Later On

A blog written for those whose interests more or less match mine.

Posts Tagged ‘coronavirus

The lack of testing means we don’t actually know what’s happening

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From a VoxCare newsletter:

Today’s coronavirus snapshot, as of 4 pm ET Monday:

  • 352,546 confirmed US cases (1,324,907 worldwide)
  • 10,389 US deaths (73,703 worldwide)
  • 1,778,487 tests conducted in the US (5,406 tests per million people)

I’ll be frank, today’s edition is a little selfish because it’s a question I really wanted to see answered. But the truth is, we need to start thinking right now about how to help rural America deal with this crisis. The outbreak is already there.   — Dylan

Until now, it’s been easy to think of the coronavirus as a problem for cities and maybe suburbs, but not for the towns and villages dotting the rest of America. But that really isn’t the case anymore — and the coming crisis could hit rural America just as hard, if not harder, as it has hit our urban centers.

To dispense with the idea that Covid-19 is only affecting cities, this map from Johns Hopkins illustrates the point better than any sentence I could write. You will notice the red dots representing the location and concentration of cases are … pretty much everywhere.

Today’s coronavirus snapshot, as of 4 pm ET Monday:

  • 352,546 confirmed US cases (1,324,907 worldwide)
  • 10,389 US deaths (73,703 worldwide)
  • 1,778,487 tests conducted in the US (5,406 tests per million people)

I’ll be frank, today’s edition is a little selfish because it’s a question I really wanted to see answered. But the truth is, we need to start thinking right now about how to help rural America deal with this crisis. The outbreak is already there.


Until now, it’s been easy to think of the coronavirus as a problem for cities and maybe suburbs, but not for the towns and villages dotting the rest of America. But that really isn’t the case anymore — and the coming crisis could hit rural America just as hard, if not harder, as it has hit our urban centers.

To dispense with the idea that Covid-19 is only affecting cities, this map from Johns Hopkins illustrates the point better than any sentence I could write. You will notice the red dots representing the location and concentration of cases are … pretty much everywhere.

I had actually assumed urban areas would be more fertile ground for the coronavirus and that’s why we were seeing more cases there. More people, in closer proximity, sharing parks and public transportation and the like. But Tara Smith, an epidemiologist at Kent State University, waved me off that notion.

“I’m not sure if it’s really population density versus more access to testing in urban areas,” she told me late last month. She pointed out that in her (and my) home state of Ohio, Covid-19 had actually shown up early in Stark County (a smaller county that contains Canton but not much else in the way of urbanity) but most of the testing had been concentrated in Cleveland.

“I think we just have no idea what’s going on in some of the less-populated areas,” she said.

And when the virus does hit our rural communities, they will have even less medical capacity than New York City or Los Angeles or Seattle. Lois Parsely laid out some sobering statistics for Alaska in a piece for Vox this weekend:

While New York state still has the highest per capita rate — 1,995 cases per million people as of March 26 — there are also significant clusters of Covid-19 in rural areas in the Midwest and South, including Arkansas, Mississippi, Georgia, and South Carolina. Every US Health and Human Services region also has shown a sharp uptick in non-flu-related influenza-type illness.

On Friday, Alaska reported 85 cases and its first Covid-19-related death. Shana Theobald, another doctor on Kodiak Island, explains the grim calculus for her state: Given that experts from the CDC estimate 40 to 70 percent of the state’s 737,500 people may eventually contract Covid-19, at least 295,000 Alaskans could get sick. Based on initial reports, 20 percent, or 59,000 people, will need hospital care.

Alaska only has 1,500 general hospital beds. And even if as few as five percent of Covid-19 patients become critically ill (a conservative estimate), that’s a minimum of 14,750 people needing ICU beds. And Theobald estimates that Alaska only has around 200. If that many people get sick over the next one to three months, only one in 25 people who need intensive care will be able to get it. Even if you halved the number of Alaskans infected with Covid-19 to 20 percent, the system will still be over capacity — by thousands of people.

It’s these kinds of equations that make epidemiologists particularly concerned about rural America. “If we believe that the way seasonal flu spreads through the country is likely similar to Covid-19, the rural eruptions tend to be later and briefer, but more impactful than in big urban areas,” said Roger Ray, a retired neurologist, physician executive, and physician consulting director with The Chartis Group.

