Week of February 7, 2022
In the office last week, a long-standing patient told me he only believes what I say to him about the vaccine. Despite his awareness of the enormous amounts of data and media on this topic, his willingness to get initially vaccinated and (as of late Friday) boosted was a function of his office visits and our conversations. I have plenty of vaccine skeptical patients and even more patients getting vaccinated without concern. This was my first experience with an "I don't trust the vaccine, but I will do whatever you tell me" patient. This kind of blind faith is humbling and unsettling. It also highlights how critical it is for healthcare providers to communicate the nuance, complexity, and interpretation of data.
Of course, the articles I found this week are right on theme, thanks to the Baader-Meinhof phenomenon. (Whatever it is I think I see looks like a data communication problem to me?)
https://science.howstuffworks.com/life/inside-the-mind/human-brain/baader-meinhof-phenomenon.htm
---- Latest Data
Case rates and hospitalizations continue to decline. Death rates are still rising.
https://www.nytimes.com/interactive/2021/us/covid-cases.html
and
https://theuscovidatlas.org/map
(You need to play with the variables on this one)
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 discusses wastewater surveillance:
https://www.cdc.gov/coronavirus/2019-ncov/covid-data/covidview/index.html
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This JAMA paper, published last week, is an excellent example of the challenges in using data. It is a study of a randomized clinical trial conducted with 360 adults recruited to complete an online survey on their interpretation of at-home COVID-19 self-test results in the setting of various risk scenarios. The question explored was how well average consumers could use the results of negative tests to make choices around quarantining. The study indicates many consumers over-value negative home antigen tests and under-value the possibility of a false-negative test, even in the presence of COVID symptoms or a high likelihood of exposure.
https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2788656
Here is a quick-view infographic about the study:
https://cdn.jamanetwork.com/ama/content_public/journal/intemed/0/ioi210089f1_1643302187.35168.png
Dr. Jeremy Faust continues to offer very well-written updates on various aspects of the pandemic. Two articles from this week of note:
First - here is an article about how Dr. Faust struggles with the absence of vaccine effectiveness data in children ages 2-4 (but not those six mos to 2 and 5 and older).
https://insidemedicine.bulletin.com/i-m-a-physician-and-a-parent-i-won-t-vaccinate-my-3-year-old-until-the-data-are-solid/
and how the nuance of his discussion is lost when interviewed on CNN:
https://twitter.com/jeremyfaust/status/1490418226064412678
Second - An in-depth discussion about the data on how the World Health Organization is not using the best data and still is not advising the use of masks in children under age 5:
https://insidemedicine.bulletin.com/the-who-continues-to-ignore-science-on-masks-and-young-children
MMWR published a paper demonstrating the relative hospitalization rates (during the early weeks of Omicron in Los Angeles) between unvaccinated, vaccinated, and vaccinated+boosted individuals.
"As of January 8, 2022, COVID-19 incidence and hospitalization rates in Los Angeles County among unvaccinated persons were 23.0 times those of fully vaccinated persons with a booster and 5.3 times those among fully vaccinated persons without a booster."
https://www.cdc.gov/mmwr/volumes/71/wr/mm7105e1.htm
(This was the data I cited that inspired my Friday patient to get boosted after his appointment.)
Medscape (I highly recommend getting a free account) offered a thoughtful discussion on knowing who to trust regarding COVID information. The article discusses experts, specialists, super forecasters, contrarians, and the problems of translating epidemiology to individual patients.
https://www.medscape.com/viewarticle/967067
And while we are looking at Medscape, you can read about the latest unpleasant long-term side effect of COVID described at a recent American Urological Association meeting - COVID Associated Cystitis (CAC). CAC is a constellation of urinary symptoms in some recently hospitalized COVID patients who experience new-onset urinary urgency and frequency. One more reason to get boosted and stay masked.
https://www.medscape.com/viewarticle/958525
Infographics!
Film Genres over time. Pay attention to that Y-axis, team. These plots are deceptively normalized in scale.
https://twitter.com/boknowsdata/status/1484888876430807050/photo/1
while we're at it, I recommend spending some time with this Wes Anderson actor frequency distribution graphic
https://twitter.com/tableaupublic/status/1453414036905906177/photo/1
both from
https://twitter.com/boknowsdata
Things I learned last week:
My son texted me an article on the ancient punishment for patricide - Poena Cullei (sewing the murderer into a large leather bag with animals and throwing them [all] into a river). While he claims it was just "something interesting he came upon," he has not yet explained why he was looking at all. Either way (and concerns for the animals aside), I have added this as another item to my ever-increasing list of "things I would rather not experience."
https://en.wikipedia.org/wiki/Poena_cullei
There are recurrent (and seemingly unsuccessful) efforts at incentivizing corvids (blackbirds, crows, etc.) to pick up trash, loose change, and other sundry items in exchange for food via kiosks.
https://corvidresearch.blog/2022/02/05/butts-for-nuts-can-crows-do-our-dirty-work-and-should-they/
Even more interesting is the discussion of the ethics of enticing birds to pick up cigarette butts and trash. I had never considered that training animals to perform tasks for food might be an impingement upon their agency.
https://twitter.com/CT_Bergstrom/status/1489066689308155908
Given the lack of ROI, I am baffled by countries eager to host the Olympics. The amount of infrastructure, organization, and complexity is remarkable. Every two years, and irrespective of viewership and other controversies, I am reminded of just how resource-intense the Olympics are.
https://www.visualcapitalist.com/how-much-does-it-cost-to-host-the-olympics/
and
https://wallethub.com/blog/olympics-facts/1819
Clean hands and sharp minds,
Adam
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