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COVID-19: politics and the stock market vs. science and survival

Updated 3-30-2020

A roundup of articles not so much about the coronavirus but about how we're managing or mismanaging or stretching the truth about or fighting about how to manage the coronavirus.


Coronavirus Misinformation Tracking Center (NewsGuard)
The U.S. Was On Track to Build Cheap, Easy-To-Use Ventilators Years Ago. Then a Big Device-Maker Got in the Way. (KHN Morning Briefing, 3-30-2020) Summaries of health policy coverage from major news organizations (with links to stories).Public health experts have long known that a ventilator shortage is a vulnerability in the system. The government tried to rectify the problem, but efforts stalled. The New York Times takes a deep-dive into what went wrong. Meanwhile, manufacturers across the country say they lack federal guidance on where to ship new products.
Help Researchers Track COVID-19 (Bob Hirshon, Scientific American, 3-26-2020) By entering your health status, even if you’re feeling fine, at the Web site COVID Near You, you can help researchers develop a nationwide look at where hotspots of coronavirus are occurring...
Exponential growth and epidemics: How is COVID-19 currently growing? (video, 3blue1brown.com) A good primer on exponential and logistic growth.
Trump: “Every Country” Spreads Lies About the Coronavirus, What’s the Big Deal? (Bess Levin, Vanity Fair, 3-30-2020) You want to know the real threat to America? Windmills.
The Coronavirus Spurs a Movement of People Reclaiming Vacant Homes (Dana Goodyear, New Yorker, 3-28-2020)
How the Pandemic Will End (Ed Yong, The Atlantic, 3-18-2020) The U.S. may end up with the worst COVID-19 outbreak in the industrialized world. This is how it’s going to play out. See also his article The Next Plague Is Coming. Is America Ready? (Atlantic, July 2018) The epidemics of the early 21st century revealed a world unprepared, even as the risks continue to multiply. Much worse is coming.
'All of This Panic Could Have Been Prevented': Author Max Brooks On COVID-19 (Terry Gross, Fresh Air, NPR, 3-24-2020) Apocalyptic novelist Max Brooks is something of an expert on planning for pandemics and other disasters. His books include World War Z, Germ Warfare and the forthcoming Devolution. “President Trump was slow to acknowledge the virus as a real threat. And thus far, the president has resisted using the Defense Production Act to force private companies to manufacture masks, gloves and other essential supplies in the fight against the coronavirus. Many government task forces that plan for disasters have yet to be activated in this crisis."
The Official Coronavirus Numbers Are Wrong, and Everyone Knows It (Alexis C. Madrigal, The Atlantic, 3-4-2020) Because the U.S. data on coronavirus infections are so deeply flawed, the quantification of the outbreak obscures more than it illuminates. Preparing for a sizable outbreak seemed absurd when there were fewer than 20 cases on American soil. Now we know that the disease was already spreading and that it was the U.S. response that was stalled. The reality gap between American numbers and American cases is wide.
The next outbreak? We're not ready (Bill Gates TED Talk, 2015) In 2014, the world avoided a global outbreak of Ebola, thanks to thousands of selfless health workers -- plus, frankly, some very good luck. In hindsight, we know what we should have done better.
Why Estonia Was Poised to Handle How a Pandemic Would Change Everything (Masha Gessen, New Yorker, 3-24-2020) The little start-up country that did better than the U.S.
Desperate for Covid-19 answers, U.S. doctors turn to colleagues in China (Sharon Begley, STAT, 3-24-2020) Fed 'up with what they see as inadequate and confusing directives from public health authorities, many physicians are trying to get on-the-ground advice directly from colleagues in countries that were the first to be hit by the coronavirus pandemic.The U.S. Centers for Disease Control and Prevention originally told physicians, nurses, and others caring for Covid-19 patients to use N95 masks, for instance, but earlier this month changed that to ordinary surgical masks for most needs....

      Severe and critical cases in China get hospitalized, but at a dedicated facility, to reduce spread from Covid-19 patient to hospital worker to non-Covid-19 patient....The Hopkins teams was impressed with China’s scrupulous measures to minimize viral transmission, “especially among health care workers,” Auwaerter said. “Such measures have successfully slowed the epidemic in China.” In contrast, failing to do so has fueled the disastrous spread of Covid-19 in Italy, physicians at a hospital in the country’s hard-hit north warned over the weekend.'
How to Talk to Coronavirus Skeptics (Isaac Chotiner, New Yorker, 3-23-2020) A science historian discusses the Trump Administration's response to the pandemic and strategies for convincing doubters that the threat of the coronavirus is real. All of the major areas where we see resistance to scientific findings in contemporary life fall into the category of implicatory denial--that is, "we reject scientific findings because we don’t like their implications."
“There’s No Boogeyman He Can Attack”: Angry at Kushner, Trump Awakens to the COVID-19 Danger (Gabriel Sherman, Vanity Fair, 3-16-2020) For weeks, Trump and his son-in-law saw the novel coronavirus mostly as a media and political problem. But the spiraling cases, plunging markets, and a Mar-a-Lago cluster finally opened eyes.
How South Korea Flattened the Curve (Max Fisher and Choe Sang-Hun, NY Times, 3-23-2020) The country showed that it is possible to contain the coronavirus without shutting down the economy, but experts are unsure whether its lessons can work abroad.

Lesson 1: Intervene Fast, Before It’s a Crisis.

Lesson 2: Test Early, Often and Safely. Read More 

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Coronavirus: How to minimize the risk of getting and spreading it

Updated 3-30-2020 (click refresh button to get updated version)

 

"Everything we do before a pandemic will seem alarmist.
Everything we do after will seem inadequate" ~ M. Leavitt

  How to protect yourself from COVID-19

Social distancing to flatten the curve
Reliable sources for updates on COVID-19
Coronavirus: A primer
Updates on coronavirus testing
How long will it take to get a vaccine?
What to do and not do (and where we can improve)
Covering the coronavirus story as a journalist
SARS, MERS, and other forms of coronavirus

 

