author is Edward Carswell, a Canadian who traveled throughout North America, delivering speeches about alcohol's evils. It seems he built a career around this.
https://oshawamuseum.wordpress.com/2017/12/22/where-the-streets-get-their-names-carswell-avenue/
As one voice in the Temperance movement, Carswell's work, in part, ultimately lead to the Volstead Act, the 18th Amendment to the constitution - aka prohibition.
https://www.archives.gov/education/lessons/volstead-act
What occurred to me is that this book's audience was likely purchasing it to "convert" someone or affirm their existing beliefs. An analog version of the crazy uncle who shares conspiracy posts on Facebook and algorithms that feed your brainstem with dopamine. Just slower and a lot more effort.
Check out page 30 of the book - there is a poem about an old apple tree that looks disturbingly like Shel Silverstein's The Giving Tree mixed with Leaving Las Vegas. I hate preachy apple trees.
https://archive.org/details/temperancestorie00cars/page/30/mode/2up
Clean hands and sharp minds, team
Adam
I'll be back on Monday.
-----------------------------------------------------------------------------
Adam Weinstein, MD
VP Medical Affairs Clinical IT Services DaVita Inc. • Cell 443-527-6333
Nephrologist - Kidney Health Center of Maryland • www.khcmd.com <http://www.khcmd.com/> • (P) 410-820-9823
CONFIDENTIALITY NOTICE: THIS MESSAGE IS CONFIDENTIAL, INTENDED FOR THE NAMED RECIPIENT(S) AND MAY CONTAIN INFORMATION THAT IS (I) PROPRIETARY TO THE SENDER, AND/OR, (II) PRIVILEGED, CONFIDENTIAL, AND/OR OTHERWISE EXEMPT FROM DISCLOSURE UNDER APPLICABLE STATE AND FEDERAL LAW, INCLUDING, BUT NOT LIMITED TO, PRIVACY STANDARDS IMPOSED PURSUANT TO THE FEDERAL HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT OF 1996 ("HIPAA"). IF YOU ARE NOT THE INTENDED RECIPIENT, OR THE EMPLOYEE OR AGENT RESPONSIBLE FOR DELIVERING THE MESSAGE TO THE INTENDED RECIPIENT, YOU ARE HEREBY NOTIFIED THAT ANY DISSEMINATION, DISTRIBUTION OR COPYING OF THIS COMMUNICATION IS STRICTLY PROHIBITED. IF YOU HAVE RECEIVED THIS TRANSMISSION IN ERROR, PLEASE (I) NOTIFY US IMMEDIATELY BY REPLY E-MAIL OR BY TELEPHONE AT (855.472.9822), (II) REMOVE IT FROM YOUR SYSTEM, AND (III) DESTROY THE ORIGINAL TRANSMISSION AND ITS ATTACHMENTS WITHOUT READING OR SAVING THEM. THANK YOU.
-DaVita Inc-
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