2,746 Matching Annotations
  1. Oct 2020
    1. In comparison, the ratio is approximately 2.5 times greater than the estimated IFR for seasonal influenza

      Take away:

      If correct numerators and denominators are used, COVID-19 is at least 10 times as deadly as seasonal influenza.

      The claim:

      The Infection Fatality Ratio for COVID-19 is “approximately 2.5 times higher than the estimated IFR for seasonal influenza.”

      The evidence:

      Blackburn et al. report an infection fatality ratio among community-living adults of 0.26% (1). If institutionalized adults had been included the ratio would be higher, likely approximating the 0.6% mortality rate among exposed individuals readily calculated by combining official death tolls, the known 30% undercount (2), and a definitive CDC study that found 10 times as many people have been exposed to the novel coronavirus than are reported as cases (3). Among the elderly, Blackburn et al. calculate COVID-19 is 2.5 times deadlier than seasonal flu. This is clearly an underestimate:

      1) Blackburn et al. use CDC estimates of case-fatality rates calculated on the basis of all Americans, including the institutionalized, not limited to much healthier community-dwellers.

      2) The seasonal influenza case fatality rates reported by the CDC, including the often cited 0.1% overall, are for symptomatic cases. Their denominators are estimated by using the reported number of influenza hospitalizations to guess the burden of clinical illness (4). But antibody studies show that 65%-85% of people infected with influenza never develop symptoms (5). The 0.6% mortality rate calculated here for SARS-CoV-2-exposed individuals is 6 times higher than the 0.1% usually cited for seasonal influenza. Given the overestimation of commonly accepted influenza mortality rates due to failure to take asymptomatic infections into account, SARS-CoV-2 can be seen to be not 2.5 times, or even 6 times, but at least 10 times as lethal as seasonal flu.

      Sources:

      1 http://www.acpjournals.org/doi/10.7326/M20-5352

      2 https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2767980

      3 https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2768834

      4 https://www.cdc.gov/flu/about/burden/how-cdc-estimates.htm

      5 https://pubmed.ncbi.nlm.nih.gov/26133025/

    1. A 2016 Lancet study found that universal breast-feeding would prevent 800,000 child deaths a year across the globe and yield $300 billion in savings from reduced health care costs and improved economic outcomes for those reared on breast milk.

      Pure corruption here. Protectionism to prop up profits of approximately 630 million versus major benefits and savings of 300 billion. Even if you look at the calculus of the entire industry of 70 billion it becomes a no brainer.

    1. She reached behind her to her bookshelf, which held about a dozen blue bottles of something called Real Water, which is not stripped of “valuable electrons,” which supposedly creates free radicals something something from the body’s cells.

      I question her credibility to market claims like this. I suspect she has no staff scientist or people with the sort of background to make such claims. Even snake oil salesmen like Dr. Oz are pointedly putting us in hands way too make a buck.

    1. many Indians continue to defecate in the open. Bangladesh’s government and charities have built latrines, too, but they have worked harder to stigmatise open defecation. Often they install latrines for the poor and then prod richer folk into following their example. A new, surprising, finding is that this works better than expecting people to copy their social superiors.
    2. Many lives have been saved by parents doing something simple. Beginning in the 1960s American military doctors and researchers in Dhaka developed a therapy for acute diarrhoea—a sweet, salty oral rehydration solution. This is now dirt cheap and widely available. At the last count, fully 84% of Bangladeshi parents with stricken children fed it to them (only a third saw a doctor). Thinly populated African countries are struggling to match that. One promising idea is to distribute the sachets along with Coca-Cola—which gets everywhere.

      amazing the reach of Coca-Cola!

    1. To find a cure for what ails America, Chetty will need to understand all of this wild variation. Which factors foster opportunity, and which impede it? The next step will be to find local interventions that can address these factors—and to prove, with experimental trials, that the interventions work

      I suspect that racial inequalities like Redlining, school support, and public housing issues (including evictions and predatory lending) will overlay these unmobile areas. cf Scarlet E series from On the Media.

