Week of February 5, 2024
A quirky side effect of this newsletter is the random associations and memories that pop into my head as I write. This week, images from high school psychology (specifically videos of rhesus monkeys suffering separation anxiety) seem to be top of mind. I don't understand why, but I am sure we have yet to create A.I. that will (unprompted) associate COVID, groundhogs, and Ikea meatballs with anxious baby monkeys.
Sudden, random memories are a thing.
https://www.scientificamerican.com/article/mind-pops/
Harry Harlow and his monkey experiments
https://en.wikipedia.org/wiki/Harry_Harlow
See below for COVID, groundhogs, and meatballs.
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Hospitalizations are rapidly falling in all states except Puerto Rico, Hawaii, and Alaska. Wastewater virus concentrations are decreasing in all areas except for western states. JN.1 is still the predominant variant.
The N.Y. Times COVID Tracker reflects only CDC-gathered hospital data. Hospitalization data are a (lagging) indicator.
https://www.nytimes.com/interactive/2023/us/covid-cases.html
Wastewater monitoring is more of a LEADING indicator.
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COVID articles
I had forgotten that, in the Spring of 2020, the NBA created an isolation "bubble" with players and team staff in Orlando to prevent COVID spread and complete the 2019-2020 season. A journal article from November 2023 highlighted the tactics and successes of this strategy. Whether such a bubble is reproducible in other settings is debatable, but with enough resources and time, you can contain and protect 5000 people and have them play professional sports.
https://academic.oup.com/jalm/article-abstract/8/6/1017/7288728
CDC data released last week indicated that the Fall 2023 XBB COVID-19 vaccine booster offered protection against hospitalization, death, AND symptomatic coronavirus infection. As Eric Topol commented, "This was a surprise finding. While [epidemiologists and infectious disease experts anticipated] 80% protection vs. hospitalizations and deaths, we haven't seen this high a level of protection vs. symptomatic infections for a long time."
https://www.cdc.gov/mmwr/volumes/73/wr/mm7304a2.htm
and
https://x.com/erictopol/status/1753145017810723327?s=42&t=cHtDhpWgAdi0UhIayqsoag
Here is a related snapshot of the intellectual fodder feeding the anti-science movement. FDA epidemiologists recently pre-released an academic paper describing the latest data on the frequency and types of reported adverse reactions associated with Moderna and Pfizer COVID vaccines. The Epoch Times, a politically biased newspaper, publishes a sensationalized article, "FDA Finds Safety Signals for Updated COVID-19 Vaccines," offering [incorrectly] calculated analysis and [mis]interpretation - anchoring on the presence of any adverse event as a reason to discredit vaccination. UPenn Professor of Public Health Jeffery Morris offers a lengthy and detailed refutation of the Epoch Times article on Twitter - detailing the data, calculations, and contextual comparisons to other vaccines. (FYI, adverse events were infrequent and consistent with other non-COVID vaccines.) Trolls come out and impugn the professor's motives. It takes 10x more energy to fight the misinformation than to write it.
Original pre-release paper (not yet peer-reviewed)
https://www.medrxiv.org/content/10.1101/2024.01.24.24301676v1.full.pdf
Epoch Times article (it is behind a registration wall)
https://www.theepochtimes.com/health/fda-finds-safety-signals-for-updated-covid-19-vaccines-5576152
Professor Jeffery Morris's post (and the follow-on trolls)
https://twitter.com/jsm2334/status/1752803380748317144
A mildly sanctimonious and repetitious footnote - this whole story is a microcosm of what I frequently see in my clinical practice. My vaccine deniers often overvalue data pointing toward a low likelihood of side effects (loss aversion fallacy) and undervalue the more likely possibility they will get or have long-term complications from COVID (gamblers fallacy). To the discomfort of many, healthcare (and life) is filled with trade-offs and balancing risks, and people seek evidence to reinforce their pre-determined opinions (confirmation bias).