How to protect yourself from COVID-19

  • Avoid close contact with people who are sick. The most common symptoms of coronavirus disease (COVID-19) are fever, tiredness, and dry cough -- and, in severe cases, difficulty breathing.
  • Avoid touching your eyes, nose, and mouth. Don't pick your nose! The disease is passed mostly by people touching their hands to their face. It's hard to resist, and one reason to wear a mask or bandanna over your nose and mouth may be to train yourself not to touch your face.
  • Stay home when you are sick. Keep 6 feet between you and others. If you walk with someone, stand to one side of them (as well as behind or in front of them) to be out of the line of fire if the person in front coughs--as the droplets may still be in the air by the time the person behind gets to the spot where the cough occurred.
  • Wash your hands often with soap and water, especially after touching possibly contaminated surfaces. Wet them with warm or cold, clean, running water and then apply soap. When lathering, make sure to get the backs of your hands, between fingers and under nails. Wash your hands for at least 20 seconds, especially after going to the bathroom; before eating; and after blowing your nose, coughing, or sneezing. Always wash hands with soap and water if hands are visibly dirty. See Why Soap Works (Ferris Jabr, NY Times, 3-13-2020) At the molecular level, soap breaks things apart. Remember this the next time you have the impulse to bypass the sink: Other people’s lives are in your hands.
  • If soap and water are not readily available, use an alcohol-based hand sanitizer with at least 60% alcohol--preferably 70%. See CDC on handwashing.
  • Cover your cough or sneeze with a tissue, then throw the tissue in the trash. The virus is dispersed through respiratory droplets.
  • NOTE THAT MANY OF THE SUPPLIES MENTIONED ARE NOT AVAILABLE CURRENTLY, BECAUSE STORES ARE RUNNING SHORT.  Stores will restock. Don't panic, and don't hoard.
  • Clean and disinfect frequently touched and shared objects and surfaces, including phones (constantly), remote controls, countertops, and refrigerator handles, using a regular household cleaning spray or wipe. ("The dirtiest places in the house are the fridge and the cupboard. Nobody knows who touched the items we've brought home from the store," says a retired NIH employee.) Sanitize the objects you and lots of other people touch, especially people outside your family--like door handles, shared keyboards at schools, salad bar tongs, etc. Here's a list of household cleaning products that will kill viral pathogens. (Center for Biocide Chemistries, American Chemical Council). A long list of products that can be used to disinfect at home—a number of Clorox and Lysol products as well as many other products. Unfortunately, many of these may well be sold out (shelves of many of these products were nearly  empty at my largest nearby supermarket on March 12). See also CDC's Environmental Cleaning and Disinfection Recommendations (CDC) Interim Recommendations for US Households with Suspected/Confirmed Coronavirus Disease 2019.
  • The Coronavirus May Linger On Plastic And Stainless Steel For Days, A Preliminary Study Found (Stephanie M. Lee, Buzzfeed, 3-11-2020)
  • Clean your phones and cellphones NIGHTLY (and other obvious germ carriers, such as doorknobs and banisters frequently).
  • Avoid touching door knobs and banisters, when possible. If you do touch them, wash your hands.
  • Wear gloves; wash or change them daily.
  • Wash towels you have touched with unclean hands. Temporarily, make use of paper towels.
  • Simple DIY masks could help flatten the curve. We should all wear them in public. (Jeremy Howard, Washington Post, 3-28-2020) When historians tally up the many missteps policymakers have made in response to the coronavirus pandemic, the senseless and unscientific push for the general public to avoid wearing masks should be near the top. The evidence not only fails to support the push, it also contradicts it. Masks effective at "flattening the curve" can be made at home with nothing more than a T-shirt and a pair of scissors. We should all wear masks — store-bought or homemade — whenever we're out in public.
  • CDC and the Surgeon General initially discouraged the use of face masks in early March,because there's a shortage and they're needed more urgently by medical personnel -- and we're in need of the medical personnel. The use of facemasks is crucial for health workers and people who are taking care of someone in close settings (at home or in a health care facility) to prevent their catching the virus.  After production on facemasks has ramped up and there is no shortage, use a facemask if you show symptoms of COVID-19 to help prevent the spread of the disease to others. If nothing else, facemasks keep YOU from touching your own mouth and nose. Read Guidance against wearing masks for the coronavirus is wrong – you should cover your face (Boston Globe) Blocking access to your nose, throat, and eyes will prevent infection from the coronavirus, flu, and any other several other respiratory viruses, which is why medical workers must wear them.

 

Further advice from virologist James Robb, MD UC San Diego. Robb has worked with this coronavirus for almost 50 years: COVID-19 has an affinity for pulmonary receptors that is extraordinary. It is most likely to be widespread in the US by mid to late March and April, he says. Here are the precautions Dr. Robb takes and will take (with some comments added). These are the same precautions he currently uses during our influenza seasons, except for the mask and gloves:

1) NO HANDSHAKING! Use a fist bump, slight bow, elbow bump, etc. Or do jazz hands , as CDC recommends.

2) Use ONLY your knuckle to touch light switches. elevator buttons, etc. Lift the gasoline dispenser with a paper towel or use a disposable glove. (Carry disposable gloves in your car.)

3) Open doors with your closed fist or hip - do not grasp the handle with your hand, unless there is no other way to open the door. Especially important on bathroom and post office/commercial doors.

4) Use disinfectant wipes at the stores when they are available, including wiping the handle and child seat in grocery carts.

5) Wash your hands with soap for 10-20 seconds and/or use a greater than 60% alcohol-based hand sanitizer whenever you return home from ANY activity that involves locations where other people have been.

6) Keep a bottle of hand sanitizer (60% alcohol) available at each of your home's entrances. AND in your car for use after getting gas or touching other contaminated objects when you can't immediately wash your hands.

7) If possible, cough or sneeze into a disposable tissue and discard. Use your elbow only if you have to. The clothing on your elbow will contain infectious virus that can be passed on for up to a week or more!

 

Dr. Robb adds: What I have stocked in preparation for the pandemic spread to the US:

1) Latex or nitrile latex disposable gloves for use when going shopping, using the gasoline pump, and all other outside activity when you come in contact with contaminated areas. Note: This virus is spread in large droplets by coughing and sneezing. This means that the air will not infect you! BUT all the surfaces where these droplets land are infectious for about a week on average - everything that is associated with infected people will be contaminated and potentially infectious. The virus is on surfaces and you will not be infected unless your unprotected face is directly coughed or sneezed upon. This virus only has cell receptors for lung cells (it only infects your lungs) The only way for the virus to infect you is through your nose or mouth via your hands or an infected cough or sneeze onto or into your nose or mouth.

 2) When there is ample stock (which at the, acquire disposable surgical masks. Their main value is to to prevent you from touching your [own] nose and/or mouth (We touch our nose/mouth 90X/day without knowing it!). This is the only way this virus can infect you - it is lung-specific. The mask will not prevent the virus in a direct sneeze from getting into your nose or mouth - it is mainly to keep you from touching your nose or mouth.)

3) Stock up now with hand sanitizers and latex/nitrile gloves (get the appropriate sizes for your family). The hand sanitizers must be alcohol-based and greater than 60% alcohol to be effective.

4) Zinc lozenges may be helpful. (This page from McGill states that Robb was misquoted and, more important, that there is no evidence to support a benefit of zinc for corona virus. There is slight evidence that zinc supplements can reduce the duration of the common cold which is a coronavirus infection, but also zinc can be toxic if you take too much.) There will be NO drugs or vaccines available this year to protect us or limit the infection within us. Only symptomatic support is available.


So what if I think I might be infected? (WashingtonPost, 3-13-2020) If you feel sick and are worried about the coronavirus, call your doctor. Don’t rush to the ER. Testing is still limited, and most cases are relatively mild. There is no treatment for COVID-19.

Steps to take if you're sick
How to Protect Yourself (CDC)

Know how it spreads. (See below)

Take steps to protect yourself: Clean your hands often. Avoid close contact.

Take steps to protect others: Stay home if you’re sick. Cover coughs and sneezes. Wear a face mask if you are sick. Clean and disinfect (with instructions).

Failure to control the virus will mean millions of deaths.



MORE RESOURCES: Coronavirus (COVID-19)

Essential links, updates, FAQs

Social distancing to flatten the curve

Reliable sources for updates
Coronavirus: A primer
Updates on coronavirus testing
How long will it take to get a vaccine?
What to do and not do (and where we can improve)
Covering the coronavirus story as a journalist
SARS, MERS, and other forms of coronavirus
Protecting yourself from COVID-19

 

Social distancing to flatten the curve

 It takes weeks to see the results.