After reading Lois’s piece, I did some crude math for Knox County, Ohio, where I grew up. It’s a county of 61,000 people; the biggest locality, Mount Vernon, has fewer than 17,000 residents. It’s an hour northeast of Columbus and about 90 minutes south of Cleveland.

If you assume half of the county’s residents get sick and 20 percent of those will need to be admitted to the hospital, you’re talking about 6,100 people who will need a bed — not all at once, but still. That’s the demand.

Knox Community Hospital, the only hospital in the county, has 115 beds. You can get to Columbus in an hour or Mansfield in 45 minutes, but those bigger cities will be dealing with their own coronavirus cases. Once you start doing the math, it gets scary quickly.

You can see why New York has instituted the plan it has, turning its entire state into one hospital system. More states may be forced to follow the same path.

We need to be doing everything we can to prepare rural America for Covid-19 — right now. Knox County has a handful of confirmed coronavirus cases. The virus is already there.

Written by Leisureguy

6 April 2020 at 4:55 pm

President Trump in his own words

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Dana Milbank collected President Trump’s actual statements for a virtual fireside chat:

The coronavirus is very much under control in the USA. We have it totally under control. I’m not concerned at all. It’s one person coming in from China. We pretty much shut it down. It will all work out well. We’re in great shape. Doesn’t spread widely at all in the United States because of the early actions that myself and my administration took. There’s a chance it won’t spread. It’s something that we have tremendous control over.

Looks like by April, you know, in theory, when it gets a little warmer, it miraculously goes away. One day it’s like a miracle, it will disappear. Just stay calm. It will go away. The Democrats are politicizing the coronavirus. This is their new hoax.

Whatever happens, we’re totally prepared. Totally ready. We’re rated number one for being prepared. We are so prepared like we never have been prepared. Taking early intense action, we have seen dramatically fewer cases of the virus in the United States. We’re very much ahead of everything.

This is a flu. I didn’t know people died from the flu. Here, we’re talking about a much smaller range. It is very mild. Some people will have this at a very light level. Some of them go to work.

The mortality rate is much, much better. In my opinion it’s way, way down. I think it’s substantially below 1 percent. A fraction of 1 percent. I think the numbers are going to get progressively better as we go along. This is just my hunch.

We have very little problem in this country. We only have five people. We only have 11 cases. Out of billions of people, 15 people. They’re getting better, and soon they’re all going to be better, hopefully. We’re going very substantially down, not up.

The United States, because of what I did and what the administration did with China, we have 32 deaths at this point. To this point, and because we have had a very strong border policy, we have had 40 deaths. As of this moment, we have 50 deaths. I have a feeling that a lot of the numbers that are being said in some areas are just bigger than they’re going to be.

Frankly, the testing has been going very smooth. The tests are all perfect. Anybody that wants a test can get a test. The tests are beautiful. We have a tremendous testing setup.

I don’t believe you need 40,000 or 30,000 ventilators. We are very close to a vaccine. A matter of months. You take a solid flu vaccine, you don’t think that could have an impact? Hydroxychloroquine and azithromycin, taken together, have a real chance to be one of the biggest game changers in the history of medicine. Based on very strong evidence.

I would love to have the country opened up and just raring to go by EasterNo way I’m going to cancel the convention. Stock Market starting to look very good to me!

We’re the ones that gave the great response. I’d rate it a 10. We’ve done a fantastic job. I think they should be appreciative. Gallup just gave us the highest rating. The highest on record.

I like this stuff. I really get it. Maybe I have a natural ability. We think it’s going to have a very good ending. We’re going to win faster than people think. I hope.

This blindsided the world! Who could have ever predicted a thing like this? This was something that nobody has ever thought could happen to this country.

I’ve always known this is a real, this is a pandemic. I felt it was a pandemic long before it was called a pandemic. I always treated the Chinese Virus very seriously.

If you’re talking about the virus, no, that’s not under control for anyplace in the world. I was talking about what we’re doing is under control, but I’m not talking about the virus. I didn’t say Easter. It was just an aspiration. I am giving consideration to a QUARANTINE.

