Week of August 9, 2021
My office policy is back to double masking (surgical over N95) plus eye protection or face shields for all care providers interacting with patients, regardless of vaccination status. This PPE is in addition to my glasses, stethoscope, Bluetooth headset, and the need for clear, loud communication with older patients (who often having hearing deficits). There is quite an increase in the physical and mental overhead in getting through a clinic day. (Who knew the head has so much usable real estate?) And thanks to pre-screening, my office patients are not symptomatic and at lower risk of infection - I am not on the front line of this pandemic. I can only imagine working with the knowledge that all the gear is THE protective barrier between myself and the known infected patients in an E.R. or ICU. Of course, I am so frustrated (and angry) at my unvaccinated patients they have no trouble hearing my passionate and emphatic arguments for vaccination and vivid descriptions of needing a ventilator. In this instance, the volume and pressure of my speech offer more information than the content.
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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
-----
Let's start with Dr. Topol's discussions about the slopes of curves, looking at infections and hospitalizations. We are on course to have a pretty sizeable 4th wave of cases and hospitalizations in the U.S.
https://twitter.com/EricTopol/status/1424141528696381440
N.Y. Magazine interviewed Dr. Topol in depth. It is not uplifting news.
https://nymag.com/intelligencer/2021/08/too-many-people-are-dying-of-covid-19-right-now.html
Data from Moderna as full FDA approval gets closer.
https://twitter.com/megtirrell/status/1423245534266118150?s=10
But, it also appears we may need a third dose after six months
"Moderna says neutralizing antibodies generated by its COVID-19 vaccine against three variants of the virus that causes the disease waned substantially 6 months after the second dose." https://www.webmd.com/vaccines/covid-19-vaccine/news/20210805/moderna-says-boosters-may-be-needed-after-6-months
Just be clear - the presence or absence of neutralizing antibodies is helpful, but not necessarily the only way the body fights infection. Still many unknowns in measuring immune capacity to fight an illness.
The Daily Beast offered this article about Facebook "wisdom" driving the sale of veterinary Ivermectin. Spoiler alert: Ivermectin doesn't treat coronavirus, and you shouldn't take veterinary pharmaceuticals. But you can learn the term "sheep drench."
https://www.thedailybeast.com/demon-sperm-doctors-new-bogus-cure-has-covid-truthers-eating-horse-paste
A few months ago, a loyal reader sent some data about Ivermectin from a pseudo-meta-analysis website. I did not have a chance to write a full review, but it was a deceptive website filled with data and the air of legitimacy. Epidemiologist Gideon Meyerowitz-Katz offers a thorough and scathing critique of the website. It is an excellent thread on critical thinking, the pitfalls of meta-analysis, and how easily data can be misused.
https://twitter.com/GidMK/status/1422044335076306947?s=20
Articles from frontline physicians are starting again.
A UCLA ICU doctor writes about the mental gymnastics of the unvaccinated.
https://www.huffpost.com/entry/icu-doctor-health-care-workers-unvaccinated-patients_n_6102ad2ae4b000b997df1f17
Dr. Heather Haq, a Baylor Children's pediatrician, writes about the COVID cases in Texas' children.
https://www.sfgate.com/opinion/article/I-treat-pediatric-covid-patients-What-I-m-seeing-16362541.php
Infographics.
1) The vicious loop of coronavirus, varients, and waves of the pandemic.
https://twitter.com/EricTopol/status/1422593573808005134. Which, as someone in the thread pointed out, mirrors the viral patterns found on social media platforms.
2) The relative lethal amounts of various foods, including avocados, beef liver, dark chocolate, and nutmeg. Hint, it takes a lot of any of these things to harm yourself.
https://www.popsci.com/how-many-avocados-it-would-take-to-kill-you/
Things I learned this week.
Olympic horses are scared by sumo wrestler statues. I read that Japanese Olympic officials removed the statue.
https://apnews.com/article/2020-tokyo-olympics-equestrian-sumo-sculpture-8c9a3588952acf9502221636a5bf29d5
and
https://www.sbnation.com/2021/8/6/22612896/sumo-statue-olympics-butt-equestrian-horses-spooked
Upon hearing this story, (and by the logic of some transitive property of horses to drivers), I searched for a comparable statute to protect my mailbox from errant drivers. No luck on acquiring sumo statuary as of the time of writing.