Comprehensive Social Distancing Is Difficult and Necessary. Here's How to Keep Your Family Safe (Asaf Bitton, MD, MPH, on WBUR, 3-14-2020) Originally published as Social Distancing: This Is Not a Snow Day (Ariadne Labs)
Why ‘flattening the curve’ may be the world’s best bet to slow the coronavirus (Helen Branswell, STAT, 3-11-2020) “If you look at the curves of outbreaks, they go big peaks, and then come down. What we need to do is flatten that down,” Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, told reporters Tuesday. “That would have less people infected. That would ultimately have less deaths. You do that by trying to interfere with the natural flow of the outbreak.” See also Does closing schools slow the spread of coronavirus? Past outbreaks provide clues (Jennifer Couzin-Frankel, Science, 3-10-2020) "We know from past epidemics of multiple types of viruses that school closure works. We know that it interrupts adult transmission even if the kids are not vectors. Here, it’s likely that kids are vectors, and preliminary evidence from China suggests that they can be."
Social distancing could buy U.S. valuable time against coronavirus (Carolyn Y. Johnson, Lena H. Sun and Andrew Freedman WaPo, 3-10-2020). The United States is at a make-or-break moment with coronavirus that will test of one of the most basic, but inconvenient and disruptive, public health tools in the book: social distancing...The goal isn’t to stop the virus; not anymore. It is to slow it down....By the time it stops feeling silly to consider major life changes, it may be too late.
The Dos and Don’ts of ‘Social Distancing’ (Kaitlyn Tiffany, The Atlantic, 3-12-2020) Experts weigh in on whether you should cancel your dates, dinner parties, and gym sessions. Recommendations for “social distancing”—a term that epidemiologists are using to refer to a conscious effort to reduce close contact between people and hopefully stymie community transmission of the virus.
Surfaces? Sneezes? Sex? How the Coronavirus Can and Cannot Spread (Heather Murphy, NY Times,3-2-2020) What you need to know about how the virus is transmitted. That page should take you to live updates on the virus, also. See also Heather Cox Richardson's Facebook post, comparing the Philadelphia and St. Louis responses to the 1918 flu epidemic. A political appointee in Philadelphia went ahead with a big parade to raise money for the Liberty Bonds that were funding WWI, wanting to keep morale up. By the end of the season, 12,000 Philadelphians had died. By contrast, the public health commissioner in St. Louis shut down the city, incurring the wrath of local businessmen, but slowing down the infection rate, so by the end of the season only 1,700 died in St. Louis, half the rate in Philadelphia. "The novel coronavirus is spreading in America, but we can still slow it down by social distancing and avoiding crowds." It spreads exponentially. "As grim as things seem right now, the future is ours to shape."
Why We Should Still Try to Contain The Coronavirus (Healy and Khan, Los Angeles Times, 3-11-2020) "The goal is no longer to prevent the virus from spreading freely from person to person, as it was in the outbreak’s early days. Instead, the objective is to spread out the inevitable infections so that the healthcare system isn’t overwhelmed with patients. Public health officials have a name for this: Flattening the curve."
Sheltering in Place: What You Need to Know (KQED) What is considered an essential activity, what activities outside the home are okay, and what are essential businesses and infrastructures, etc.
How to Seek a Safe Respite Outdoors While Social Distancing (Lynn Jolicoeur and Lisa Mullins, KQED, 3-25-2020) Move about as much [as possible], rather than being stagnant ... for prolonged periods of time.
How Kids' Lit Is Responding to the Coronavirus (Alex Green, Publishers Weekly, 3-17-2020) Children’s authors and publishers are going digital to provide kids with ways to read, draw, engage, and support other children who might need a helping hand. PW lists online resources to help stay-at-home famillies: a free writing course for kids, bilingual videos and teaching guides, a coloring book designed by acclaimed illustrators, access to free books for educators, parents, and librarians, and a hashtag to search for more content on social media.

 

Reliable sources for updates on COVID-19


Coronavirus Disease 2019 (COVID-19) Situation Summary (CDC updates) Includes background information, including relationship to MERS and SARS betacoronaviruses.This is an emerging, rapidly evolving situation and CDC will provide updated information as it becomes available, in addition to updated guidance. Follow CDC Twitter feed: @CDCgov
Covid19 Cases in United States (CDC map and data) and Preventing and treating coronavirus disease 2019 (COVID-19) (CDC)
Rolling updates on coronavirus disease (COVID 19) (World Health Organization) "We need facts, not fear, we need science, not rumors, we need solidarity, not stigma.”
Kaiser Health Network, Kaiser Family Foundation (invaluable resource, especially on policy) @KHNews
MedlinePlus Twitter feed (National Library of Medicine, NIH, @MedlinePlus)
Spotlight on Coronavirus (Science Friday with Ira Flatow, National Public Radio, @scifri). Listen to useful explanations such as Coronavirus: Sanitizing, According to Science
Boston’s infectious disease specialists’ message to the public: Don’t be cavalier about the coronavirus (Boston Infectious Disease Specialists, Boston Globe, 3-13-2020) Main take-aways:
(1) Testing capacity is still woefully lacking, and we therefore must conserve Covid-19 testing for those most in need.
(2) The community must begin social distancing immediately.
(3) The public should help in conserving vital medical resources, such as health care provider time and personal protective equipment, such as masks and gloves.
Preventing COVID-19 Spread in Communities (CDC)
CDC Guidance for Travelers
• The best way to see where the disease has spread, and how much: COVID-19 map (Johns Hopkins University & Medicine). See also their Coronavirus Resource Center and its Situation Reports.
Coronavirus updates, NY Times (and related stories by Knvul Sheikh). See especially Tracking Every Coronavirus Case in the U.S.: Full Map
Washington Post: Latest News on Coronavirus
NIH Updates on coronavirus (National Institutes of Health)
Coronavirus articles (STAT)
The New Yorker’s coronavirus news coverage and analysis temporarily free for all readers.
PBS News updates
BBC News, including Coronavirus and fake news – what to believe?.
Coronavirus stories (Politico) Politico Nightly: Coronavirus Special Edition

 

 

Do not trust unreliable sources.

When Mr. Trump and Dr. Fauci disagree, listen to Dr. Fauci. Fighting coronavirus requires scientific knowhow, not presidential cheerleading.

Coronavirus Misinformation Tracking Center (NewsGuard) Sites identified as publishing materially false information about the virus.
The coronavirus ‘infodemic’ is real. We rated the websites responsible for it (JohnGregory, STAT, 2-28-2020)
Annals of Internal Medicine
Tech Companies Aim to Stop COVID-19 Disinformation (Tim Mak, Morning Edition, NPR, 3-16-2020) "Fake news spreads faster and more easily than this virus and is just as dangerous."~ World Health Organization's Director-General Tedros Adhanom.
       John Gregory, the deputy editor of health at NewsGuard, says there are three big buckets of coronavirus misinformation circulating right now. "No. 1, conspiracies about the origins of the virus; two, bad health cures, either ineffective or both ineffective and harmful. And three, minimizing the outbreak, saying it's not as big of a deal as the media is making it out to be."

