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Comments on this site are moderated. This is a site for science learning and science discussion. It is not a site for debating or downplaying the merits of science; comments of that sort will not be approved. Comments that attempt to suggest that COVID-19 or other established science are a hoax will not be approved. Flippant or dismissive comments that do not further scientific discussion will not be approved. Derisive or mean-spirited comments will never be approved.
Thoughts on COVID-19 October 12, 2020
Just how many Americans have been exposed to COVID-19 is a difficult number to know with absolute certainty but each day we get closer and closer as serological (antibodies to the virus present in the blood) studies begin to roll in. Many Americans drastically overestimate this number, perhaps as some form of wishful thinking. Current…
Comparing COVID-19 to the Flu, Again
Early in the COVID-19 pandemic there was much wishful, and perhaps to some degree magical thinking crying out that COVID-19 is “no worse than Flu!” Sadly and defying all logic and science, the cry remains prevalent today. For those that care about numbers a recent pre-print article looks at the experience at one tertiary care…
State of The Disunion
A look today at how we’re doing with COVID-19. First let’s look at my home region, Riverside County. Like much of the country Riverside is seeing significant increases in new daily cases. Over the last week or so we’ve been seeing over 500 new cases each day on most days. Yesterday, Riverside saw its highest…
Major Treatment Breakthrough for COVID-19
A brief note today on some big COVID-19 news. Researchers from Oxford have announced that they plan to publish very exciting results from a large trial examining potential treatments for COVID-19. They have shown that dexamethasone (Decadron) reduced mortality by one third (28% vs 40%) when given to patients requiring ventilatory support and by 20%…
Thoughts on COVID-19 June 15, 2020
It’s been a time of great unrest in the Unites States and around the world after the death of George Floyd in Minneapolis at the hands of several police officers there. Demonstrations continue to occur around the country. Unquestionably we’ll see some disease surges in cities where protests occurred. Some factors that could lead to…
Asymptomatic Spread of SARS-CoV-2
A few days ago, the WHO’s technical lead on COVID-19 Maria Van Kerkhove, caused quite a kerfuffle by suggesting that infected, asymptomatic people with COVID-19 very rarely spread the infection. The WHO and Dr. Van Kerkhove fairly quickly walked back those comments but not before her words raced through the internet and caused heated discussion…
Why You Should Be Wearing a Mask, Starting Yesterday
Early on in the COVID-19 crisis, the US government, CDC and Public Health made an important error. US citizens were told that they should not wear masks. This mistake wasn’t completely without support in the scientific literature. Studies looking at mask-wearing as a way to prevent getting infected with a virus weren’t very convincing. Additionally,…
Thoughts on COVID-19 May 26, 2020
Last week I was on call for public health and wasn’t able to post much. This long weekend was about recovering from call. Hopefully I’ll get back into a more regular schedule this week. The Basic Reproduction Number (R0/R-naught) for the US looks like it has crossed back above 1 for the whole country. The…
COVID-19 is a Bad, Weird Disease
In a study released this week in the New England Journal of Medicine (NEJM) researchers in Europe examined 7 lungs from patients who died of COVID-19, 7 lungs of patients with acute respiratory distress syndrome from influenza A (H1N1) and 10 age-matched non-infected control lungs. They examined the lungs using a variety of tools including…
Thoughts on COVID-19 May 19, 2020
Governor Newsom relaxed California’s requirements for accelerated reopening. The new criteria focus less on how many deaths a county or municipality have and more on the number of cases. The new criteria will allow for up to 25 cases per 100,000 members of the population and no more than an 8% positive test rate. This…
Vitamin D and COVID-19
On March 23, former CDC Director Dr. Tom Frieden published an opinion piece on Fox News suggesting that Vitamin D could be protective against COVID-19. I’ve read the piece and it’s reasonable. Dr. Frieden gave a measured suggestion that maintaining normal Vitamin D levels could help stave off severe illness from COVID-19, particularly in vulnerable…
Thoughts on COVID-19 May 13, 2020
Predictive models for US deaths are beginning to coalesce around a projection of 110,000-115,000 deaths by June 6. By August 1st we’re looking at around 180,000 deaths. Youyang Gu has used the data from his incredibly accurate COVID-19 model to calculate Infection Fatality Rate (IFR) of about 1% for the virus. The IFR is difficult…
SARS-CoV-2 Shows Remarkable Spread Through Choir Group
The Morbidity and Mortality Weekly Report (MMWR) by Lea Hamner et al. released today describes the impressive spread of SARS-CoV-2 from one symptomatic individual to 53 (33 confirmed and 20 probable) out of 61 members of a choir in Washington State. Of those infected, two eventually died. The report startlingly illustrates some important phenomena related…
Hong Kong Combination Therapy Trial Shows Improved Outcomes
Very briefly tonight because it’s late. The docs at MGH FLARE presented a study out of Hong Kong showing significant improvements in recovery time for patients with COVID-19. The study, a randomized trial, looked at combination treatment with Interferon beta-1b and two anti-viral medications, lopinavir-ritonavir and ribavirin. Interferon beta-1b is part of the innate immune…
Am I at Risk for Believing Conspiracy Theories?
