What Adam is Reading 2-9-21

on

Tuesday, February 9, 2021

 

Seemingly contradictory ideas can sometimes be simultaneously correct. I am watching three converging trends - the increasing prevalence of variant SARS-CoV-2 strains, the ways to describe vaccine effectiveness, and the (currently improving) trends in case and death rates.  The coming weeks will demonstrate the confusing connection between these topics:

  • We must vaccinate as many people as possible ASAP to prevent hospitalization and death.  But I suspect we will need vaccine boosters at some point to avoid mild to moderate illness. 
  • We will still need to mask and distance to protect those not yet vaccinated.  We probably need better masking as well, since the new variants are more transmissible.
  • And, depending on how well we do the first two, the case and death rates may (or may not) worsen due to the new strains. 

 

These are not contradictions, but it is easy to appreciate how complex this gets.  On top of pandemic fatigue, we now communicate a more complex mélange of hope, perseverance, and epidemiology.

 

 

-----Latest Data---

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=casesf

Also, look at https://covidtracking.com/data

 

The U.S. Regionally - N.Y. 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.

 

Vaccine Tracker

https://www.bloomberg.com/graphics/covid-vaccine-tracker-global-distribution/

-----

 

A loyal reader pointed me to Eric Topol's thoughts on the projected increase in B.1.1.7 strain.  Read the thread.

https://twitter.com/EricTopol/status/1358544056788295681

more from the NYT

https://www.nytimes.com/2021/02/07/health/coronavirus-variant-us-spread.html

 

Virologist Florian Krammer spawned a discussion about whether previously infected COVID patients should only get one mRNA vaccine dose given how robust their measured immune responses are (citing yet another paper on this topic).  Given our lack of testing, I would not be in favor of confusing the messaging to the general public.   However, it does appear there is science behind the thought.  Moreover, the article cited demonstrates that previously infected individuals need to be vaccinated.

https://twitter.com/florian_krammer/status/1358939148313362433?s=10

 

Epidemiologist Zoe Hyde offered a thorough review of data on AZ and Novavax against the South African variant.  It appears these vaccines are not as effective in preventing mild to moderate disease but still good at preventing severe illness and hospitalization.  Prior COVID infection did not offer protection against this variant.

https://twitter.com/DrZoeHyde/status/1358749325610737665

 

The CDC released a new toolkit for Pregnant People and New Parents.  This question has come up frequently on our Q&A calls and via email.

https://www.cdc.gov/coronavirus/2019-ncov/communication/toolkits/pregnant-people-and-new-parents.html

 

 

Infographic of the day: The Japanese have detailed and highly-categorized processes of wrapping items with a cloth.  Today I learned about Furoshiki.

https://www.notechmagazine.com/wp-content/uploads/2014/04/060403-5.jpg

from

https://www.notechmagazine.com/2014/04/furoshiki-zero-waste-shopping-in-japan.html

 

 

---Bonus Round---  Cooking for your pre-Medieval family

 

I found myself reading about the Roman Empire's sports drink, posca, originally from Greece (phouska).   The beverage speaks to various cultural, medical, and economic realities - how do you supply large quantities of potable hydration at a manageable cost?  The Roman army had between 200,000 and 400,000 soldiers spanning a vast portion of Europe, the Middle East, and North Africa.  As such, they needed calories and safe liquids to drink.  Enter a combination of diluted red wine vinegar, maybe with honey, small amounts of wine, and other herbs.  Safer than water alone, it does not contain much alcohol and offers a way to transport calories in a dense form.

 

Moreover, after Roman soldiers served their 25 years, they retired.  Posca became a drink for civilian life too.   Interestingly, there is no exact recipe, but plenty of debate.  I suspect there was a lot of local variation.

https://pass-the-garum.blogspot.com/2013/09/posca.html

 

The website (Pass the Garum -  is a fantastic collection of recipes from Ancient Rome) https://pass-the-garum.blogspot.com/p/about-me.html

 

While you are at it, you should read about modern posca, the History of Gatorade.  A Nephrologist from the University of Florida, Robert Cade, developed the drink.   It is, for the most part, flavored and sweetened human sweat.  Enjoy!

https://science.howstuffworks.com/innovation/everyday-innovations/who-invented-sports-drinks1.htm

and

https://en.wikipedia.org/wiki/Robert_Cade

 

 

Clean hands and sharp minds,

 

Adam



 

-----------------------------------------------------------------------------

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

 

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