Updates on coronavirus testing


‘We're behind the curve’: U.S. hospitals confront the challenges of large-scale coronavirus testing (Jon Cohen, Science, 3-11-2020) “The reality is most people will not be able to get a test this week, and most people will not be able to get a test next week,” says physician and epidemiologist Michael Mina, who helps run the diagnostic lab at Brigham and Women’s Hospital in Boston and has been critical of the Trump administration in blistering tweets. Mina "also anticipates that there will be—or may already be—a shortage of reagents needed to run the test kits."
The 4 Key Reasons the U.S. Is So Behind on Coronavirus Testing (Olga Khazan, The Atlantic, 3-13-2020) Bureaucracy, equipment shortages, an unwillingness to share, and failed leadership doomed the American response to COVID-19.

(1) Red Tape. Dozens of labs in the U.S. were eager to make tests and willing to test patients, but they were hamstrung by emergency use authorization (EUA) regulations for most of February, even as the virus crept silently across the nation.

(2) Hard-to-get virus samples.Miller said it would help if researchers, governments, and companies firmed up pathogen-sharing contracts in advance of an outbreak.

(3) “We don’t have a nationalized health-care system where you put the same equipment in all the hospitals,” Wu says. “We have all these independent hospital systems with their own equipment in their own labs.” Even though some hospitals actually have the new, functional CDC tests, the extraction machines and reagents that are used to perform them are in short supply.

(4) Leadership and coordination problems. For months, President Trump made light of the coronavirus. “Much of what he’s said publicly about the virus has been wrong, a consequence of downplaying any troubles on his watch.” Trump put Mike Pence, who has no public health experience, in charge, late, and there was infighting between and little coordination among departments.
The Dangerous Delays in U.S. Coronavirus Testing Haven’t Stopped (Robinson MeyerAlexis C. Madrigal, The Atlantic, 3-9-2020)
Reviewing Public Health Record of Coronavirus Commander Mike Pence (KHN, 2-28-2020) KHN Midwest editor and correspondent Laura Ungar appeared on “CNN Newsroom with Brooke Baldwin” to discuss Vice President Mike Pence’s appointment to lead the nation’s response to the novel coronavirus in light of how he handled a 2015 HIV outbreak when he was governor of Indiana. Prevention and quick evidence-based action are the most important steps to take in these health crises and Pence took neither in 2015.
Key Missteps at the CDC Have Set Back Its Ability to Detect the Potential Spread of Coronavirus (Caroline Chen, Marshall Allen, Lexi Churchill and Isaac Arnsdorf, ProPublica, 2-28-2020) The CDC designed a flawed test for COVID-19, then took weeks to figure out a fix so state and local labs could use it. New York still doesn’t trust the test’s accuracy.
Drive through testing begins at Edinburgh hospital (BBC News, 2-28-2020)
New California Coronavirus Case Reveals Problems with U.S. Testing Protocols (Anna Maria Barry-Jester and Rachel Bluth, KHN, 2-27-2020)
Estimates fall short of the F.D.A.’s pledge for 1 million coronavirus tests. Health care supply companies and public health officials have cast doubt on the federal U.S. government’s assurances of greatly ramped-up testing for the virus, as complaints continue that the need for testing remains far greater than the capacity. Some companies developing tests say their products are still weeks away from approval. See also What went wrong with the coronavirus tests in the U.S. (Carolyn Y. Johnson and Laurie McGinley, WaPo, 3-7-2020)
‘It’s Just Everywhere Already’: How Delays in Testing Set Back the U.S. Coronavirus Response (Sheri Fink and Mike Baker, NY Times, 3-10-2020).
The Strongest Evidence Yet That America Is Botching Coronavirus Testing (Robinson Meyer and Alexis C. Madrigal, The Atlantic, 3-6-2020) "The haphazard debut of the tests—and the ensuing absence of widespread data about the epidemic—has hamstrung doctors, politicians, and public-health officials as they try to act prudently during the most important week for the epidemic in the United States so far....the capacity to test for the coronavirus varies dramatically—and sometimes dangerously—from state to state."

 

How long will it take to get a vaccine?


CIDRAP COVID-19 Resource Center (Center for Infectious Disease Research and Policy) "You can make a vaccine against anything very quickly. But it needs to be effective and safe. This is a long process that can take months to years, even under optimal conditions." ~ -Michael Osterholm, PhD, MPH


COVID-19 Vax Moving at Brisk Clip, but Will It Be Soon Enough? (Ed Susman, MedPage Today, 3-10-2020) At a medical conference, "Anthony Fauci, MD, said the time from sequencing of the virus -- which arose in central China in late December 2019 -- to human trials of a vaccine candidate is expected to move with unprecedented speed -- around 2 months. Zunyou Wu, MD, of the Chinese Center for Disease Control and Prevention, shared some key insights on COVID-19 from China:
---The majority of cases arise from close contact of symptomatic cases
---Transmission is driven by family clusters
---Second-degree household attack rates were around 10% early in the outbreak, but fell to 3% with faster isolation
---Virus shedding is highest early in the disease course and can occur 24-48 hours before symptom onset
---Virus shedding usually continues for 7-12 days in mild/moderate cases and for >2 weeks in severe cases.
Trump is pushing a dangerous, false spin on coronavirus — and the media is helping him spread it (Margaret Sullivan, Washington Post, 3-1-2020) A vaccine is NOT coming along "rapidly." It will probably take a year to a year and a half, says NIH expert Anthony Fauci. [He has since revised that estimate upward because new steps are being taken.]

 

Coronavirus: A primer


Here’s the Biggest Thing to Worry About With Coronavirus (Aaron E. Carroll, NY Times, 3-12-2020) "A crucial thing to understand about the coronavirus threat — and it’s playing out grimly in Italy — is the difference between the total number of people who might get sick and the number who might get sick at the same time.... Our country has only 2.8 hospital beds per 1,000 people. We don’t have enough ventilators and I.C.U. beds if there’s a significant surge of new cases. As with Italy, the health system could become overwhelmed."  We must "flatten the curve."
The Coronavirus, by the Numbers (James Gorman, NY Times, 3-5-2020) Adam Kucharski, a mathematician who studies the spread of disease, explains some of the figures that keep popping up in coronavirus news.
Coronavirus: A primer (Dr. Jane A. Culp's excellent explanation of basics, Herald-Star, 3-3-2020; bolding added) "There are seven strains of coronavirus known to cause disease in humans. Four of these strains are the alpha form, and three strains are in the beta form. The world has experienced two other outbreaks of beta coronavirus. The first was in 2002 when severe adult respiratory syndrome was first noted in a Chinese province. This beta coronavirus originated in bats and transmitted the virus to another species — the skivat cat. The skivat cat transmitted the virus to humans. The mortality rate for SARS was 9 percent to 10 percent.

     "The second outbreak of a beta coronavirus occurred in 2012 with Middle Eastern respiratory syndrome. MERS originated in camels with transmission to humans. The mortality rate for MERS was at least 36 percent and in some reports listed as being close to 50 percent.

     "That brings us to the present with the novel (new) third beta coronavirus causing the disease COVID19. The animal (possibly a bat) to human transmission first occurred in the Chinese city of Wuhan, home to 11 million people. The mortality rate for COVID19 is estimated at 2 percent to 2.5 percent."
Analysis: One Sure Thing About COVID-19: No Telling How Many People Have It (Elisabeth Rosenthal, Kaiser Health News, 3-3-2020) It has been nearly three months since the first cases of a new coronavirus pneumonia appeared in Wuhan, China, and it is now a global outbreak. And yet, the world still doesn’t have a clear picture of some basic information about this outbreak.
The New Coronavirus Is a Truly Modern Epidemic (Ed Yong, The Atlantic, 2-3-2020) New diseases are mirrors that reflect how a society works—and where it fails.
Here’s a Glossary for the Ongoing Coronavirus Outbreak’s Vocabulary (Dan Robitzski, Futurism/Neoscope, 3-2-2020)

 

 

What to do and not do (and where we can improve)

Matt Pearce (a Los Angeles Times reporter) tweeted: "I imagine all the closures and cancellations give people a sense of ominousness. But it's really an amazing act of social solidarity: We're sacrificing so we can give nurses, doctors and hospitals a fighting chance. Start from there and hopefully we can figure out the rest."