So you’re talking about 2.2 million deaths. If we could hold that down…between 100,000 and 200,000, and we all together have done a very good job. START MAKING VENTILATORS, NOW!!!!!! FORD, GET GOING ON VENTILATORS, FAST!!!!!! Invoke “P”. I want our life back again.

It was nobody’s fault. No, just things that happened. I don’t take responsibility at all.

Written by Leisureguy

31 March 2020 at 7:31 pm

A Medical Anthropologist Tells Us Why She Was So Wrong About Coronavirus

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Matthew Gault writes in Vice’s Motherboard:

In the early days of the coronavirus pandemic, many public health experts were sure that the virus could be beaten before it had a disastrous impact: as long as testing was robust, and the systems in place functioned properly, America would pull through relatively unscathed.

They may have been right, but we’ll never know, because testing has not been robust, and the systems in place have all failed miserably.

One expert I spoke with in late February was Theresa MacPhail, a medical anthropologist, Assistant Professor at Stevens Institute of Technology, and author of the book The Viral Network: A Pathology of the H1N1 Influenza Pandemic. MacPhail worked with the CDC in 2009 as a volunteer intern as part of its Global Disease & Detection unit, taking part in global conference calls on the H1N1 pandemic and seeing how the organization is structured. She was in Hong Kong during its H1N1 outbreak.

In late February, she spoke optimistically with me about America’s ability to handle the coming Covid-19 outbreak. In early March, she got sick with what she believes to be Covid-19. She reached out to me recently, insisting to go on the record again to say that she was wrong, and that she put too much faith in the CDC and America’s ability to manage the crisis.

How are you feeling?
I feel guilty. I feel like I should have known better.

What was it about our previous conversation that made you feel guilty?
I made a lot of assumptions and didn’t think twice about having made them. I know I’m not alone, I’m just one of the only people that is saying publicly, “Well, I got this completely wrong.”

I think it was overconfidence. I feel like what we’re seeing is a bit of hubris. We’re basically suffering, partially, because there was no plan for when the [Center for Disease Control] fucked up, because they don’t fuck up, or they haven’t in the past. They don’t have a protocol for when they can’t do an assay. And that’s exactly what happened. Their assays didn’t work. And there was no plan for that.

What do you mean by an assay?
I just assumed that the US system would be a little bit better, would be a little bit more robust and do more testing and containment than China was able to do, and I just couldn’t have been more wrong.

When we talked, I was still so confident that this response was gonna look like the 2009 [H1N1] pandemic response, which was a good response. Initially, it had some problems… but once they realized what was going on, they kicked into gear and everything went pretty well.

One thing that’s super different is that the CDC in 2009 provided central leadership. They were proactively reaching out to state, regional, and local Health officials saying, ‘Here’s what you need to be doing. Here’s what this should look like.’ And people did it.

I am scared and enraged because there’s no central authority here. I don’t understand what’s going on.The CDC isn’t giving press briefings. They’re just absent. And that could be because the administration is muzzling them. Or it could mean that there’s disarray inside the CDC. And I guess all of that will come out.

But I feel guilty because I knew them. So it’s a bit like not wanting to think your Uncle Bob did something wrong or was capable of doing something wrong. That’s why I feel bad, because I just assumed that this response would look like the old response. And it doesn’t at all, and I just feel so awful.

I wasn’t one of those people sounding the warning alarm. I really felt like we had a shot at containing [it]. But that meant that we had to have tests. I didn’t realize what 10 years of underfunding public health had done.

You got sick after we spoke last, right?
I was never tested, but if I had to lay bets I would say I have it. I’m still sick now. I’m on day 25. I got sick on March 1. It was the classic sore throat, feeling a little bit disgusting, and then at day five or six my fever started to spike. It got as high as 102.5 and never went below 100, despite taking massive amounts of fever reducer.

I started having tightness in my chest. I had a dry cough. I went to the ER on March 9. They put me in a separate room. Before all this went down, I had been contacted to go to Washington to the House of Representatives and give a public statement before Congress about what we’ve learned in pandemics past. Of course, that all got shot out of the water.

