outbreak! (ebola, sars, coronavirus, etc)

oh, whoops! i misread your post to say "hostility toward the masked", my bad

Both are bad!

The efficacy of face masks against the spread of COVID-19 is unknown.

hmm is this really true?

― sleeve, Wednesday, May 27, 2020 3:18 PM (forty-two minutes ago) bookmarkflaglink

empirically, the truth is we don’t know exactly and will probably never know. I can be as dogmatic as anyone about the importance of randomized trials when it comes to medications I prescribe, but up till now it has been more or less impossible to design a study on mask-wearing that will really answer the question we want to know, which is whether wearing masks reduces risk of transmission of [viral illness of interest]. I read the major trials a few weeks ago because, like you and karl, I was frustrated by the obstinacy of people whose opinions I respect when it comes to medical evidence who insisted that mask-wearing not be compelled in the absence of convincing evidence in its favor. the trials are mostly small, and the patients in the mask-wearing arms rarely actually wore the masks; not surprisingly, it has been difficult to show statistically a clear effect. this also gets at the deeper issue of what question randomized trials actually test, which even many doctors have difficulty grasping: these studies attempted to probe the effects of recommending mask-wearing; it is much more challenging to study the effects of actually wearing a mask. it is evident that, in more normal times, the benefits of recommending that people with the flu or another viral illness wear masks to protect family members (or vice versa) are likely marginal. what is worth debating is whether those data are necessarily generalizable to our current setting, when the topic of infectious disease and its spread is almost unavoidable, and the number of people who potentially stand to benefit is much greater. common sense, and basic knowledge of droplet kinetics, dictate that wearing masks most likely provides a small benefit that, considered at the scale of all of american society, probably translates to many lives saved.

the benefits of recommending that people with the flu or another viral illness wear masks to protect family members (or vice versa) are likely marginal.

Medical lab tech Katie Corley coughed on two petri dishes, one while wearing a mask, and one without a mask. (From her public FB post.) pic.twitter.com/Ez65r2lE2r

— Sophie Rapp (@SophieSRapp) May 25, 2020

https://pbs.twimg.com/media/EY0zg0XU0AAn5RJ?format=jpg&name=small

Yes but please let's keep obsessing about whether an imperfectly worn mask is better than nothing, thxbye

so that's confirmed then?

bacteria and viruses are different things

yes, and she addressed this, because she is a medical tech

1. I used a cloth mask I made myself with disposable lab coat material.
2. I used blood agar.
3. The plate on the right looks "old" or "stale" because of the growth. Some of the organisms on this plate are alpha hemolytic, meaning they partially hemolyze blood. The agar itself is made with 5% sheep's blood, so when it's partially hemolyzed, it turns a dark green color.
4. As for the growth, it's mostly viridans strep, staph species (not staph aureus), neisseria species, and corynebacterium. Pretty normal oral flora.
5. I realize that viruses are 1,000 times smaller than bacteria. The point of the masks is to prevent droplet spread, which carry bacteria as well as viruses.

basic knowledge of droplet kinetics, dictate that wearing masks most likely provides a small benefit that, considered at the scale of all of american society, probably translates to many lives saved.

― k3vin k.

now we're talking, thank you sir

link from another M.D. friend:

After evidence revealed that airborne transmission by asymptomatic individuals might be a key driver in the global spread of COVID-19, the WHO recommended universal use of face masks. Masks provide a critical barrier, reducing the number of infectious viruses in exhaled breath, especially of asymptomatic people and those with mild symptoms (12) (see the figure). Surgical mask material reduces the likelihood and severity of COVID-19 by substantially reducing airborne viral concentrations (13). Masks also protect uninfected individuals from SARS-CoV-2 aerosols (12, 13). Thus, it is particularly important to wear masks in locations with conditions that can accumulate high concentrations of viruses, such as health care settings, airplanes, restaurants, and other crowded places with reduced ventilation. The aerosol filtering efficiency of different materials, thicknesses, and layers used in properly fitted homemade masks was recently found to be similar to that of the medical masks that were tested (14). Thus, the option of universal masking is no longer held back by shortages.[...]

Aerosol transmission of viruses must be acknowledged as a key factor leading to the spread of infectious respiratory diseases. Evidence suggests that SARS-CoV-2 is silently spreading in aerosols exhaled by highly contagious infected individuals with no symptoms. Owing to their smaller size, aerosols may lead to higher severity of COVID-19 because virus-containing aerosols penetrate more deeply into the lungs (10). It is essential that control measures be introduced to reduce aerosol transmission.

https://science.sciencemag.org/content/early/2020/05/27/science.abc6197

i did not realise that the federal govt spent 10s of millions to help develop remdesivir:

https://www.washingtonpost.com/business/2020/05/26/remdesivir-coronavirus-taxpayers/

sigh

More than 100 scientists and clinicians have questioned the authenticity of a massive hospital database that was the basis for an influential paper published last week that suggested the use of chloroquine and hydroxychloroquine to treat people with Covid-19 did not help and may have increased the risk of abnormal heart rhythms and death.