    1. How this phenomenon translates into absolute, rather than relative, risk, however, is a bit thorny. A large study published in 2018, for instance, found that among women who had children between 34 and 47, 2.2 percent developed breast cancer within three to seven years after they gave birth (among women who never had children, the rate was 1.9 percent). Over all, according to the American Cancer Society, women between 40 and 49 have a 1.5 percent chance of developing breast cancer.

      The rates here are so low as to be nearly negligible on their face. Why bother reporting it?

    1. They’re mostly things that everyone was supposed to be doing all along, such as ensuring that bathrooms have exhaust fans and that air filters are changed regularly and of high-enough quality to catch the virus. That means they should be high-efficiency particulate air (HEPA) filters or MERV-rated 13 or 14, which are essentially the N-95 masks of air filters.
    1. “We ought to have a social compact: If you’re sick, whether you’ve got Covid-19 or not, you should separate yourself from society,” Mr. Gostin said. “That’s your part of the bargain, you’re doing it for your neighbors, your family and your community.”“In exchange,” he said, “we as a nation owe you the right to a humane period of separation, where we meet your essential needs like medicine, health care, food and sick pay.”
    1. Reporting on a study at Queensborough Community College, also in the CUNY system, Sheila Beck notes that the library’s reserve textbook collection is “heavily used,” however, staffing and other concerns have prompted librarians to consider “less labor intensive and less costly alternatives.“ Beyond textbook reserves, academic librarians can help students to locate required course readings in other ways: older editions of their required textbook, pre- or post-prints of articles in institutional repositories, articles or other texts in databases subscribed to by the library, or readings that may be in the public domain or otherwise available on the open web.

      The basic economics of this system would indicate (especially as classes become larger and larger) that more careful consideration of choice, economics, accessibility, availability, etc. on a larger institutional level creates larger marginal gains for those in the class. If a staff librarian, teacher, or someone else within the system does the leg-work up front and does it well, then the dozens or even hundreds of students in the course don't need to spend (read: waste) their own time re-inventing the proverbial textbook wheel once they're in the class.

      Portions of the situation here make me wonder if we might pull a page from Dr. Peter Pronovost's playbook in the health care space and create a simple checklist of what to do when planning for textbooks and readings. Checklists that include things like:

      • will the texts actually be used?
      • will they be primary to the subject or are they supplementary?
      • What are their prices?
      • Are alternate materials available?
      • Are older editions available?
      • are public domain or open web versions available?
      • are there copies in the library? reserves? pirated versions? pre/post prints?
      • etc.

      Once such a checklist is available, institutions should require that it be available along with syllabi and other course listings.

      cross references:

    1. A scientific review of the science behind lockdown concludes the policy was a MISTAKE & will have caused MORE deaths from Covid-19

      Take Away: The new scientific paper confirms earlier modeling work and should not be interpreted as a detailed prediction for future deaths due to the ongoing pandemic.

      The Claim: "A scientific review of the science behind lockdown concludes the policy was a MISTAKE & will have caused MORE deaths from Covid-19"

      The Evidence: The scientific process involves replication and confirmation of experiments and studies. A new paper replicates and expands on an early modeling study of the COVID-19 pandemic in England (1). Their findings support the earlier results. However, there are limitations to the replication paper, which does not accurately reflect the current state of the pandemic response and does not make detailed predictions for a second wave of infections and deaths.

      A recent expert response to the paper further explains (2):

      "It needs to be stressed that all the simulations assume that interventions are only in place for 3 months (18th April – 18th July) and then completely relaxed. This gives rise to a strange set of scenarios where a second wave is allowed to progress in an uncontrolled manner."