University of Ottawa scientist Andrew Pelling uses de-cellularized cellulose plant "scaffolds" to grow human tissue, such as an apple slice as the frame for an ear.
https://www.atlasobscura.com/articles/medical-implants-made-from-vegetables
Stay safe out there. Clean hands and sharp minds, team
Adam
My office policy is back to double masking (surgical over N95) plus eye protection or face shields for all care providers interacting with patients, regardless of vaccination status. This PPE is in addition to my glasses, stethoscope, Bluetooth headset, and the need for clear, loud communication with older patients (who often having hearing deficits). There is quite an increase in the physical and mental overhead in getting through a clinic day. (Who knew the head has so much usable real estate?) And thanks to pre-screening, my office patients are not symptomatic and at lower risk of infection - I am not on the front line of this pandemic. I can only imagine working with the knowledge that all the gear is THE protective barrier between myself and the known infected patients in an E.R. or ICU. Of course, I am so frustrated (and angry) at my unvaccinated patients they have no trouble hearing my passionate and emphatic arguments for vaccination and vivid descriptions of needing a ventilator. In this instance, the volume and pressure of my speech offer more information than the content.
------
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
-----
Let's start with Dr. Topol's discussions about the slopes of curves, looking at infections and hospitalizations. We are on course to have a pretty sizeable 4th wave of cases and hospitalizations in the U.S.
https://twitter.com/EricTopol/status/1424141528696381440
N.Y. Magazine interviewed Dr. Topol in depth. It is not uplifting news.
https://nymag.com/intelligencer/2021/08/too-many-people-are-dying-of-covid-19-right-now.html
Data from Moderna as full FDA approval gets closer.
https://twitter.com/megtirrell/status/1423245534266118150?s=10
But, it also appears we may need a third dose after six months
"Moderna says neutralizing antibodies generated by its COVID-19 vaccine against three variants of the virus that causes the disease waned substantially 6 months after the second dose." https://www.webmd.com/vaccines/covid-19-vaccine/news/20210805/moderna-says-boosters-may-be-needed-after-6-months
Just be clear - the presence or absence of neutralizing antibodies is helpful, but not necessarily the only way the body fights infection. Still many unknowns in measuring immune capacity to fight an illness.
The Daily Beast offered this article about Facebook "wisdom" driving the sale of veterinary Ivermectin. Spoiler alert: Ivermectin doesn't treat coronavirus, and you shouldn't take veterinary pharmaceuticals. But you can learn the term "sheep drench."
https://www.thedailybeast.com/demon-sperm-doctors-new-bogus-cure-has-covid-truthers-eating-horse-paste
A few months ago, a loyal reader sent some data about Ivermectin from a pseudo-meta-analysis website. I did not have a chance to write a full review, but it was a deceptive website filled with data and the air of legitimacy. Epidemiologist Gideon Meyerowitz-Katz offers a thorough and scathing critique of the website. It is an excellent thread on critical thinking, the pitfalls of meta-analysis, and how easily data can be misused.
https://twitter.com/GidMK/status/1422044335076306947?s=20
Articles from frontline physicians are starting again.
A UCLA ICU doctor writes about the mental gymnastics of the unvaccinated.
https://www.huffpost.com/entry/icu-doctor-health-care-workers-unvaccinated-patients_n_6102ad2ae4b000b997df1f17
Dr. Heather Haq, a Baylor Children's pediatrician, writes about the COVID cases in Texas' children.
https://www.sfgate.com/opinion/article/I-treat-pediatric-covid-patients-What-I-m-seeing-16362541.php
Infographics.
1) The vicious loop of coronavirus, varients, and waves of the pandemic.
https://twitter.com/EricTopol/status/1422593573808005134. Which, as someone in the thread pointed out, mirrors the viral patterns found on social media platforms.
2) The relative lethal amounts of various foods, including avocados, beef liver, dark chocolate, and nutmeg. Hint, it takes a lot of any of these things to harm yourself.
https://www.popsci.com/how-many-avocados-it-would-take-to-kill-you/
Things I learned this week.
Olympic horses are scared by sumo wrestler statues. I read that Japanese Olympic officials removed the statue.
https://apnews.com/article/2020-tokyo-olympics-equestrian-sumo-sculpture-8c9a3588952acf9502221636a5bf29d5
and
https://www.sbnation.com/2021/8/6/22612896/sumo-statue-olympics-butt-equestrian-horses-spooked
Upon hearing this story, (and by the logic of some transitive property of horses to drivers), I searched for a comparable statute to protect my mailbox from errant drivers. No luck on acquiring sumo statuary as of the time of writing.
University of Ottawa scientist Andrew Pelling uses de-cellularized cellulose plant "scaffolds" to grow human tissue, such as an apple slice as the frame for an ear.
https://www.atlasobscura.com/articles/medical-implants-made-from-vegetables
Stay safe out there. Clean hands and sharp minds, team
Adam
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