Answers to frequently asked questions about COVID-19 (Harvard Health Publishing) Including What are the symptoms? What should I do if I feel sick? If a loved one gets it, how do I care for them? How do I keep from getting it?
Psst, After You Wash Your Hands, Clean Your Smartphone (Slate)
How to Clean and Disinfect Yourself, Your Home, and Your Stuff (Jess Grey, Wired, 3-19-2020) Including how to do your laundry!
Food Safety and Coronavirus: A Comprehensive Guide (J. Kenji López-Alt, Serious Eats, 3-20-2020) Questions about COVID-19 and food safety, answered.
Keeping the Coronavirus from Infecting Health-Care Workers (Atul Gawande, New Yorker, 3-21-2020) What Singapore’s and Hong Kong’s success is teaching us about the pandemic."The factors that appear to be important in protecting health-care workers from the disease have been insuring meticulous hand hygiene and cleaning; restricting clinics and hospitals to necessary patient visits; shifting as much care as possible to virtual channels (such as phone and video); and applying standard droplet precautions (surgical mask, gloves, and gown) with respiratory patients."
When and how to use masks (WHO, Advice for the public)
COVID-19 - Some Drug-Related Issues (The Medical Letter)
Trump's mismanagement helped fuel coronavirus crisis (Dan Diamond, Politico, 3-7-2020) Current and former administration officials blame the president for creating a no-bad-news atmosphere that stifled attempts to combat the outbreak. Fortunately, we're learning to listen to Dr. Fauci instead of Trump.
Not His First Epidemic: Dr. Anthony Fauci Sticks to the Facts (Denise Grady, NY Times, 3-9-2020) Dr. Anthony Fauci, the nation’s leading expert on infectious diseases, is widely respected for his ability to explain science without talking down to his audience and to correct the president.
The Use of Bleach (Hong Kong health department during SARS crisis). Bleach is a good disinfectant but it's dangerous if misused. Follow instructions!
Interim Guidance for Responding to COVID-19 among People Experiencing Unsheltered Homelessness Key actions that local and state health departments, homelessness service systems, housing authorities, emergency planners, healthcare facilities, and homeless outreach services can take to protect people experiencing homelessness from the spread of COVID-19.
Whether planned surgery should proceed (Centers for Medicare & Medicaid Services). Determining essential vs. elective surgery. "At all times, the supply of personal protective equipment (PPE), hospital and intensive care unit beds, and ventilators should be considered, even in areas that are not currently dealing with COVID-19 infections."
Does Everyone Over 60 Need To Take The Same Coronavirus Precautions? (Judith Graham, KHN, 3-24-2020) If you’re going to the store, consider wearing cloth gloves, because viruses don’t survive as well on soft surfaces. Try not to handle your smartphone when you’re out of the house. “A phone is a hard plastic surface that can easily get contaminated,” she said. Are you frail? Answer these questions: “F: Are you consistently fatigued? R, for resilience: Can you climb a flight of stairs? A, for aerobic: Can you walk a block? I, for illnesses: If you’ve got five or more, that’s bad. L, for loss of weight: That’s not good.” If you answer yes to three or more of those questions, you should be “really careful and self-isolate,” Morley said. ...even healthy people are becoming sick.
Life on Lockdown in China (Peter Hessler, Letter from Chengdu, New Yorker, 3-30-2020) Forty-five days of avoiding the coronavirus. 'There seems to be a brief window—perhaps two or three days—when people are infectious but not yet showing symptoms. Gabriel Leung, the dean of medicine at the University of Hong Kong, told me that he believes between twenty and forty per cent of infections come from people who don’t yet seem sick. “They could be spreading it through droplets, say during eating or speaking,” he said. “These droplets could contaminate surfaces, and this is how it spreads.”'
U.S. Health Workers Responding to Coronavirus Lacked Training and Protective Gear, Whistle-Blower Says (Emily Cochrane, Noah Weiland and Margot Sanger-Katz, NY Times, 2-27-2020) Team members were not properly trained, lacked necessary gear and moved freely around and off military bases where Americans were quarantined, a whistleblower complains.
How prepared are you for disaster? sites geared to helping you prepare for hurricanes, earthquakes, tornadoes, floods and flash floods, and to increase child and campus security. Many of the steps are helpful in a pandemic.
Help fight Medicare fraud (Medicare.gov) Guard your Medicare card like it’s a credit card.
Why Texas is so far behind other states on virus response(Politico, 3-18-2020) Texas leaders have been reluctant to set restrictions conservative voters might consider draconian and business leaders oppose. They’ve also opposed steps to expand health insurance coverage. The state, which didn’t expand Medicaid, has the highest uninsured rate in the country meaning millions of people don’t have doctors to call if they show symptoms.
Coronavirus grocery list: What items you need to buy in case of self-quarantine (Today show) The foods you may need to have in case you or your family needs to self-quarantine.
What am I supposed to do about my fundraising event: Event planning and COVID-19: (Vimeo video, Laura Pierce of Washington Nonprofit and Rebecca Zanatta of Ostara Group, a nonprofit consulting group) Cancel? or something else?
Worries about medical bills and lost pay may hamper coronavirus efforts in the United States (Amy Goldstein, Washington Post, 3-2-2020) The race to curb the spread of the new coronavirus could be thwarted by Americans fearful of big medical bills if they get tested, low-income workers who lose pay if they take time off when sick, and similar dilemmas that leave the United States more vulnerable to the epidemic than countries with universal health coverage and sturdier safety nets. As the test for the virus becomes more widely available, health-care experts predict that some people with flu-like illnesses — or those who may have been exposed — will avoid finding out whether they have been infected because they are uninsured or have health plans that saddle them with much of the cost of their care.
These Common Household Products Can Destroy the Novel Coronavirus (Consumer Reports) On surfaces, that is, and why you need to clean using the right stuff. Soap and water is right up there with disinfectants.
Tipsheet for Journalists: Covering the Coronavirus Epidemic Effectively without Spreading Misinformation (Laura Helmuth, TheOpenNotebook, 3-2-2020) See tip sheets for journalists below.
Avoid cruise ships, says State Department (Noah Weiland and Maggie Haberman, NY Times, 3-9-2020) “Absolutely don’t get on a cruise ship,” says Dr. Anthony Fauci, who has overseen epidemics for decades at NIH/NIAID.
Coronavirus: Fake health advice you should ignore (BBC News, 3-8-2020) Drinking water every 15 minutes (and eating garlic) cannot kill the virus. You should remain well-hydrated, however.
I.O.C.’s Reassurance About the Tokyo Olympics Rankles Some Athletes (NY Times, 3-18-2020) Some athletes on a conference call about whether to cancel the Summer Olympics in Tokyo in July were left dumbfounded when an athlete representative from Europe made a comment playing down the severity of the virus and blaming the news media for hyping its risks. The I.O.C. is insisting the games will go on; the athletes are worried about the health risk.
What you need to know about the coronavirus (Washington Post, 3-3-2020)
Online training as a weapon to fight the new coronavirus (World Health Organization, 2-7-2020) This free learning resource is available to anyone interested in novel coronavirus on WHO’s open learning platform for emergencies, OpenWHO.org.
Here Is What a WHO Global Health Emergency Means (Washington Post) While the recommendations aren’t enforceable, there’s considerable pressure for countries to abide by the WHO’s advisories.
You’re Likely to Get the Coronavirus (James Hamblin, The Atlantic, 2-24-2020) Most cases are not life-threatening, which is also what makes the virus a historic challenge to contain. (WHO)
Basic protective measures against the new coronavirus (ANSInet, 2-29-2020)
Growing Concerns Of Coronavirus Should Spur Plans – Not Panic – In The Workplace (Julie Appleby, Kaiser Health News, 2-28-2020)
World experts and funders set priorities for COVID-19 research (WHO, 2-12-2020)