I asked the ER doctor, “Can you tell me in your professional opinion, are you prepared for this?” He said, “Absolutely not.” He had been doing this for 12 years. He was there for the 2009 pandemic. He said in 2009 they were overprepared. They had extra flu kits, they had extra supplies, they were ready. They had been prepared by the Department of Health. The communication had been clear. He said, “I hate to tell you this but we’re underprepared now. We don’t have extra supplies. We don’t have any tests.” That’s when I started to think, “This is serious.”

The only way we get out of this, the only way we return to a semblance of normal, is massive testing. And I’m starting to get worried because when are we doing that? It’s mind boggling.

You’ve mentioned a few times that past responses were better. What do you mean? . . .

Continue reading.

Written by Leisureguy

31 March 2020 at 12:47 pm

Experimental AI tool predicts which COVID-19 patients develop respiratory disease

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ScienceDaily has an interesting report:

An artificial intelligence tool accurately predicted which patients newly infected with the COVID-19 virus would go on to develop severe respiratory disease, a new study found.

The work was led by NYU Grossman School of Medicine and the Courant Institute of Mathematical Sciences at New York University, in partnership with Wenzhou Central Hospital and Cangnan People’s Hospital, both in Wenzhou, China.

Named “SARS-CoV-2,” the new virus causes the disease called “coronavirus disease 2019” or “COVID-19.” As of March 30, the virus had infected 735,560 patients worldwide. According to the World Health Organization, the illness has caused more than 34,830 deaths to date, more often among older patients with underlying health conditions. The New York State Department of Health has reported more than 33,700 cases to date in New York City.

Published online March 30 in the journal Computers, Materials & Continua, the study also revealed the best indicators of future severity, and found that they were not as expected.

“While work remains to further validate our model, it holds promise as another tool to predict the patients most vulnerable to the virus, but only in support of physicians’ hard-won clinical experience in treating viral infections,” says corresponding study author Megan Coffee, MD, PhD, clinical assistant professor in the Division of Infectious Disease & Immunology within the Department of Medicine at NYU Grossman School of Medicine.

“Our goal was to design and deploy a decision-support tool using AI capabilities — mostly predictive analytics — to flag future clinical coronavirus severity,” says co-author Anasse Bari, PhD, a clinical assistant professor in Computer Science at the Courant institute. “We hope that the tool, when fully developed, will be useful to physicians as they assess which moderately ill patients really need beds, and who can safely go home, with hospital resources stretched thin.”

Surprise Predictors

For the study, demographic, laboratory, and radiological findings were collected from 53 patients as each tested positive in January 2020 for the SARS-CoV2 virus at the two Chinese hospitals. Symptoms were typically mild to begin with, including cough, fever, and stomach upset. In a minority of patients, however, severe symptoms developed with a week, including pneumonia.

The goal of the new study was to determine whether AI techniques could help to accurately predict which patients with the virus would go on to develop Acute Respiratory Distress Syndrome or ARDS, the fluid build-up in the lungs that can be fatal in the elderly.

Continue reading.

Written by Leisureguy

31 March 2020 at 11:38 am

Posted in Health, Medical, Science, Software, Technology

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Donald Trump Is Trapped

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Peter Wehner writes in the Atlantic:

For his entire adult life, and for his entire presidency, Donald Trump has created his own alternate reality, complete with his own alternate set of facts. He has shown himself to be erratic, impulsive, narcissistic, vindictive, cruel, mendacious, and devoid of empathy. None of that is new.

But we’re now entering the most dangerous phase of the Trump presidency. The pain and hardship that the United States is only beginning to experience stem from a crisis that the president is utterly unsuited to deal with, either intellectually or temperamentally. When things were going relatively well, the nation could more easily absorb the costs of Trump’s psychological and moral distortions and disfigurements. But those days are behind us. The coronavirus pandemic has created the conditions that can catalyze a destructive set of responses from an individual with Trump’s characterological defects and disordered personality.

We are now in the early phase of a medical and economic tempest unmatched in most of our lifetimes. There’s too much information we don’t have. We don’t know the full severity of the pandemic, or whether a state like New York is a harbinger or an outlier. But we have enough information to know this virus is rapidly transmissible and lethal.

