Week of August 29, 2022
Our kids head back to school this week, starting their junior and senior high school years. We have spent time debating the tradeoffs of them continuing to wear masks in class. While the consequences of COVID (for them) are relatively low-risk, it is interesting to see how they work through the social pressure vs. the risk of infection considerations. I do not like being a physician-parent when the ideal medical solution (masks and air filtration for prolonged indoor activities) and the most socially acceptable answers do not align.
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In the U.S., COVID case rates and hospitalizations are declining in almost all states. Yet, daily across the U.S. (on average), about 450 people are still dying, and there are 40,000 hospitalized patients.
N.Y. Times Tracker
https://www.nytimes.com/interactive/2021/us/covid-cases.html
Country Comparison from FT.com
https://ig.ft.com/coronavirus-chart/?areas=eur&areas=usa&areas=twn&areas=nzl&areas=e92000001&areas=fra&areasRegional=usny&areasRegional=usnm&areasRegional=uspr&areasRegional=ushi&areasRegional=usfl&areasRegional=usco&cumulative=0&logScale=1&per100K=0&startDate=2021-06-01&values=deaths
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The return to school is an excellent time to review the value of good air filtration and masks as primary prevention for airborne viral spread. Interestingly, homemade air filters (comprised of a box fan and 4-5 furnace filters called a Corsi-Rosenthal box) have demonstrated excellent air filtering capabilities.
Here is an interview with Jim Rosenthal:
https://twitter.com/Global_Montreal/status/1563183234610917378
and
https://aghealth.ucdavis.edu/news/corsi-rosenthal-box-diy-box-fan-air-filter-covid-19-and-wildfire-smoke
and numerous YouTube videos
https://www.youtube.com/results?search_query=corsi-rosenthal+box
Dr. Jeremy Faust published an excellent FAQ on Paxlovid (best use cases, rebound updates, etc.)
https://insidemedicine.bulletin.com/paxlovid-rebound-update-your-questions-answered/
Dr. Ashish Jha (the current White House COVID19 response coordinator summarized a recent paper on Paxlovid as well
https://twitter.com/AshishKJha46/status/1563212111807119360
Dr. Eric Topol started a good discussion on a poorly written article examining the association between physical activity as a predictor of COVID infection, severity, and death. The Twitter comments are primarily anecdotal, but the review of the article (lack of controlling for confounders and other biases) is helpful. It is an excellent example of a hypothesis that seems intuitive (exercise is good and protective against all things COVID) but does not have the data to support it (at least in this meta-analysis).
https://twitter.com/EricTopol/status/1561864021610864640
Random Medical Technologies and Realities
Over the last week, I noted several articles about Amazon and United Healthcare looking to purchase Signify Health, a value-based care company offering technology, a provider network, and contracts with employers and Medicare Advantage plans. Signify bought or merged with other companies in the past to get to its current size. The trends and companies enabling value-based care are worthy of attention as almost any chronic disease can benefit from proactive care management and monitoring.
From this past week:
https://www.fiercehealthcare.com/health-tech/signify-health-shares-jump-amazon-unitedhealth-reportedly-eye-takeover-deal
From 2021:
https://www.fiercehealthcare.com/tech/signify-health-raises-564m-its-ipo-driven-by-investor-interest-home-care-value-based-models
Infographics!
A world of sandwiches.
https://www.tasteatlas.com/sandwiches
(Note you need to click the "view map" button to appreciate the global spread of sandwiches from the Puerto Rican Jibarito to the Vada pav of Mumbai.)
The Wikipedia entry on the sandwich's history seems to pair nicely with this topic.
https://en.wikipedia.org/wiki/Sandwich
Things I learned this week.
There are hairy Hungarian pigs called Mangalicas, prized for their taste and fat content. Besides their physical characteristics, there are many random facts about this breed of pigs. They are the hairiest pig. They have a relative lack of muscle (i.e., a low meat-to-fat ratio). And in the mid-20th century, the centralized planners of then communist Hungary nearly drove the breed to extinction. Aside from not being Kosher, I am intrigued by an animal prized by Michelin-starred chefs and disliked by Hungarian communists.
https://www.theguardian.com/world/2019/dec/27/hungary-fight-to-save-mangalica-pigs
and
https://www.reuters.com/article/us-hungary-pork/a-rescued-breed-of-pig-infuses-hungarian-cuisine-with-tasty-fat-idUSKBN0OV2G420150615
I found an interesting set of articles highlighting ongoing research into the safety and photochemistry of tattoo ink.
https://www.npr.com.ng/tattoo-ink-can-contain-cancer-causing-chemicals-experts-warn/amp/
The articles stem from press releases about data presented at the recent American Chemical Society meeting in Chicago by SUNY professor John Swierk. Swierk's research stems from his exploration of photochemistry, specifically the chemistry of de-pigmented tattoo ink (i.e., laser tattoo removal).
https://www.eurekalert.org/news-releases/960976
As you might imagine, Swierk is now a media star in the world of tattoo enthusiasts.
https://www.johnswierk.com/copy-of-publications
Clean hands and sharp minds,
Adam
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