 

Covering the coronavirus story as a journalist


Coronavirus: Resources for reporters (First Draft News)

Despite pronouncements, no quick turnaround likely for COVID-19 treatments, vaccines (Bara Vaida, Covering Health, AHCJ, 3-20-2020)  "An inaccurate statement that President Trump made during a March 19 news briefing - that the malaria drug hydroxychloroquine had been approved as a COVID-19 treatment - demonstrates how skeptical journalists should remain when covering the unfolding story about treatments and preventative measures. While there are more than 85 trials for vaccines and treatments underway for COVID-19, scientists don't expect them to be available to the public soon, despite what some headlines suggest." President Trump is absolutely NOT a reliable source, and some of the things he's said have caused harm.
Covering COVID-19 and the coronavirus: 5 tips from a Harvard epidemiology professor (Denise-Marie Ordway, Journalist's Resource, 3-6-2020) Choose experts carefully. Distinguish what is known to be true from what is thought to be true — and what’s speculation or opinion. Use caution when citing research findings from “preprints,” or unpublished academic papers. Ask academics for help gauging the newsworthiness of new theories and claims. To prevent misinformation from spreading, news outlets also should fact-check op-eds. Read the work of journalists who cover science topics well.
Presenting Trump and Science as Equals Isn’t Balanced, It’s Dangerous (Neil deMause, Fairness & Accuracy in Reporting, or FAIR, 3-23-2020) Stopping the coronavirus pandemic from taking millions of lives may require news organizations to take sides—but if it’s on the side of science, that’s the kind of bias that journalism needs.
Tipsheet: Covering the Coronavirus Epidemic Effectively without Spreading Misinformation (Laura Helmuth, The Open Notebook, 3-2-2020)
I Lived Through SARS and Reported on Ebola. These Are the Questions We Should Be Asking About Coronavirus. (Caroline Chen, ProPublica, 3-5-2020) Instead of asking: How many test kits do you have? Ask this: How many samples are you running per patient? Instead of saying: The mortality rate is X%. Say this: Scientists estimate the mortality rate is X%, based on the information they have.
Mapping coronavirus, responsibly (Kenneth Field, ESRI, 2-25-2020)
Covering Coronavirus: Expert Tips for Journalists and Communicators (YouTube video, CDC at National Press Club, 2-10-2020, 1 hr 26 minutes) Streamed live, available with comments via LiveStream replay.
Use caution when reporting on pandemic potential of Wuhan coronavirus (Bara Vaida, Association of Health Care Journalists, 1-23-2020)
Finding the latest COVID-19 studies — and covering them thoughtfully (Tara Haelle, Covering Health, AHCJ, 3-20-2020) In the early days of the coronavirus pandemic, most data came from news reports, clinical summaries and preprints. Now more and more peer-reviewed studies are coming out each day, and it's challenging to keep up with them. Several journals have set up dedicated coronavirus sites that can help in keeping up with the research. The Lancet's COVID-19 Resource Centre, JAMA Network's COVID-19 resource center and NEJM's Coronavirus (COVID-19) page all include the newest studies, commentary and related data and information on the pandemic.
The Simplest Way to Spot Coronavirus Misinformation on Social Media (Will Oremus, OneZero, 3-4-2020) A digital literacy expert shares his method. Fact-check!
The many challenges of covering the coronavirus (Jon Allsop, CJR, 3-9-2020) The challenge here is to communicate nuance and uncertainty in formats—headlines, tweets, and so on—that reward brevity and clarity.
What Investigative Reporters Around the World Need to Be Asking About COVID-19 (Amruta Byatnal, Global Investigative Journalism Network, 3-10-2020) Q&A with Thomas Abraham, an expert on infectious disease and global health security, and the author of Twenty-first Century Plague: The Story of SARS and of Polio: The Odyssey of Eradication. Remember that science evolving as rapidly as this is hedged by huge amounts of uncertainty.
How newsrooms can tone down their coronavirus coverage while still reporting responsibly (Al Tompkins, Poynter, 3-4-2020) When you do anecdotal stories about sickness and death from coronavirus, infuse them with the data that points out the wider context of the issue.
How to name a coronavirus ( Merrill Perlman, CJR, 2-24-2020)
10 tips for journalists covering COVID-19 (Taylor Mulcahey, International Journalism Network, 3-5-2020)
How to Report on the COVID-19 Outbreak Responsibly (Bill Hanage, Marc Lipsitch, Scientific American, 2-23-2020) Reporting "should distinguish between at least three levels of information: (A) what we know is true; (B) what we think is true—fact-based assessments that also depend on inference, extrapolation or educated interpretation of facts that reflect an individual’s view of what is most likely to be going on; and (C) opinions and speculation."

 

SARS, MERS, and other forms of coronavirus


Coronavirus (World Health Organization) Coronaviruses are zoonotic, meaning they are transmitted between animals and people. Detailed investigations found that SARS-CoV was transmitted from civet cats to humans and MERS-CoV from dromedary camels to humans. Several known coronaviruses are circulating in animals that have not yet infected humans.
• "In 2002, SARS spread virtually unchecked to 37 countries, causing global panic, infecting more than 8,000 people and killing more than 750. MERS appears to be less easily passed from human to human, but has greater lethality, killing 35% of about 2,500 people who have been infected." ~ The Guardian
COVID-19, MERS & SARS (NIH/NIAID) Coronaviruses (CoV) are a large family of viruses that cause illness ranging from the common cold to more severe diseases such as Middle East Respiratory Syndrome (MERS-CoV) and Severe Acute Respiratory Syndrome (SARS-CoV). A novel coronavirus (nCoV) is a new strain that has not been previously identified in humans.