The qualities we most need in a president during this crisis are calmness, wisdom, and reassurance; a command of the facts and the ability to communicate them well; and the capacity to think about the medium and long term while carefully weighing competing options and conflicting needs. We need a leader who can persuade the public to act in ways that are difficult but necessary, who can focus like a laser beam on a problem for a sustained period of time, and who will listen to—and, when necessary, defer to—experts who know far more than he does. We need a president who can draw the nation together rather than drive it apart, who excels at the intricate work of governing, and who works well with elected officials at every level. We need a chief executive whose judgment is not just sound, but exceptional.

There are some 325 million people in America, and it’s hard to think of more than a handful who are more lacking in these qualities than Donald Trump.

But we need to consider something else, which is that the coronavirus pandemic may lead to a rapid and even more worrisome psychological and emotional deterioration in the commander in chief. This is not a certainty, but it’s a possibility we need to be prepared for.

Here’s how this might play out; to some extent, it already has.

Let’s start with what we know. Someone with Trump’s psychological makeup, when faced with facts and events that are unpleasant, that he perceives as a threat to his self-image and public standing, simply denies them. We saw that repeatedly during the early part of the pandemic, when the president was giving false reassurance and spreading false information one day after another.

After a few days in which he was willing to acknowledge the scope and scale of this crisis—he declared himself a “wartime president”—he has now regressed to type, once again becoming a fountain of misinformation. At a press conference yesterday, he declared that he “would love to have the country opened up, and just raring to go, by Easter,” which is less than three weeks away, a goal that top epidemiologists and health professionals believe would be catastrophic.

“I think it’s possible. Why not?” he said with a shrug during a town hall hosted by Fox News later in the day. (Why Easter? He explained, “I just thought it was a beautiful time, a beautiful timeline.”) He said this as New York City’s case count is doubling every three days and the U.S. case count is now setting the pace for the world.

As one person who consults with the Trump White House on the coronavirus response put it to me, “He has chosen to imagine the worst is behind us when the worst is clearly ahead of us.” . . .

Continue reading.

Written by Leisureguy

27 March 2020 at 3:01 pm

Why Was It So Hard to Raise the Alarm on the Coronavirus?

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David Wallace-Wells has a column well worth reading in New York. It begins:

A bit before midnight on January 20, a Harvard epidemiologist named Eric Feigl-Ding posted a long, terrifying Twitter thread mostly summarizing, and in a few places contextualizing, a new, pre-publication paper on the infectiousness of the novel coronavirus that had, at the time, forced Wuhan into a total lockdown but had not yet been detected outside of China. The context he added was, mostly, alarmism.

“Holy mother of god,” the thread began, “the new coronavirus is a 3.8!!!” That figure referred to what’s called the reproduction number, or “R0,” of a disease: how many people would be infected by a single sick person. “I really hate to be the epidemiologist who has to admit this, but we are potentially faced with … possibly an unchecked pandemic that the world has not seen since the 1918 Spanish Influenza. Let’s hope it doesn’t reach that level but we now live in the modern world 🌎 with faster ✈️+ 🚞 than 1918. @WHO and @CDCgov needs to declare public health emergency ASAP!”

The thread has since been deleted, though you can still read a preserved version of it here. It was, for many Americans, if not the first time they had heard of coronavirus, perhaps the first time they had seen a global alarm raised over it. And in doing so, it produced what is by now a sort of predictable backlash: other scientists and science journalists taking issue with it, en masse, pointing out that the paper had not yet been published; that Feigl-Ding’s comparison to the infection rate of SARS was inaccurate; that most estimates of the R0 number were now lower than 3.8. Feigl-Ding’s tweets got more readers than those of his critics’. But those credentialed in epidemiology and public health were much more likely to see the criticism as sober and responsible, Feigl-Ding himself as an irresponsible alarmist, and the impulse to raise alarm a deeply reckless one. An Atlantic story about it was headlined “How to Misinform Yourself About the Coronavirus.”