      “It is this that leads to the counter-intuitive headline finding “that school closures would result in more overall covid-19 deaths than no school closures” – actually what the authors find is that a short period of intense lock-down (including the closure of schools) leads to a large second wave if it is allowed to run with no controls. To be fair the authors do highlight this in the paper, but it is not in the reported press release." -Prof Matt Keeling, Professor of Populations and Disease, University of Warwick

      Sources:

      (1) https://www.bmj.com/content/371/bmj.m3588

      (2) https://www.sciencemediacentre.org/expert-reaction-to-reanalysis-of-model-used-for-imperial-report-9-and-impact-of-school-closures/

    1. The model predicted that school closures and isolation of younger people would increase the total number of deaths, albeit postponed to a second and subsequent waves. The findings of this study suggest that prompt interventions were shown to be highly effective at reducing peak demand for intensive care unit (ICU) beds but also prolong the epidemic, in some cases resulting in more deaths long term. This happens because covid-19 related mortality is highly skewed towards older age groups. In the absence of an effective vaccination programme, none of the proposed mitigation strategies in the UK would reduce the predicted total number of deaths below 200 000.

      Take away: This model excludes the possibility of vaccination. As many vaccines are in stage three clinical trials, the conclusion that more people will die from closing schools, etc. will most likely not be realized.

      The claim: School closures and isolation of younger people will increase total number of deaths from second and subsequent waves of COVID-19 when restrictions are lifted.

      The evidence: This model predicts more deaths from the combination of place closures such as schools, case isolations, household quarantine, and social distancing of over 70s than for the combination of case isolation, household quarantine, and social distancing for over 70s. The majority of the deaths for the combination of place closures, case isolations, household quarantine, and social distancing of over 70s occur once the restrictions are lifted. This model excludes the possibility of a vaccine reducing the size of the second wave.

      At least ten companies have a COVID-19 vaccine in the final stage (Phase III) of clinical trials (1). Therefore a model which excludes vaccination will most likely not be accurate to reality once a vaccine is widely administered.

      Source:

      1 https://www.who.int/publications/m/item/draft-landscape-of-covid-19-candidate-vaccines

    1. CDC reverses course on testing for asymptomatic people who had Covid-19 contact

      Take Away

      Transmission of viable SARS-CoV-2 RNA can occur even from an infected but asymptomatic individual. Some people never become symptomatic. That group usually becomes non-infectious after 14 days from initial infection. For persons displaying symptoms , the SARS-CoV-2 RNA can be detected for 1 to 2 days prior to symptomatology. (1)

      The Claim

      Asymptomatic people who had SARS-CoV-2 contact should be tested.

      The Evidence

      Yes, this is a reversal of August 2020 advice. What is the importance of asymptomatic testing?

      Studies show that asymptomatic individuals have infected others prior to displaying symptoms. (1)

      According to the CDC’s September 10th 2020 update approximately 40% of infected Americans are asymptomatic at time of testing. Those persons are still contagious and are estimated to have already transmitted the virus to some of their close contacts. (2)

      In a report appearing in the July 2020 Journal of Medical Virology, 15.6% of SARS-CoV-2 positive patients in China are asymptomatic at time of testing. (3)

      Asymptomatic infection also varies by age group as older persons often have more comorbidities causing them to be susceptible to displaying symptoms earlier. A larger percentage of children remain asymptomatic but are still able to transmit the virus to their contacts. (1) (3)

      Transmission modes

      Droplet transmission is the primary proven mode of transmission of the SARS-CoV-2 virus, although it is believed that touching a contaminated surface then touching mucous membranes, for example, the mouth and nose can also serve to transmit the virus. (1)

      It is still unclear how big or small a dose of exposure to viable viral particles is needed for transmission; more research is needed to elucidate this. (1)

      Citations

      (1) https://www.who.int/news- room/commentaries/detail/transmission-of-sars-cov-2- implications-for-infection-prevention-precautions

      (2) https://www.cdc.gov/coronavirus/2019- ncov/hcp/planning-scenarios.html

      (3) He J, Guo Y, Mao R, Zhang J. Proportion of asymptomatic coronavirus disease 2019: A systematic review and metaanalysis. J Med Virol. 2020;1– 11.https://doi.org/10.1002/jmv.26326

    1. Forexample, there is evidence that people inhigher socio-economic groups are morelikely to be successful in quitting smoking