     Research evidence suggests that SARS-CoV-2, MERS-CoV, and the original SARS-CoV all originated in bats. SARS-CoV then spread from infected civets to people, while MERS-CoV spreads through infected dromedary camels to people. Scientists are trying to determine how SARS-CoV-2 spread to people.    
Middle East respiratory syndrome coronavirus (MERS-CoV) (WHO)
Severe Acute Respiratory Syndrome (SARS)

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Overcoming Flu Vaccine Hesitancy: The Caregiver's Resource Sheet

Flu: Quick Start Resources
CDC's Flu Overview
Emergency Flu Symptoms (VeryWellHealth) Symptoms such as difficulty breathing, shortness of breath, and chest pain or severe abdominal pain indicate a need to go to the hospital. Click here for all symptoms and more information: https://www.verywellhealth.com/when-you-should-go-to-the-hospital-with-the-flu-770306
Flu Prevention Prevent the flu to the best of your ability by taking certain key steps such as vaccinating and keeping your hands and common surfaces clean. Learn more tips here: www.healthyessentials.com/wellness-solutions/cold-flu-prevention-tips
Flu Vaccine Finder (CDC)

Flu Vaccine Fact List
Flu Shot Fact and Fiction (NPR)
Flu Vaccine Side Effects
Complete Guide to the 2019-2020 Influenza Vaccine

 

Overcoming Flu Vaccine Hesitancy

When Flu Facts Aren't Enough, Use Persuasion: Managing Vaccine Resistant Attitudes and Beliefs
Talking Points About the Flu
Flu Shots and Persuasion
Seven Ways to Talk to the Vaccine Hesitant that might actually change their minds.
How to Respond to Vocal Vaccine Deniers in Public (Best Practice Guidance)
Explaining 'Herd Immunity' May Convince More People to Get Flu Shots
Anonymous Nurse: Convincing Patients to Get Vaccinated Is Becoming More Difficult
Patients Skeptical of the Flu Vaccine? Here’s How to Reason With Them
Understanding Extreme Vaccine Hesitancy Anti-Vaxxers: Singular in Focus, Varied in Argument. Four distinct types of anti-vaccination content seen in Facebook posts: 1) Mistrust of scientific community ("doctors uneducated, parents need to educate selves"), mandatory vaccination threatens ability to make decisions about own children; 2) mistrust of chemicals in vaccines, preference for homeopathic approaches; 3) Safety-- belief that vaccines cause autism, that kids who don't get vaccinated are healthier; 4) 'Conspiracy: government "hides" information that anti-vaccination groups believe to be facts.'


Links courtesy of the CDC and the Public Health Corps

("Putting the Public Back Into Public Health")

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Autopsies: when and why and how


Wikipedia provides a useful overview of Autopsy. For example: The four main types of autopsies:

Medico-Legal Autopsy or Forensic or coroner's autopsies seek to find the cause and manner of death and to identify the decedent. They are generally performed, as prescribed by applicable law, in cases of violent, suspicious or sudden deaths, deaths without medical assistance or during surgical procedures.

Clinical or Pathological autopsies are performed to diagnose a particular disease or for research purposes. They aim to determine, clarify, or confirm medical diagnoses that remained unknown or unclear prior to the patient's death.

Anatomical or academic autopsies are performed by students of anatomy for study purpose only. Virtual or medical imaging autopsies are performed utilizing imaging technology only, primarily magnetic resonance imaging (MRI) and computed tomography (CT).
When and why are autopsies done? (WebMD) Autopsies don't always have to be done. If you do need one, it's usually both a medical and a legal process. Every local government has an official who records deaths. She's called either a coroner or a medical examiner. All but a handful of states require medical examiners to be doctors. Coroners may be doctors as well, but don't have to be.
What Happens in an Autopsy? Tara Long, The Seeker, 8-26-14) We've all seen autopsies performed on television shows. Are these depictions accurate? Tara explains everything that happens during an autopsy.
How Autopsies Work (Robert Valdes & Patrick J. Kiger, How Stuff Works)
Without Autopsies, Hospitals Bury Their Mistakes (Marshall Allen, Pro Publica, 12-15-11) Hospital autopsies have become a rarity. As a result, experts say, diagnostic errors are missed, opportunities to improve medical treatment are lost, and health-care statistics are skewed.
A Day in the Life of an Embalmer (YouTube, Tobin Brothers Funerals, 10-minute video)
Verbal autopsies used in push to better track global deaths (Christina Larson and Mike Stobbe, AP in WaPo, 10-6-19) A "verbal autopsy" is an interview in which a trained health worker asks a close relative or caretaker about a recently deceased person. Increasingly, health officials are using these tools and their computer algorithms to learn more about the global course of human disease. About 50 countries have attempted verbal autopsy projects, and the list is growing. Bloomberg Philanthropies — a major funder of international health data initiatives — is funding verbal autopsies as well as cancer registries and other programs intended to help developing countries gather accurate data about the health of their citizens. An estimated 60 million people in the world will die this year, and half will have no death certificates or other records describing what killed them. Most will be in low- and middle-income countries, particularly in Africa and parts of Asia. That means the common understanding of overall disease and mortality trends in the developing world often relies upon broad estimates and guesswork. Knowing what's killing people can be tricky. U.S. doctors are required to sign death certificates, but recent studies suggest some doctors put down certain conditions as a default, which is one reason some experts believe heart disease has been over-reported as a cause of death in the U.S.
Verbal autopsy methods questioned (Declan Butler, Nature, 2010) Controversy flares over malaria mortality levels in India.
Use of verbal autopsy to determine mortality patterns in an urban slum in Kolkata, India (Suman Kanungo et al, WHO, 2010)
Searching cause of death through different autopsy methods: A new initiative (Abhishek Das and Ranadip Chowdhury, NCBI: Family Med Prim Care. 2017;6(2):191–195. doi:10.4103/jfmpc.jfmpc_194_16) Extensive bibliography leads to unexpected articles.
Bill And Melinda Gates: Autopsies Could Prevent Epidemics, Save Countless Lives (Dominique Mosbergen, HuffPost, 5-15-15) Bill and Melinda Gates believe that performing "minimal autopsies" on dead children could save countless lives. Last week, the Gates Foundation announced that it was investing $75 million in a series of "disease surveillance sites" that will conduct post-mortem examinations on children in order to figure out "how, where and why children are getting sick and dying." Dubbed the Child Health and Mortality Prevention Surveillance Network, or CHAMPS, the program will initially be launched in six locations in Africa and South Asia. Knowing what children are dying from could help pinpoint a new disease or nip an emerging epidemic in the bud. Gates said he believes that such a system could have proved exceedingly useful in the case of the recent Ebola epidemic, for instance. See also Bill Gates's Quest to Determine Why Children Are Dying (Olga Khazan, The Atlantic, 5-6-15) The Gates Foundation's 'Child Health and Mortality Prevention Surveillance Network, or CHAMPS, will be spread initially throughout six locations in Africa and South Asia. It will rely on field workers to take biopsies of children who have perished and on beefed-up laboratories that will perform medical testing... a "global warning and response system" that's geared toward outbreaks like Ebola.'
Breakthrough in how autopsy practice is conducted worldwide (Science Daily, 5-24-17) A ground-breaking study by Guy Rutty and Bruno Morgan from the University of Leiceste (pathologists and radiologists) could represent a breakthrough in how autopsy practice is conducted in the United Kingdom and around the world. A previous study of PMCT published in the Lancet in 2012 showed promise for using medical imaging to investigate the cause of natural death, but with a major weakness: the inability to diagnose coronary artery disease, the most common cause of natural death. Professor Morgan explained: "In clinical CT scanning, a contrast agent is injected into a vein and circulation delivers it around the body. This allows the CT scan to show the state of blood vessels anywhere in the body. However, the lack of circulation in cadavers means these techniques cannot be used." This has been overcome by developing a novel minimally invasive coronary artery angiography technique.