Two months later, we are, inarguably, in the midst of a global pandemic. It took three months for COVID-19 to reach 100,000 confirmed cases globally; ten more days to reach 200,000; just four more to reach 300,000, and three to reach 400,000. And while the “true” R0 number is hard to pin down in the real world, where it reflects social practices and cultural mores (and can be dramatically reduced by social distancing), an authoritative recent report from the Imperial College (the one that alarmed Boris Johnson enough to back off of his “herd immunity” plan and Donald Trump enough to stop dismissing the coronavirus and start using it to sell himself, laughably, as a wartime president) suggested that the R0 value of COVID-19 could be as high as 3.5 — proposing a likely range of 1.5 to 3.5. Other estimates are as high as 4.08 and above. Those estimates are probably too high, at least by modeling the spread of the virus in a world now belatedly awake to it and taking at least some precautions against it. But the same Imperial College report suggested that even with efforts to mitigate the spread of the virus in the U.S., more than a million Americans may die. In just two months, what sounded like hysteria to scolding experts has become conventional wisdom among even cautious epidemiologists. “We’re looking at something that’s catastrophic on a level that we have not seen for an infectious disease since 1918,” Dr. Jeffrey Shaman, a Columbia professor projecting the spread of the virus, told the New York Times on Friday. Where had I read that before?

There may be particular questions, in other words, about particular data points and comparisons contained in Feigl-Ding’s rushed thread — though it’s worth pointing out that even in the initial thread, he suggested the true R0 might be closer to 2.5, and in subsequent tweets corrected the other points. And the broad message? The purposeful incitement of public alarm? If the question is whether Feigl-Ding was right to be alarmed by what he was reading, whether alarm was an appropriate response to what we knew even then about the infectiousness and lethality of this disease, and whether it was therefore responsible to induce panic in the public, we can say — with the benefit of hindsight, yes, but also definitively — it was. And if the question is whether, on January 20, the world as a whole should have freaked out considerably more about the coronavirus, initiating emergency planning and launching medical preparation on a war footing immediately, the answer, eight weeks later, is blindingly obvious: Yes, of course we should have, and we would all be in a much better, safer, and probably more prosperous place if we had.

Today, the world is almost a controlled experiment in pandemic response, and the returns are already unmistakable: The nations that . . .

Read the whole thing.

Written by Leisureguy

26 March 2020 at 7:18 pm

Handling groceries and takeout foods safely during the pandemic

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UPDATE: The video below is bogus. See this Twitter thread

For a good video on food-handling safety, watch the one in this post on Serious Eats.  /update

[Video that was in this post has been removed: bogus advice]

Written by Leisureguy

26 March 2020 at 8:36 am

Posted in Daily life, Food, Health, Medical, Video

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What Do You Tell Someone Who Still Won’t Stay Home?

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Written by Leisureguy

19 March 2020 at 5:46 pm

Posted in Daily life, Health, Medical, Science

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How a country serious about coronavirus does quarantine

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Watch this.

Written by Leisureguy

15 March 2020 at 9:14 pm

Posted in Daily life, Healthcare, Medical

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President Trump has no moral compass: Trump ‘offers large sums’ for exclusive access to coronavirus vaccine

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Philip Oltermann reports in the Guardian:

The Trump administration has offered a German medical company “large sums of money” for exclusive access to a Covid-19 vaccine, German media have reported.

The German government is trying to fight off what it sees as an aggressive takeover bid by the US, the broadsheet Die Welt reports, citing German government circles.

The US president had offered the Tübingen-based biopharmaceutical company CureVac “large sums of money” to gain exclusive access to their work, wrote Die Welt.

According to an anonymous source quoted in the newspaper, Trump was doing everything to secure a vaccine against the coronavirus for the US, “but for the US only”. . .

Continue reading. There’s more.

Written by Leisureguy

15 March 2020 at 5:23 pm

No Matter What Some Public Officials Say, the Message You Need to Hear Is “Stay Home”

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Charles Ornstein reports in ProPublica:

On Saturday afternoon, U.S. Sen. Ted Cruz took to Twitter to ask his followers to heed the advice of public health officials and politicians on the other side of the aisle:

“If you can stay home, stay home,” the Texas Republican wrote. “And wash your hands.”

Hours later, the Republican governor of Oklahoma tweeted from a packed restaurant in Oklahoma City showing that he is performatively not doing this. “Eating with my kids and all my fellow Oklahomans at the @CollectiveOKC. It’s packed tonight! #supportlocal #OklaProud”

He deleted the tweet an hour later.

On Sunday morning, Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases at the National Institutes of Health, told CBS’ “Face the Nation,” “Right now, personally, myself, I wouldn’t go to a restaurant.”