      Privilege impacts the ability to make important health decisions

  2. Sep 2020
    1. The impact of global warming on population health is a growing concern. Solar energy workers often work in very hot weather; where OSHA supports that there exist some hazards attempting to the health and safety of the workforce. Among the heat-related effects defined as a consequence of exposures to hot environments are, dehydration, heat exhaustion, heat stroke, and death. In order to ensure the safety of the solar workforce, the present study aims to provide with relevant information that could contribute to the development or improvement of safety procedures.The research paper briefly outlines the relation between sunny environments, heat load, heat-related occupational and safety, natural hazards, and climate change conditions. Followed by the description of the assessment method and safety limits. The assessment of levels of heat stress was based on a

      direct relation of results to health (not necessarily worker productivity however)

    1. Most instructors will have the experience and knowledge of their students’ situation to make wise choices about activities that will work best.

      Academic professors are acknowledging their students well-being which is important and shows care from both sides of the professor and student. This allows the student know that even though the professor is mainly involved with education, they still care.

    1. There are two possible approaches to build widespread SARS-CoV-2 immunity: (1) a mass vaccination campaign, which requires the development of an effective and safe vaccine, or (2) natural immunization of global populations with the virus over time. However, the consequences of the latter are serious and far-reaching—a large fraction of the human population would need to become infected with the virus, and millions would succumb to it.

      Take away: Mass infection without vaccination to achieve herd immunity will result in millions of deaths based on the observed death rate and may not result in herd immunity due to virus mutation. Historically, vaccination results in less deaths than the disease.

      The claim: Herd immunity from widespread disease instead of vaccination will lead to many people dying.

      The evidence: Approximately 50-67% of a given population is estimated to need to be infected for herd immunity to COVID-19 to exist which will result in millions of deaths. This is supported by additional publications (1, 2). This number assumes that the virus will not mutate to the point where re-infection is possible. If mutation occurs, COVID could become established in the general population similar to influenza or the common cold (3). A third publication estimates a needed infected percentage of 29-74% (4). These publications support the statement that millions will die if herd immunity is achieved via infection without vaccination. Historically, vaccination results in fewer deaths/disease on a population level than the disease for which the vaccine is designed to prevent (5-7).

      Sources:

      1 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7314002/

      2 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7262166/pdf/JMV-9999-na.pdf

      3 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7164482/

      4 https://www.cambridge.org/core/services/aop-cambridge-core/content/view/A1480DAE803D4CD4A3E9F79B82309584/S1935789320001913a.pdf/covid19_reflections.pdf

      5 https://pubmed.ncbi.nlm.nih.gov/28708957/

      6 https://pubmed.ncbi.nlm.nih.gov/29668817/

      7 https://pubmed.ncbi.nlm.nih.gov/12531323/

    1. Ten minutes of massage or rest will help your body fight stress
      • Short-term treatments like a massage, or just resting for a bit, reduce stress by boosting the parasympathetic nervous system (PNS).
      • Relaxation therapies show promise as a way to treat stress, but so far scientists haven’t developed a standardised method to test them - until now.
      • This study is the first standardised approach, and the results show that both rest and a massage increase heart rate variability (HRV) - higher HRV = greater relaxation.
      • Researchers say this shows we don’t need professional treatment in order to relax, even a 10-minute rest can boost our PNS and calm us down.
      • These conclusions will enable further experiments to study how different relaxation methods can help people with stress-related conditions like depression
    1. Take away: People are infectious for only part of the time they test positive. The tests for COVID-19 were granted emergency status by the FDA so some debate concerning the most ideal number of cycles is to be expected. It is worth noting that the FDA has the disclaimer "Negative results do not preclude 2019-nCoV infection and should not be used as the sole basis for treatment or other patient management decisions. Negative results must be combined with clinical observations, patient history, and epidemiological information (2)."