One of the really cool things about staying off of Facebook is that I’m not bombarded with conspiracy theories all day. One of the bad things about leaving Facebook is that I’m not bombarded with conspiracy theories all day. I, for instance, just found out that there’s a video called Plandemic spreading around the internet…
The Myth of Inflated Death Counts
COVID-19 death counts and accusations that they have been inflated is a topic I’ve avoided writing about because it’s politically charged. When something becomes political these days it moves away from the realm of science and into the realm of dogma, or quasi-religion. That’s why I shun politics. How do you rationally and logically discuss…
Routine Vaccinations Plummet in US During COVID-19 Crisis
A study by Santoli et al. is showing that there has been a sharp drop in ordering of routine non-influenza and measles-containing vaccines since the national state of emergency was declared over COVID-19. There was also a very worrisome drop in the administration of measles-containing vaccine. Parental concerns about COVID-19 have produced a sharp drop-off…
Thoughts on COVID-19
The Washington Post is reporting that cell phone data tracked by the University of Maryland’s Transportation Institute showed that tens of thousands of people flocked to Georgia after businesses were permitted to open. Over 60,000 more trips into the state were recorded than the week before the opening on April 24. Most of these travelers…
We All Deserve Some Good News on COVID-19
The usual caveats apply here. Everything we know about SARS-CoV-2, the virus that causes COVID-19 is new. We’ve only known about it for about 4 months or 5 months. Our understanding is changing daily as researchers around the world mobilize to develop better treatments and vaccines. Research released in this kind of time-frame has, by…
Blood Pressure Medications and COVID-19
When it comes to COVID-19, the role blood pressure medications like angiotensin-converting enzyme (ACE) inhibitors (e.g. Lotensin, Vasotec, and Zestril) and angiotensin-receptor blockers or ARBs (e.g. Losartan/Cozaar and Irbesartan/Avapro) has spanned a full spectrum of possibly having a beneficial effect to potentially worsening outcomes. The reason these medications have come under scrutiny lies with the…
Thoughts on COVID-19
Governor Newsom announced the start of Phase II of California’s COVID-19 response today by allowing limited pick-up service openings for businesses like book stores, sporting goods stores, and florists as early as this coming Friday. This is a measured loosening of restrictions to be sure as there’s no real congregating allowed and this is probably…
COVID-19 is Far More Deadly than Flu
Understanding the difference in deaths due to flu and deaths due to COVID-19 requires an understanding of how the CDC calculates flu deaths annually. Flu is dramatically underreported each year. Some of the reasons for that undercounting include a fairly narrow window for detecting the virus through testing (i.e. even if a patient has flu,…
The Curious Case of Sweden
Sweden’s approach to COVID-19 is different from most countries. Is it working there? Should the US have adopted this strategy? A closer look at the Swedish experience reveals significant problems with the Scandinavian country’s approach and highlights inherent differences between the two countries that largely prohibit its application in the US. Facing a novel Coronavirus…
On Bitter Pills
“The cure can’t be worse than the disease.” This is a common and somewhat understandable refrain in recent months. Is the damage to the economy caused by public health interventions like social distancing and shelter-in-place worse than the potential damage of COVID-19 itself? Is the cure worse than the disease? How can we know? “The…
Hope for Remdesivir
The National Institute of Allergy and Infectious Diseases (NIAID) released a statement today indicating that preliminary data from a government-run study of Remdesivir shows that the drug appears to reduce recovery time by 31% (median of 4 days) in patients with advanced COVID-19 disease and lung involvement. It may also have a benefit in mortality…
What The Bakersfield Doctors Got Horribly Wrong
A week ago Drs. Dan Erickson and Artin Massihi shared data from their regional urgent cares that seemed to indicate that SARS-CoV-2 had spread much further in their region than testing would indicate and that it was therefore much less dangerous than thought. They went so far as to say that the stay-at-home order is…
Has Riverside County Finally Passed Its COVID-19 Peak
A brief look this morning at some data where I live. Here are some of the data for Riverside County since April 15 Daily New Cases Daily New Deaths So looking at a population like Riverside County can be challenging compared to larger centers around the country. There will inevitably be variations in the graphs…
Thoughts on COVID-19 from a New Home
For some time I’ve been considering leaving Facebook. While there are many positive aspects of the social media giant, there are some things about it that I find hard to stomach. It’s a great place to share photos of family and pets and jiu jitsu, but it’s a terrible place for conversations. The world is…
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