In an open letter addressed to The Lancet’s editor, Richard Horton, and the paper’s authors, they asked the journal to provide details about the provenance of the data and called for the study to be independently validated by the World Health Organization or another institution.

To paraphrase Didier Raoult, the French doctor who started it all, ‘I dare you, run a poll between me and Véran [France’s minister of health], we’ll see who comes out on top’.

the sad thing about this controversy is it's all centering around a paper that, due to the limits of its design, should not change our view of whether HCQ/CQ works one way or another

Senator Bob Casey Jr., Democrat of Pennsylvania, announced he has tested positive for coronavirus antibodies after experiencing mild symptoms. He’s the third senator known to have a confirmed case.

xpost seriously - even if the study was flawed, there isn't a (non-discredited) study which shows that it IS.

and my friend who takes a maintenance prescription for HCQ actually had his latest RX reduced to 30 pills instead of 90 as his carrier cited there was a shortage in availability, presumably due to the extra people taking it for COVID-19.

same, i have a friend with lupus who takes it

If the one human trial is a good indicator, the efficacy of remdesivir against COVID-19 is very modest. According to that WaPo article, the 'break even' cost for the patent-holding company could be around $1/dose. The eventual price should reflect those two factors... but will it?

Martin Shkreli to thread

https://news.sky.com/story/coronavirus-monkeys-escape-with-covid-19-samples-after-attacking-lab-assistant-11996752

Did not have that one on my 2020 dumpster fire bingo card.

come ON

Looks like Trump made good on his threat and is going to pull the US out of the WHO.

They should tell him they need six months’ notice.

so now researchers have figured out how COVID-19 causes so many different symptoms in different organs: It is a disease of the blood vessels. They hope that this will point toward possible treatments.

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30937-5/fulltext

Toward the end:

This hypothesis provides a rationale for therapies to stabilise the endothelium while tackling viral replication, particularly with anti-inflammatory anti-cytokine drugs, ACE inhibitors, and statins.

Presumably, since this article was listed as published in late April, this treatment strategy has been attempted in some cases and some preliminary data collected, even if there have not been any trials. I wonder how its going.

people keep touting this blood vessel angle since then but i haven't seen anything really decisive on it (not that i've been paying as much attention the past couple few weeks)

not now ebola

https://www.who.int/news-room/detail/01-06-2020-new-ebola-outbreak-detected-in-northwest-democratic-republic-of-the-congo-who-surge-team-supporting-the-response

USA deaths: after 5 weeks of steady decline, the 7-day moving average is trending positive for the first time since late-April.

what a nightmare

I'm dreading the numbers 4-6 weeks from now

average new cases and hospitalizations have been ticking up in Austin over the last week+

everything plateaued, so they opened things up without letting real decreases happen, genius move

In all fairness, what even is a "plateau"

In this context, I believe it means something like 'when people really really want to start doing normal things again, no seriously like really a lot, do you even know how boring it is being inside all the time'.

Nothing on the top but a bucket and a mop
And an illustrated book about birds

otm

where is charley harper when we need him most

I've hardly thought about COVID all week (and yes, "I'm dreading the numbers 4-6 weeks from now"). Has this been posted on any of the relevant threads?

http://www.cnn.com/world/live-news/coronavirus-pandemic-06-03-20-intl/h_d9360b4e277953a4490fa5ee17285938

He's always seemed pretty cautious with such pronouncements.

The plan is to manufacture doses of the vaccine even before it is clear whether the vaccines work, making close to 100 million doses by November or December, Fauci said. That’s so if it does work, it can be deployed quickly.

I saw that after I posted--he still sounds optimistic.

“Which tells us, that if the body is capable of making an immune response to clear the virus of natural infection, that’s a pretty good proof of concept,” Fauci said. “Having said that, there is never a guarantee.”

He was a 12-18 months person early on with regards to a vaccine, so early 2021 almost fits that timeline--maybe 2-3 months ahead.

"The US should have 100 million doses of one candidate Covid-19 vaccine by the end of the year, Dr. Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases (NIAID) and a member of the White House coronavirus task force, said Tuesday.

“Then, by the beginning of 2021, we hope to have a couple hundred million doses,” Fauci said during a live question and answer session with the Journal of the American Medical Association.

uh, what happens between the end of this year and the beginning of 2021? do all other objects get doubled as well? might be a good time to put all your money out on the lawn, make a quick profit for the new year

lol

please touch the Orb of Doubling again Mr. President

but the Orb of Doubling carries a 10% chance of losing it all!!

tbh 2020 is the kind of year where you roll the dice anyway

The second one is a quote, and the first is a weird summary of a quote from one of those guys that's always keen to have an argument about how many 'several' is, and you can tell that he wants the answer to be 'seven'

Cases in Texas are on the rise. So is the positive rate. pic.twitter.com/Qa4iGquhWf

— Topher Spiro (@TopherSpiro) June 2, 2020

^ whole state-by-state rundown thread, fyi

Meanwhile, I think I saw (and while the exact numbers may be off the gist remains the same) that after a bunch of contact tracing in Hong Kong, they determined that a small handful of super-spreader events accounted for a huge number of cases, but of those who contracted Covid, 70% did not pass it along. For some reason certain people just spread the fuck out of this.