https://en.wikipedia.org/wiki/Gambler%27s_fallacy
https://en.wikipedia.org/wiki/Loss_aversion
https://en.wikipedia.org/wiki/Confirmation_bias
Medical Trends and Technology
The early reviews of Apple's Vision Pro "not V.R., but spatial computing" headset are incredibly positive. (I read one comment, "It is like someone from the future came back in time to give us this tech.") While Apple has not offered overt medical applications, it is not hard to extrapolate the value of a mixed AR/VR tool into healthcare environments. The biggest detractor (I see) is the awkwardness of wearing the device while interacting with other humans in real space. (I can only imagine what my patients would say if I walked into an exam room wearing a Vision Pro.) I wonder if Apple's headset will inspire a wider acceptance of head-mounted wearable tech. I also wonder if we are sliding toward the V.R. isolation described by Ready Player One.
Some amazing and amazingly awkward early use cases:
https://x.com/heyronir/status/1754028177910034721?s=42&t=cHtDhpWgAdi0UhIayqsoag
An article from a few months ago on the healthcare opportunities of the Vision Pro:
https://www.macrumors.com/2023/10/25/apple-explores-vision-pro-health-capabilities/
Discussion about the use of the Vision Pro for healthcare training:
https://www.linkedin.com/pulse/how-apple-vision-pro-change-healthcare-simulation-forever-marble
The New York Times published a consumer-friendly summary of research on the relationship between alcohol and gut microbiome. The article cited data indicating moderate alcohol intake (several drinks a week), especially red wine, may benefit gut biodiversity. These data are not an excuse to start drinking but MAY support a decision not to stop moderate intake due to concerns about maintaining a well-balanced microbiome.
Infographics
I did not realize Punxsutawney Phil was immortal (124 years old!?!) and a strong economic driver for Pennsylvania. That sounds like a winning combination.
I also did not realize Boulder, Colorado, has a competing rodent, Flatiron Freddy. Freddy's weather prediction skills are not equal to Phil's, as Freddy is "a deceased and stuffed yellow-bellied marmot whose "handlers" have posed into various scenes since 2010." (I am sure my Boulder friends will have comments and recommendations on what to smoke to appreciate Freddy.)
Things I learned this week
I do not routinely wear ties, but I learned about the Merovingian Tie Knot. This knot projects a "post-apocalyptic/Hunger Games" formal look. It is good to be prepared for cocktail parties during a zombie apocalypse?
https://www.instagram.com/reel/C2mvHQzMHQe/?igsh=MTN1eXU4YTlwNDhiOQ%3D%3D
Thanks to a loyal reader, I learned that Ikea sold 30 Turkey-sized, 10lb meatballs to (fortunate?) U.K. customers during Christmas 2023. "Combining the scale of the U.K.'s favourite Christmastime poultry with the deliciousness of the IKEA meatball, the Turkey-Sized Meatball is a festive centrepiece that's likely to prompt laughter and joy." [I have kept the British spellings with excessive u's and oddly ordered "re's" to emphasize this was not available in the U.S.]. Let us all pray that 2024 is the year people worldwide can experience ginormous Ikea meatballs (a globe filled with meat globes, one might say).
Living with A.I.
The New York Times is exploring how to integrate generative A.I. into the news publication process.
https://www.theverge.com/2024/1/30/24055718/new-york-times-generative-ai-machine-learning
and
https://www.threads.net/@zseward/post/C2upYZZOEVT
Dr. Eric Topol published another excellent blog post on how A.I. can improve diagnostic accuracy, especially in areas of medicine that require visual interpretation - like pathology and radiology.
https://erictopol.substack.com/p/toward-the-eradication-of-medical
A.I. art of the week
"In the style of Dali, Groundhogs playing basketball with a giant meatball while wearing V.R. goggles."
https://drive.google.com/file/d/1h7JZy3Akw7XPxlzW3oURWyJOkpkcGrVy/view?usp=sharing
Clean hands and sharp minds,
Adam
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