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Notes on True Justice: Bryan Stevenson's Fight for Equality

Following are my notes from a screening by the American Film Institute of TRUE JUSTICE: BRYAN STEVENSON'S FIGHT FOR EQUALITY, the documentary that opened the AFI Doc Festival in DC on June 19, 2019. Based on Bryan Stevenson's book Just Mercy: A Story of Justice and Redemption, an Amazon bestseller that got 3,603 customer reviews (averaging five stars).

 

There have been four stages of racial injustice in the United States, says Stevenson:
Slavery
Lynching, 1877-1950
Segregation
Mass incarceration.

 
Lynching, 1877-1950. The North prevailed after the Civil War, but the South won the narrative. An 1876 Supreme Court decision allowed lynching to go for decades -- and, in the South, a reign of terror and violence.Between 1877 and 1950, there were 4,075 lynchings of African Americans in 12 Southern States, according to the Equal Justice Initiative. Two hundred bills were introduced in Congress to make lynching illegal, but none succeeded in being enacted into legislation until two decades into the 21st century (2018). See The U.S. Finally Made Lynching a Federal Crime (Brigit Katz, Smithsonian, 12-21-18)


Segregation. In Brown v. Board of Education, 347 U.S. 483 (1954), the Supreme Court outlawed segregated public education facilities for blacks and whites at the state level. The Civil Rights Act of 1964 superseded all state and local laws requiring segregation.

 

Mass incarceration and the death penalty. Statistics for 1980 thru 2019 are shocking. Look at statistics on the U.S. state and federal prison population from 1925 through 2017, on this Trends in U.S. Corrections. According to The Sentencing Project "The United States is the world's leader in incarceration with 2.2 million people currently in the nation's prisons and jails — a 500% increase over the last forty years. Changes in sentencing law and policy, not changes in crime rates, explain most of this increase. These trends have resulted in prison overcrowding and fiscal burdens on states to accommodate a rapidly expanding penal system, despite increasing evidence that large-scale incarceration is not an effective means of achieving public safety."
Fear and anger are the essential ingredients of injustice—why we put so many people wrongfully in prison. We spend all that money to keep people in prison in a system where enough money can buy "not guilty."
A 2005 Supreme Court decision made it illegal to give children a death sentence. Instead, many of those in prison for life sentences are children who were tried in adult courts. One in three black male children now expect to go to prison (and the number of black women in prison is increasing, too). Many of these prisons are now privately fun. See What's wrong with America's prisons.

 

Stevenson's focus is on all those black people who are improperly convicted (without a proper defense) or unfairly sentenced. As for the death penalty: "Since 1973, 166 people have been released from death row after evidence of their innocence was uncovered. A shocking rate of error has emerged: for every nine people executed in this country, one innocent person has been exonerated."  One in ten wrongful executions is an unjustifiable standard. We have to do better at winning the narrative battle, says Stevenson. "Truth-telling changes you."



Visit the new National Memorial for Peace and Justice, informally known as the National Lynching Memorial, a national memorial to commemorate the victims of lynching in the United States -- to acknowledge past racial terrorism and advocate for social justice in America. 

 

Excerpt from

The Black Family and Mass Incarceration by Bruce Western and Christopher Wildeman

(see also The Moynihan Report)

"Mass imprisonment of the late 1990s can be traced to two basic shifts in politics and economics. The growth of harsh sentencing policies and a punitive approach to drug control began with a rightward shift in American politics, first visible at the national level in the mid-1960s. Barry Goldwater's ill-fated presidential run in 1964 was pivotal (Beckett 1997; Gest 2001). Goldwater, in accepting the Republican nomination, warned that crime and disorder were threats to human freedom, and freedom must be 'balanced so that liberty lacking order will not become the license of the mob and of the jungle.' The Republican campaign of 1964 linked the problem of street crime to civil rights protest and the growing unease among whites about racial violence.
"Although Goldwater was roundly defeated by Lyndon B. Johnson, conservatives within the Republican Party had brought to the national stage a new kind of politics. Historically, responsibilities for crime control were divided mostly between state and local agencies. The Republicans had placed the issue of crime squarely on the national agenda. What is more, by treating civil rights protest as a strain of social disorder, veiled connections were drawn between the crime problem, on one hand, and black social protest, on the other."

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Health news and advice (top sites)

Looking for good articles about health and wellness? Here are links to some of the best.
Kaiser Health News
Jane E. Brody (New York Times)
Well (New York Times section)
Medical links for patients, families, and caregivers
Shots (Health news from NPR)
Where journalists get their medical news and information
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How prepared are you for disaster?

Updated and organized 3-29-2020

Sites geared to helping you prepare for poisoning, pandemics, hurricanes, earthquakes, tornadoes, flood and flash floods, fires, and disasters and emergencies generally. Let me know in comments if anything important is missing.

 

PREPARING FOR DISASTERS AND EMERGENCIES, GENERALLY
A preparation & safety awareness guide for travellers (Postcard Travel)
How to Pack an Emergency Kit for Any Disaster (Kenneth R. Rosen, NY Times, 7-3-17) The Life Straw "is Mr. Smyth’s choice for purification straws you can drink water through." If you have a container to drink from, iodine water purification tablets  Read More 

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The flu: what you need to know

assembled by Pat McNees, updated 11-19-19
A Guide to the Seasonal Flu for Seniors (National Council for the Aging)
Flu Shots (elsewhere on this website)
Influenza virus in China remains potential pandemic threat (Bara Vaida, Covering Health, AHCJ, 12-5-18) A strain of an influenza virus now circulating in China remains a potential pandemic threat while many gaps remain in preparing for such an event, a group of global health experts at the National Academy of Sciences (NAS) warned last month. The virus spreading in China, called H7N9 (flu virus names reflect their protein makeup) first emerged among poultry workers in 2013 and has sickened 1,567 people and killed 615.
A Century After the 1918 Flu Pandemic: Why Are We Still Concerned Today? (National Academy of Medicine event, 11-26-18) Webcast said to be available.
In the Flu Battle, Hydration and Elevation May Be Your Best Weapons (Kate Murphy, NY Times, 1-12-18). A good explanation of how the flu works and how to deal with it. Drink a cup or so of water or other liquid every hour, and avoid alcoholic and caffeinated beverages. Over-the-counter medications that suppress your cough and dry your sinuses may not be the best idea; you want to get rid of the infection. 'Although you want to rest, lying flat all the time can be problematic because it collapses your lungs so you can’t cough as efficiently, trapping bacteria in your respiratory tract. If the virus destroys enough cells in your bronchial tubes it creates openings for bacteria to get into your lungs, which can lead to pneumonia, a potentially life-threatening complication of the flu. When your lungs are vertical rather than horizontal, “you’re able to breathe deeply and freely  Read More 

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Medical links for patients, families, and caregivers

After links to dictionary-style online sites come links to helpful sites with a more specific focus. Alphabetical order.
Cochran Library Evidence-based medicine. Review. Database. Trials. More resources.
The Dartmouth Atlas of Health Care (slow loading)
Drugs.com (a free drug information service)
First Aid (Mayo Clinic's alphabetical links to how to  Read More 

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Helen Jean Medakovich Sarchielli(1939-2000)

Some deaths come too soon and Helen Jean Medakovich’s was one of them. When she succumbed to lung cancer on October 11, 2000, she was not yet 61—and she was a young 60. It was not only that she was too young to die—it was that she was so unlikely a person to stop being alive. Being alive was what Helen Jean did best.  Read More 
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