Week of August 16th, 2021
We are on a road trip around Massachusetts this week. Eating take-out, seeing only vaccinated friends, and lots of outdoor activities are the hallmarks of this trip. I think we have some semblance of equilibrium between safety and fun. But this balance means we are making numerous small judgments - avoiding groups of people (what is a crowd?), indoor spaces (are tents or covered patios indoors?), and people that project "defiant maskelessness" (marked by attitude? red hats? something else?). These decisions are more art than science, based on appearances and feelings. And despite the "health and safety" justification, I have to check myself from being too judgmental. Outrage and anger can be intoxicating.
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U.S. Hotspot Map via N.Y. Times.
Regional variation, but case rate rising everywhere https://www.nytimes.com/interactive/2021/us/covid-cases.html
CDC Weekly Review of Data and Variant Tracking
https://www.cdc.gov/coronavirus/2019-ncov/covid-data/covidview/index.html
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There was a flood of articles this week.
There continues to be mixed data as to how effective the various vaccines are against the Delta variant. I suspect the immune status of each person, the time since completing vaccination, and the degree of exposure all play a role.
https://www.axios.com/coronavirus-vaccines-pfizer-moderna-delta-biden-e9be4bb0-3d10-4f56-8054-5410be357070.html
and
https://twitter.com/erictopol/status/1423511369232445444?s=10
And the FDA approved a third dose of Pfizer and Moderna vaccines for immunocompromised individuals.
https://www.nytimes.com/2021/08/11/us/politics/third-vaccine-dose-approval.html
Japanese officials identified the first case of the Lambda variant (from Peru) during the Olympics. https://www.japantimes.co.jp/news/2021/08/13/national/lambda-olympic-case/
But, Lambda may not be as transmissible or successful (evolutionarily speaking) as Delta
https://twitter.com/EricTopol/status/1426672618388611075
MMWR offered a fantastic roundup of the current known types and frequencies of vaccine side effects. The bottom line is that side effects are rare, and the vaccine's benefits far outweigh the risks.
https://www.cdc.gov/mmwr/volumes/70/wr/mm7032e4.htm?s_cid=mm7032e4_w
The Washington Post reported on several studies looking at the link between wildfire smoke and higher death rates from coronavirus. The mechanism is not clear, but the association was strong. "Beyond a higher number of coronavirus cases, the Harvard study also found that health outcomes in covid-19 cases worsened as air quality deteriorated. An increase of fine particulate matter of 10 micrograms per cubic meter was associated with an increase of 8.4 percent in covid-19 deaths across all counties."
https://www.washingtonpost.com/climate-environment/2021/08/13/this-is-very-dangerous-combination-new-study-says-wildfire-smoke-leads-higher-covid-risks/
An Arkansas state senator discussed his efforts at achieving 90+% vaccination rates in his manufacturing business of 85 people. Valuable but time-consuming learning points here.
https://twitter.com/jimhendren1/status/1426314397648048130?s=10
I found numerous "dueling banjos"-like headlines reflecting the wide variation in pandemic response amongst U.S. states.
Example #1
West Virginia state officials asked the FDA to approve 3rd doses for all people over 50, irrespective of immune status.
https://wchstv.com/news/local/no-greenlight-yet-but-wva-officials-want-covid-booster-shot-for-all-50-and-over
The Governor of South Carolina articulated his belief that COVID concerns are exaggerated and mask-wearing is an individual decision.
https://abcnews4.com/news/local/governor-mcmaster-some-experts-exaggerating-covids-danger
Example #2
Chicago public schools are making vaccines mandatory for staff and teachers:
https://www.wbez.org/stories/cps-says-all-teachers-and-staff-must-get-covid-19-vaccine/17934047-9703-4f81-800b-87a48fe4aa8c
and
Washington State University is removing "personal or philosophical" exemptions to the school's vaccine requirement:
https://apnews.com/article/sports-health-education-coronavirus-pandemic-093b8bd10ee8e584b9b0a6b0a479b3fd
Compared to the Cobb County Georgia school board member is actively sharing scientifically false data about vaccines and masks being ineffective.
https://www.wsbtv.com/news/local/cobb-county/cobb-county-parents-upset-school-board-member-sharing-false-vaccine-information/IC25EDXLSVF6RPZNBLYPFRA2VU/
Example #3
North Texas has no available pediatric ICU beds.
https://www.nbcnews.com/news/us-news/north-texas-runs-out-pediatric-icu-beds-amid-covid-surge-n1276783
The Governor and Attorney General of Texas are actively attempting to overturn various Texas school boards mask mandates.
https://www.ksat.com/news/local/2021/08/13/appeals-court-sides-against-gov-abbott-upholds-bexar-county-mask-mandate-in-schools/
and
https://twitter.com/steve_vladeck/status/1427029515738525703
Infographics!
Fix.com offers an entire series of infographics comparing and contrasting whiskey. https://www.fix.com/blog/which-whisky-is-right-for-you/
Things I learned this week
There is an online museum dedicated to documenting the history of Early Offices and the devices used within. Given the pandemic and the evolving meaning of office space, this may be capturing a soon-to-be-forgotten bits of history. Enjoy the extensive discussion of paper clips!
https://www.officemuseum.com/paper_clips.htm
There are more inconveniently messy ways to make coffee than a French Press. Maybe we will one day have a 19th-century vacuum coffee pot in the office since it requires an open flame and two large glass bulbs.
http://baharris.org/coffee/History.htm
For example:
https://www.amazon.com/Diguo-Belgian-Belgium-Balance-Egyptian/dp/B011E98I22/ref=asc_df_B011E98I22/
Clean hands and sharp minds,
Adam
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Adam Weinstein, MD
VP Medical Affairs Clinical IT Services DaVita Inc. • Cell 443-527-6333
Nephrologist• University of Maryland Shore Medical Group • (P) 410-820-9823
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