Week of November 22, 2021
Though this year will be turducken-less, I still really like Thanksgiving. No other holiday is a secular celebration focused on gathering, gratitude, and food. I am grateful to have had so much time at home over the last 18 months. What stands out is witnessing the progression of my kids' competitive and witty dinner time banter. Topics this week included font names as medical concerns (Helvetica has infected your Calibri) and eyebrows - (their evolutionary function and consequences of absence). You can't hear this stuff if you are traveling or at a meeting.
If you are wondering (I'm sure you were), eyebrow evolution is a topic of some interest in scientific literature. Are eyebrows tools for social interaction or happenstance of changing hominid skull morphology? I'm sure many foreheads will furrow, and eyebrows will rise in emphasis as Thanksgiving conversation devolves into angry bickering about this topic. Either way, we can all be thankful for gracilized foreheads.
https://www.nature.com/articles/s41559-018-0528-0
and
https://pubmed.ncbi.nlm.nih.gov/?linkname=pubmed_pubmed&from_uid=29632349
and
https://go.gale.com/ps/i.do?id=GALE%7CA155794742&sid=googleScholar&v=2.1&it=r&linkaccess=abs&issn=00030996&p=AONE&sw=w&userGroupName=anon%7Ed8153bc8
---- Latest Data
Case rates are still rising in the U.S., still mainly in the Western states. Hospitalizations are now increasing. E.U. countries are experiencing more rapidly rising case and death rates. Eastern European case rates appear to be stabilizing - but central Europe is concerning. See https://www.ft.com/content/1b164c18-737f-4b82-b40d-e957b545e38e
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&areas=rus&areas=rou&areas=lva&areasRegional=usny&areasRegional=usla&areasRegional=usnv&areasRegional=usar&areasRegional=usks&areasRegional=usmo&cumulative=0&logScale=1&per100K=1&startDate=2021-06-01&values=cases
The CDC Weekly Review of Data and Variant Tracking discusses the value of vaccinating 5 to 11-year-olds.
https://www.cdc.gov/coronavirus/2019-ncov/covid-data/covidview/index.html
------------------
Eric Topol highlighted a randomized, placebo-controlled booster study presented by the CDC. It appears boosters are very, very beneficial and safe.
https://twitter.com/EricTopol/status/1461786768131465219
CDC slides: https://www.cdc.gov/vaccines/acip/meetings/downloads/slides-2021-11-19/02-COVID-Perez-508.pdf
Fortunately, the FDA and CDC approved boosters for all Pfizer and Moderna recipients >18 years of age who are >6 months out from their initial vaccinations. J&J vaccine recipients should be getting boosters two months after their vaccine dose.
https://www.cdc.gov/coronavirus/2019-ncov/vaccines/booster-shot.html?s_cid=11709:cdc%20covid%20booster%20recommendations:sem.ga:p:RG:GM:gen:PTN.Grants:FY22
The American Academy of Pediatrics released a peer-reviewed pre-print manuscript from numerous state departments of health looking at risk factors for ICU admissions, the need for mechanical ventilation, or death amongst hospitalized children. "Approximately 30% of hospitalized children had severe COVID-19, and 0.5% died during hospitalization. A COVID-19 occurred among 12.0 per 100,000 children aged <18 years and was highest among infants, Hispanic children, and non-Hispanic Black children." While unsurprising that chronic illness and minority status were risk factors for worse outcomes, it is again a great reminder that vaccinating all children protects the most vulnerable.
https://publications.aap.org/DocumentLibrary/Journals/Pediatrics/PEDS2021053418.pdf
Here is a review of data by a U.K. epidemiologist on the vaccine's ability to reduce the likelihood of infection but not transmission when a breakthrough infection occurs. The bottom line - "those who are vaccinated [still need] to take precautions- masking, getting tested, isolating if positive, because the transmission is efficient [if infected]."
https://twitter.com/dgurdasani1/status/1462508714083106826?s=10
I continue to be surprised by the lack of focus on monoclonal antibodies. A team from Mayo published data on breakthrough cases of COVID amongst vaccinated, high-risk individuals. High-risk patients treated with a single dose of monoclonal antibodies had a significantly lower hospitalization rate in the 28 days following diagnosis. Based on these data, you need to treat four high-risk, vaccine breakthrough COVID+ patients to avoid one hospitalization - which is an impressive number needed to treat.
https://academic.oup.com/jid/advance-article/doi/10.1093/infdis/jiab570/6429422
I find continued focus on treatments like ivermectin (a drug used for treating parasitic infestations in humans and animals) disconcerting. The published studies are poorly designed, sometimes falsified, and messy. And yet, there are enough signals in the data to stoke the conspiracy theorists and alternative medicine crowd. Scott Alexander (a pseudonymous-named psychiatrist famous for a tech-sector blog) offered an interesting and comprehensive post looking at the data for trends, confounders, and other logical flaws.
The most interesting summary point is, "Parasitic worms are a significant confounder in some ivermectin studies, such that they made them get a positive result even when honest and methodologically sound."
Please stay skeptical (the author is anonymous), but the thought process seems reasonable. And, for bonus points, read the comments to the post. Oh boy.
https://astralcodexten.substack.com/p/ivermectin-much-more-than-you-wanted
For context - a New York Times article on the blog author from Feb 2021:
https://www.nytimes.com/2021/02/13/technology/slate-star-codex-rationalists.html
Infographics!
There has been a push in the nephrology world to alter the formulas that estimate kidney function. For many years, the most commonly used formula included a variable that accounted for a patient's race (African American vs. Caucasian). Here is a fantastic visualization of the impact of removing the race variable from the formula:
https://twitter.com/tsaiduck77/status/1462092418065604616?s=10
Article of note:
https://www.sciencedirect.com/science/article/pii/S2589537021004788
The Global Transportation System visualized
https://d3exkutavo4sli.cloudfront.net/wp-content/uploads/2012/12/global-transportation-systems-infographic.jpg
from
https://www.livabl.com/2012/12/measuring-worlds-transportation-systems-infographic.html
Things I learned this week.
There are comprehensive instructions on growing large, pure salt crystals at home. I did not know I wanted a large, clear salt crystal, but it seems I do.
https://crystalverse.com/sodium-chloride-crystals/
I went down the rabbit hole of food-based health claims in my periodic search for new data demonstrating my dream that chocolate has health benefits. My entry point was a Guardian article I found:
https://www.theguardian.com/society/2021/nov/19/good-or-bad-top-cardiologist-gives-verdict-chocolate-coffee-wine
I found the cited editorial by cardiologist Thomas Luscher in the European Heart Journal.
https://academic.oup.com/eurheartj/advance-article/doi/10.1093/eurheartj/ehab654/6409460
But with a little more searching, I learned that Luscher is the recipient of significant funding from Nestle and Mars. In addition, food benefit data, albeit fairly represented by Luscher in his editorial, is confusing and marred by problematic studies and conflicting data.
https://forbetterscience.com/2016/12/16/chocolate-health-advice-by-thomas-luscher-and-peer-review-by-jonas-malmstedt/
Clean hands and sharp minds - and have a safe Thanksgiving.
Adam
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