This is a NYT article recording the death rates in NYC per zip code from data provided by the NYC Health Department. Neighborhoods with high populations of black and Latinos and low income people have the highest death rates, while zip codes where the wealthy reside have almost no deaths. A city councilwoman from Starrett City (Crooklyn) explains that there are multigenerational families in Starrett City who don't have the luxury of going to their vacation homes. As you might imagine looking at the starkness of the data, it is actually much worse. The city's zip code data doesn't reflect the disparities in testing. And, in not-so-recent memory, I recall the closing of several city hospitals, Harlem, Sydenham among others, and the relocation of a hospital on Central Park West to Valhalla, NY. leaving many poor areas underserved even at that time, 40 years ago.
https://www.nytimes.com/2020/05/19/us/politics/hydroxychloroquine-trump-coronavirus.htm
This is a NYT article about the ascendancy of "anecdotal evidence" into the pantheon, where it clearly doesn't belong. A good quote on This Week In Virology was that "the plural of anecdote is anecdotes, not data". If our chief executive, the oxidizer in chief, is promoting hydroxychloroquine, a malaria drug, for Covid-19, how does that compete with drug efficacy testing? Dr. Hernandez, director of the Clinical Research Institute at Duke U said "When we have this playing out in the media instead of the scientific and clinical communities, people don't know what the right answer is..." An analysis of veterans treated with hydroxychloroquine found that 28% compared with 11% who had routine care dies. No matter how you round the numbers, it is criminal to promote this drug. There is no substitute for randomized controlled clinical trials. I ran some of those trials of cancer drugs and it makes a difference how the subjects are selected and matched and how the stats are done.
https://www.nytimes.com/2020/05/19/climate/coronavirus-climate-change-survey.html
Another NYT article about perspectives on climate change among Americans. This is a survey by Yale and George Washington Universities, published on Tuesday showing that 73% of Americans polled believed that climate change was happening, similar to polling in 2019. This was not expected because of a psychological hypothesis in psychology called the finite pool of worry, which suggests that when people’s level of concern about one issue rises, concern about others tends to fall.
https://www.nytimes.com/2020/05/17/opinion/mount-st-helenscoronavirus.html?searchResultPosition=3
This is an article from the NYT about how the Mt. St Helen's blast, 40 years ago, changed volcanology. David Johnson, a geologist and one of the first scientists summoned to monitor new warning signs from the mountain, was barred from meeting the press, based on his dire predictions of a cataclysmic event. Like the probability of a pandemic, it was well-established that one of the dozen or so volcanoes in the 800-mile Cascade Range might soon turn active and this was, in fact, overdue.Mr. Johnson died in the explosion.
This is an article in NYT pointing out the consequences of including diagnostic tests and serological tests, not the least of which is that some individuals may experience both tests, artificially inflating the numbers of those who have been tested. Two other reasons, equally significant, are that diagnostic testing attempts to quantify the amount of active disease in the population and that serological testing can be unreliable, as some of the tests have shown to be with a 50% accuracy rate. This has been attributed to confusion and fatigue in state and local boards of health.
More from the NYT about the concerns that routine immunization services have been disrupted due to the you-know-what. The article reports a WHO survey of 129 poor and middle-income countries and found that 68 were experiencing a disruption of their large-scale vaccination services through clinics and other interventions. Polio, recently, has all but been eradicated, a tremendous accomplishment, that now is under threat. Before the pandemic, measles cases were already rising, in 2017, there were seven and a half million estimated cases with 124,000 deaths. In 2019 the US alone reported 1282 measles cases, its highest in more than 25 years.
This is a link to JAMA article about serological testing done in LA
County. Thirty-five individuals out of 865 tested positive. After adjusting for
test sensitivity and specificity, the unweighted and weighted prevalence of
SARS-CoV-2 antibodies was 4.34%, which would imply that approximately 367 000
adults had SARS-CoV-2 antibodies, which is substantially greater than the 8430
cumulative number of confirmed infections in the county on April 10. Therefore,
death rates based on confirmed cases may be higher than rates based on number
of infections. By implication, contact tracing methods to limit the spread of
infection will be challenging.
This is a NYT article about animal
experiments done at Beth Israel Deaconess and published in science which show
in principle that a vaccine may be protective against Covid-19 in monkeys. In
one set of experiments, the monkeys were infected with the coronavirus and
developed lung inflammation, recovered and made antibodies to the coronavirus,
which were shown to be neutralizing. When the monkeys were challenged by a
second dose of the virus, they produced neutralizing antibodies which defeated
the virus in the monkeys’ nasal passages. In a separate experiment, prototype
vaccines were tested on monkeys. The monkeys received pieces of DNA, which
their cells turned into viral proteins which were intended to train the monkeys’
immune systems to recognize the virus. Several variations of a viral challenge
were attempted. Some vaccines gave only partial protection but others,
specifically the vaccine that trained the immune systems to recognize the
entire spike protein, worked best.
This links to an article in NEJM about Covid-19 in incarcerated populations. The authors advise that improved preparation is "essential" for minimizing impacts of Covid-19 on incarcerated persons, correctional staff, and surrounding communities. Racial minorities, homeless people and mentally ill are overrepresented in incarcerated populations and are housed in close proximity in prisons, making them exceptionally vulnerable to infection. These populations already have an increased rate of HIV, HCV and TB Social distancing in nigh-near impossible in prisons. In order to "flatten the curve" the authors advise“decarcerating,” or releasing, as many people as possible, including those who are least likely to commit additional crimes, but also on the elderly and infirm. Incarcerated people who are infected should be separated from the general prison population. People who have recovered from Covid-19 could help with custodial and care efforts since they may be immune.
No comments:
Post a Comment