Week of August 15, 2022
Critical thinking and thoughtful doubt are healthy tools to cope with the sense of disorder that comes from change. But doubt is on a spectrum that ends with dogmatic obstinacy or unhelpful inflexibility. I've been reading about the value of embracing ambivalence and finding comfort in changing your opinion. Sometimes, not having the answer is the answer.
Some reading:
https://hbr.org/2021/09/embracing-the-power-of-ambivalence
and
https://apple.news/AUPs-G7_BTNu9CiR4OnA42A
and in the true spirit of this topic, here is an article on the trade-offs of ambivalence:
https://www.washingtonpost.com/wellness/2022/01/10/ambivalence-healthy-change-habits-resolutions/
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COVID case rates and hospitalizations are now declining in many states. Deaths are still rising, with ~ 500 people dying daily in the U.S.
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 CDC updated COVID guidance late last week. The CDC is re-balancing the risk of infection and inconvenience. The gist of the CDC logic and recommendations:
- Most Americans have had COVID and/or received a vaccine.
- As such, many Americans have a reduced risk of death and hospitalization.
- Each person will need to understand their infection risk and mitigate it.
- People exposed to the coronavirus, but do not have a positive test, should still wear a mask and get tested at least five days after exposure.
- People who test positive should continue to isolate themselves immediately and stay home for five full days if positive.
https://www.washingtonpost.com/health/2022/08/11/cdc-coronavirus-recommendations/
There are trade-offs to this strategy. The immunocompromised, unvaccinated, and older adults are now more dependent on others to behave responsibly. Here are some thoughts from an oncologist, Dr. Vincent Rajkumar, who offers his frustrations and concerns on behalf of his patients.
https://twitter.com/VincentRK/status/1557904786057531392
The FDA also changed guidance for asymptomatic individuals using home antigen tests after known exposure to COVID. Use three tests over four days (On days 0, 2, and 4) to increase the sensitivity (avoid a false negative result). The sensitivity of home antigen tests is lower with Omicron.
https://www.fda.gov/medical-devices/safety-communications/home-covid-19-antigen-tests-take-steps-reduce-your-risk-false-negative-fda-safety-communication?utm_source=CDRHTwitterD
Dr. Ellie Murray, an epidemiologist, discusses her pre-print (not yet peer-reviewed) observational study on the impact of lifting mask mandates in Eastern Massachusetts schools. Her discussion on "why you should belive my study" is fantastic.
https://twitter.com/EpiEllie/status/1557399491438952449
"Schools that removed mask policies had an average *increase* of 44.9 cases per 1,000 people over a 15-week period compared to if they had not removed their mask polices. This adds up to an estimated 11,901 *extra* COVID cases!"
I will close the COVID topic with two articles reflecting my concerns about relying on personal responsibility to protect our most vulnerable citizens. Prolonged illness and death are still consequences for many people (especially the patients I care for).
https://www.statnews.com/2022/08/04/covid-has-settled-into-a-persistent-pattern-and-remains-damaging-it-may-not-change-anytime-soon/
and
https://www.theatlantic.com/ideas/archive/2022/08/long-covid-monovirus-ebv/671080/
Medical Realities and Technology
A random conversation about saunas triggered my medical skepticism this week. However, I was encouraged to explore the history and medical benefits of saunas, which I did. While sauna history is somewhat banal (Finland, steam, etc. https://en.wikipedia.org/wiki/Sauna), I found a surprisingly robust body of medical research on the cardiovascular health benefits of 10-20 minutes of sauna use 3-5 times per week. I found a good summary article of available evidence on the physiologic effects of saunas. It appears that independent of exercise, saunas can reduce cardiovascular risk.
https://www.mayoclinicproceedings.org/article/S0025-6196(18)30275-1/fulltext#secsectitle0075
From the review paper on the proposed physiology :
"We have recently shown that regular Finnish sauna baths are associated with a decrease in circulating levels of inflammatory markers such as high-sensitivity C-reactive protein, fibrinogen, and leukocytes at baseline and long-term follow-up. Whether sauna bathing has any effects on circulating interleukins is currently unknown. Finnish sauna baths have also been found to positively modulate circulating levels of lipids such as total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and triglycerides. There is also evidence that sauna exposure [may] boost the immune system." To be clear, I suspect these positive results can also apply to people not from Finland.
Given how limited the risks are (other than financial - I note a home sauna is $5-10k, installed), I am comfortable saying at the least saunas are not harmful, and there is some data to suggest benefits. While I am not ready to build a sauna in my house, this is a fantastic example of skepticism driving education.
Infographics!
The Fairmont Hotel offers the most popular types of ice cream in different countries. I must find some spaghetti-eis.
https://www.fairmont.com/infographics/most-popular-ice-cream/
and
https://www.thespruceeats.com/spaghetti-ice-cream-sundae-from-germany-1446804
Things I learned this week
I was unhappy to learn that people competitively eat live goldfish.
https://www.smithsonianmag.com/smart-news/great-goldfish-swallowing-craze-1939-180954429/
I learned that Boston Robotic's dog robots patrol the streets of Pompeii. An airborne drone laser scanner maps the city and guides the robot dog. (Fourteen-year-old me cannot believe that last sentence is science fact.) The notion of robots guarding and exploring ancient cities is exciting and unsettling.
https://www.smithsonianmag.com/smart-news/why-a-robot-is-roaming-the-pompeii-ruins-180979856/
and
https://twitter.com/optimoprincipi/status/1557640458221895686
If you have unmet remote exploration or security needs (or need to monitor your ancient ruins), you can buy a dog robot for ~$75k.
https://spectrum.ieee.org/boston-dynamics-spot-robot-dog-now-available
Clean hands and sharp minds,
Adam
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