Meanwhile, U.S. Rep. Devin Nunes, a California Republican, spoke on Fox News and said, “If you’re healthy, you and your family, it’s a great time to just go out, go to a local restaurant, likely you can get in easy. Let’s not hurt the working people in this country … go to your local pub.”

Stay Home, Even if You Feel Fine

The discordant messages underscore the immense challenges conveying common messages during a public health crisis, one that has happened time and again as the novel coronavirus that causes COVID-19 has swept across the country.

“The most important thing is for people to change their daily routines and really reduce their social interactions,” said Dr. Joshua Sharfstein, a former federal and state health official who is now vice dean for public health practice and community engagement for the Bloomberg School of Public Health at Johns Hopkins University.

“I don’t think it is the consistent message from all health and political officials. If people are going to change the way they live their lives, they need to hear about the need to do that from every credible source of information they have because if they get mixed messages it’s easy to lapse back to not changing.”

From the availability of testing to the need to avoid handshakes, from where patients should go if they develop symptoms to whether to touch your face, the messages — and the actions by the public officials and even sometimes the doctors delivering those messages — have been contradictory.

Go to the ER; Don’t Go to the ER

One day last week, for example, a New York City allergy practice sent patients an email telling them what to do if they suspect they have symptoms consistent with infection with COVID-19.

“As you may be aware, there is a shockingly low number of available tests, and all testing now is done through local emergency departments in the area,” the note read.

Hours later, the advice was retracted: “It has been brought to our attention that the recommendation to visit the ED if one suspects COVID19 is incorrect. One should call their primary care provider to be screened and whether a visit to a lab or emergency department is necessary. … We are sorry for the confusion.”

While the government’s inability to get coronavirus tests in the hands of doctors and local health departments has been roundly criticized for preventing leaders from understanding how the virus is spreading, the mixed messages being given by leaders and others throughout this outbreak threatens to have a continuing effect.

“In some places, at least, there’s an advice vacuum and that leaves a lot of people trying to figure out what’s available and what to do,” Sharfstein said.

Conflicting Information Causes Real Harm

Accurate information is the coin of the realm in public health emergencies such as this one. Setting expectations and sharing accurate information is vital, experts say.

At all levels of government and medicine, that hasn’t happened.

During a visit to the Centers for Disease Control and Prevention this month, . . .

Continue reading.

Written by Leisureguy

15 March 2020 at 3:06 pm

Posted in Daily life, Medical, Politics

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No, Holding Your Breath is Not a ‘Simple Self-Check’ for Coronavirus

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Misinformation is flying around. Check Snopes. From that link:

One frequently copied and pasted bit of text that has gone viral on Facebook, Twitter, and WhatsApp suggests a simple self-check for coronavirus infection, usually attributed to “Taiwan Experts,” “Stanford University,” or “Stanford Hospital Board,” among others:

The new Coronavirus may not show signs of infection for many days. How can you know if you are infected? By the time you have fever and/or cough and go to the hospital, the lung is usually 50% fibrosis. Taiwan experts provide a simple self-check that we can do every morning: Take a deep breath and hold it for more than 10 seconds. If you do this successfully without coughing, without discomfort, stiffness or tightness, there is no fibrosis in the lungs; it basically indicates no infection. In critical times, please self-check every morning in an environment with clean air.

The viral text is often combined with other frequently recurring coronavirus claims including a paragraph attributed to “serious excellent advice by Japanese doctors” about keeping your throat moist, and a set of recommendations that begins with a claim about differentiating between a cold and COVID-19. Snopes addressed the “serious excellent advice” here, and addressed the list of tips that begin with a purported way to diagnose a cold versus COVID-19 here. This article deals only with the “self-check” claim attributed to Taiwan experts, which is flawed for several reasons.

The “simple self-check” hinges on two central and unsupported assertions: First, that early COVID-19 infections include as a symptom a condition known as pulmonary fibrosis; and second, that the ability to hold your breath for 10 seconds is an accurate indicator of fibrosis. Neither is the case.

There’s more information at the link. Check it out.

Written by Leisureguy

11 March 2020 at 7:09 pm

Posted in Daily life, Medical

Tagged with ,

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