      The claim: Up to 90 percent of people diagnosed with coronavirus may not be carrying enough of it to infect anyone else

      The evidence: Per Walsh et al. (1), SARS-CoV-2 virus (COVID-19) is most likely infectious if the number of PCR cycles is <24 and the symptom onset to test is <8 days. RT-PCR detects the RNA, not the infectious virus. Therefore, setting the cycle threshold at 37-40 cycles will most likely result in detecting some samples with virus which is not infectious. As the PCR tests were granted emergency use by the FDA (samples include 2-9), it is not surprising that some debate exists currently about where the cycle threshold should be. Thresholds need to be set and validated for dozens of PCR tests currently in use. If identifying only infectious individuals is the goal, a lower cycle number may be justified. If detection of as many cases as possible to get closer to the most accurate death rate is the goal, setting the cycle threshold at 37-40 makes sense. A lower threshold will result in fewer COVID-19 positive samples being identified. It is worth noting that the emergency use approval granted by the FDA includes the disclaimer that a negative test does not guarantee that a person is not infected with COVID-19. RNA degrades easily. If samples are not kept cold or properly processed, the virus can degrade and result in a false negative result.

      Source: 1 https://academic.oup.com/cid/advance-article/doi/10.1093/cid/ciaa638/5842165

      2 https://www.fda.gov/media/134922/download

      3 https://www.fda.gov/media/138150/download

      4 https://www.fda.gov/media/137120/download

      5 https://www.fda.gov/media/136231/download

      6 https://www.fda.gov/media/136472/download

      7 https://www.fda.gov/media/139279/download

      8 https://www.fda.gov/media/136314/download

      9 https://www.fda.gov/media/140776/download

  3. Aug 2020
    1. Lozano, R., Fullman, N., Mumford, J. E., Knight, M., Barthelemy, C. M., Abbafati, C., Abbastabar, H., Abd-Allah, F., Abdollahi, M., Abedi, A., Abolhassani, H., Abosetugn, A. E., Abreu, L. G., Abrigo, M. R. M., Haimed, A. K. A., Abushouk, A. I., Adabi, M., Adebayo, O. M., Adekanmbi, V., … Murray, C. J. L. (2020). Measuring universal health coverage based on an index of effective coverage of health services in 204 countries and territories, 1990–2019: A systematic analysis for the Global Burden of Disease Study 2019. The Lancet, 0(0). https://doi.org/10.1016/S0140-6736(20)30750-9

    1. Nguyen, L. H., Drew, D. A., Graham, M. S., Joshi, A. D., Guo, C.-G., Ma, W., Mehta, R. S., Warner, E. T., Sikavi, D. R., Lo, C.-H., Kwon, S., Song, M., Mucci, L. A., Stampfer, M. J., Willett, W. C., Eliassen, A. H., Hart, J. E., Chavarro, J. E., Rich-Edwards, J. W., … Zhang, F. (2020). Risk of COVID-19 among front-line health-care workers and the general community: A prospective cohort study. The Lancet Public Health, 0(0). https://doi.org/10.1016/S2468-2667(20)30164-X

    1. Harper, Craig A., and Darren Rhodes. ‘Ideological Responses to the Breaking of COVID-19 Social Distancing Recommendations’, 19 August 2020. https://doi.org/10.31234/osf.io/dkqj6.

    2. Harper, Craig A., and Darren Rhodes. ‘Ideological Responses to the Breaking of COVID-19 Social Distancing Recommendations’, 19 August 2020. https://doi.org/10.31234/osf.io/dkqj6.

    3. Harper, Craig A., and Darren Rhodes. ‘Ideological Responses to the Breaking of COVID-19 Social Distancing Recommendations’, 19 August 2020. https://doi.org/10.31234/osf.io/dkqj6.

    1. Sherrard-Smith, E., Hogan, A. B., Hamlet, A., Watson, O. J., Whittaker, C., Winskill, P., Ali, F., Mohammad, A. B., Uhomoibhi, P., Maikore, I., Ogbulafor, N., Nikau, J., Kont, M. D., Challenger, J. D., Verity, R., Lambert, B., Cairns, M., Rao, B., Baguelin, M., … Churcher, T. S. (2020). The potential public health consequences of COVID-19 on malaria in Africa. Nature Medicine, 1–6. https://doi.org/10.1038/s41591-020-1025-y