Week of October 18, 2021
On Friday, a vaccine-hesitant patient (who is about to receive a work-mandated second dose of the Moderna vaccine) told me, "You all win." The fallacy-rich nature of those three words in that context is remarkable. I took a moment to explain that "the real winner" is the patient and society as a whole. I did not unpack that there is no "we all" or that vaccination is not a zero-sum competition. Ironically, the patient works in a job that estimates and mitigates risk. We all have blind spots, biases, and silos of thought. The trick, I suppose, is having the wisdom to listen to trusted advisors who help you see through such barriers.
---- Latest Data
Deaths, case rates, and hospitalizations continue to decline. A few articles have pointed out that no new variants of interest have emerged in recent weeks. Nevertheless, on a 7-day rolling basis, the US is experiencing 1600 deaths per day from COVID (compared to 220 in July 2021). That is the equivalent of eight 737s per day, on average. The vast majority of these deaths are unvaccinated individuals.
https://www.nytimes.com/interactive/2021/us/covid-cases.html
and
https://theuscovidatlas.org/map?src=county_usfacts&var=Confirmed_Count_per_100K_Population&mthd=lisa&v=2
Country Comparison from FT.com
https://ig.ft.com/coronavirus-chart/?areas=eur&areas=usa&areas=gbr&areasRegional=usny&areasRegional=usla&areasRegional=usnv&areasRegional=usar&areasRegional=usks&areasRegional=usmo&cumulative=0&logScale=1&per100K=1&startDate=2021-06-01&values=cases
CDC Weekly Review of Data and Variant Tracking
https://www.cdc.gov/coronavirus/2019-ncov/covid-data/covidview/index.html
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The FDA offered guidance on Moderna and J&J boosters this week. CDC approval is the next step.
https://www.cnn.com/2021/10/14/health/fda-vaccine-advisers-moderna-thursday/index.html
and
https://www.statnews.com/2021/10/15/fda-advisory-panel-votes-19-0-to-endorse-booster-dose-of-jj-vaccine/
Monica Gandhi, an infectious disease physician, offered her summary of recommendations with data.
https://twitter.com/monicagandhi9/status/1449149340967002116?s=10
I saw this article come up several times on Twitter this week in discussing the impact of crowded college football events.
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2783110
I am not sure those citing these data are fully capturing the nuance. "The findings [...] suggest that NFL and NCAA games held with limited in-person attendance [and masking and distancing] were not associated with increased COVID-19 cases in the counties where they were held. Further research is needed to account for potential spillover to counties adjacent to the those hosting games." An older study looked at surrounding counties following large-scale political gatherings:
https://siepr.stanford.edu/research/publications/effects-large-group-meetings-spread-covid-19-case-trump-rallies
"We conclude that these eighteen [political] rallies ultimately resulted in more than 30,000 incremental confirmed cases of COVID-19. Applying county-specific post-event death rates, we conclude that the rallies likely led to more than 700 deaths (not necessarily among attendees)."
A more recent article demonstrates precisely how hard it is to know what is going on. When testing is not required, younger adults make up the crowd, and state-reported data is spotty, it is impossible to feel confident in understanding the infectious impact of these events.
https://www.gainesville.com/story/news/state/2021/10/08/florida-football-stadiums-packed-but-not-apparent-covid-19-hotspots/6036556001/
Bottom line - I am still wary of hanging out in large crowds of unmasked individuals of unknown vaccination status. However, if you are vaccinated, there is a lower risk of becoming infected and a low risk of death and hospitalization. Just remember you could potentially infect the immunocompromised and the young.
The coronavirus origin story seems to be leaning more toward animal to human transfer (as opposed to lab accident). The NY Times covered new data from a survey of bats from around southeast Asia.
https://www.nytimes.com/2021/10/14/science/bat-coronaviruses-lab-leak.html
There was some interesting data on COVID antigen test kits published this week. It appears that validation studies against PCR testing may have under-estimated the sensitivity (and hence value) of the antigen tests. The authors argue that when used to detect viral antigens in exposed or mildly symptomatic individuals, the sensitivity may be higher than initially reported in late 2020. It is a complex paper, but the BBC article helps.
Paper
https://www.dovepress.com/recalibrating-sars-cov-2-antigen-rapid-lateral-flow-test-relative-sens-peer-reviewed-fulltext-article-CLEPBBC
BBC article
https://www.bbc.com/news/health-58899612
The retrospectoscope of history offers the opportunity to learn and evolve. I did not know that the definitions of aerosols and droplets were so arbitrary. Nor did I fully understand why 6 feet is the distance that is considered "safe." This Royal Society journal article is a fascinating review of the history of our understanding of contagious respiratory diseases.
https://royalsocietypublishing.org/doi/10.1098/rsfs.2021.0049
Infographics!
First, narrative tropes, rhetoric, and logical fallacies as applied to COVID - from the Canadian Association of Science Centres. (As an American, I firmly believe they should research the ordering of "er" vs. "re" in Centres.)
https://twitter.com/ScienceUpFirst/status/1448680264088100864
The best James Bond infographic I have ever seen - actors vs. critical analysis vs. film revenue:
https://www.chartr.co/newsletters/2021/10/13/no-time-to-die
The chemistry of frozen desserts
https://cen.acs.org/articles/95/i29/Periodic-graphics-chemistry-frozen-desserts.html
Things I learned this week
Wolfish (Anarhichas) is a genus of eel-like fish with antifreeze proteins in their blood and a neuromuscular reflex causing their jaws to snap shut, even after death. They are not kosher (no scales), but there are plenty of recipes if they don't bite you first.
About
https://www.talkingfish.org/2015/fish-feature/the-atlantic-wolffish-antifreeze-included
Watch the decapitated wolffish head bite a soda can!
https://www.iflscience.com/plants-and-animals/watch-the-severed-head-of-a-wolffish-bite-down-on-a-can-of-coke/
Learn about antifreeze proteins
https://www.sciencedirect.com/topics/agricultural-and-biological-sciences/antifreeze-proteins
Wolffish recipes
https://www.denverpost.com/2020/01/29/wolffish-recipe/
I have previously written about Cassowaries and my fascination with big, scary-looking birds - the closest living relatives to dinosaurs. This week I became aware of Shoebill Storks. They are critically endangered birds of East Africa that eat fish and looks like a mythical creature. In captivity, they will bow their head and click at you. Unlike cassowaries, they will not viciously attack.
The Audobon Society has the shoebill listed amongst their "terrifying birds of the world" pages. I am not sure it is terrifying.
https://www.audubon.org/news/the-shoebill-or-most-terrifying-bird-world.
Watch this 3-minute video of a Shoebill (rescued and now living in Australia): https://www.youtube.com/watch?v=-p2RyFnudDw
Lastly, you can take a stroll down a rabbit hole in which headline-seeking journalists bend data to imply prehistoric giant storks (Leptoptilos robustus) ate the babies of prehistoric hobbit-like humans (Homo floresiensis) on an island near Indonesia. This story is conjecture but also truly terrifying. (And now you know why I pay much attention to the size of the cardinals at my bird feeder.)
https://www.npr.org/sections/krulwich/2011/01/25/133178380/killer-storks-eat-human-babies-perhaps
Clean hands and sharp minds,
Adam
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