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Sunday, November 29, 2020

Homelessness during the Covid-19 pandemic


I saw this segment on the CBS Sunday Morning show.
I will be buying her books.

Recall my March 2019 about "health care for the homeless in Baltimore."

Recent local news:
From Apollo's Arrow:
...for the over half a million homeless people in the United States, the directive to “stay home, stay safe” (rural Vermont’s coronavirus message) must have seemed ludicrous, if not infuriating.55 Unsurprisingly, a study of 402 homeless adults sleeping in a shelter in Boston on April 2 and April 3, 2020, found that 36 percent of them tested positive for SARS-2, whereas in the city as a whole at the time, the percentage was likely less than 2 percent...

Christakis, Nicholas A.. Apollo's Arrow (p. 192). Little, Brown and Company. Kindle Edition.

[Nov 30th update] November will end with more than 4.3 million new US Covid-19 cases. Perhaps 80,000 of those people will be dead by January 2021.

Thursday, November 26, 2020

"Happy" Thanksgiving 2020

We're hunkered down at our house, grateful to simply be alive, sheltered, and thus far Covid-free. As frustrated by this again-spiking pandemic as anyone.

Stay safe and well.
I am deep into "Apollo's Arrow." Bracing. Illuminating. Highly recommended. Another great place within which to hide a $100 bill from Donald Trump.
…There is something about a threat that reoccurs at the dim reaches of living memory, every fifty or one hundred years, that makes our species seem particularly small. When such a threat reappears, human suffering is combined with the sad realization that we should have seen it coming. Epidemics generally take advantage of the deepest and most highly evolved aspects of our humanity. We evolved to live in groups, to have friends, to touch and hug each other, and to bury and mourn one another. If we lived like hermits, we would not be victims of contagious disease. But the germs that kill us during times of plague often spread precisely because of who we are. And so for centuries, our response in a time of plague has been to rediscover the necessity of surrendering these aspects of our nature for a while.

We forget the lessons of past pandemics for different reasons. In some cases, they are simply too far back in our collective memory or too obscured by other events. Those plagues have become objects of inquiry to small groups of academic historians or scientists or they are subjects of oral traditions or myths. During Passover in early April 2020, several of my Jewish friends observed that biblical plagues had always been abstract for them, but now they felt more real; the point of the story at the seder was more manifest. In other cases, the reasons for forgetting are more prosaic, more epidemiological, more related to numbers: the particular pandemic disease was not fatal enough (2009 H1N1 influenza), or it did not afflict enough people because it was not infectious enough (MERS), or it burned out too fast (SARS-1), or it afflicted a confined subgroup of the human population (Ebola), or it was brought low by a vaccine (measles and polio), or by treatment (HIV), or by eradication (smallpox), allowing most people to simply push the disease out of their minds.

While the way we have come to live in the time of the COVID-19 pandemic might feel alien and unnatural, it is actually neither of those things. Plagues are a feature of the human experience. What happened in 2020 was not new to our species. It was just new to us.

Christakis, Nicholas A.. Apollo's Arrow (pp. 83-84). Little, Brown and Company. Kindle Edition.
FALL 2020

Sunday, November 22, 2020

Honoring our nurses


From 1993 to 2013, I served three intermittent tenures with the Nevada / Utah Medicare QIO, HealthInsight (hospitalization outcomes analyst, Novell network administrator, Health IT workflow advisor). Most of my colleagues, including senior management, were nurses. I could not have more respect for their abilities and dedication. The medical system could not function at all without them. That has never been more clear, and as we head into our dark winter of renewed Covid-19 incidence and prevalence acceleration, it will become acutely more evident. We now have numerous reports of acute care staffing shortages (nurses predominantly among them).


I have been an ICU nurse for 17 years. I never thought I'd leave. Now I'm not sure I'll ever go back. 

I've been on the front lines of Covid-19 since it broke out eight months ago. More than 250,000 people have now died in the United States. Case numbers are rising in all 50 states and Washington, D.C.And health care workers like me are burning out. 

Meanwhile, President Donald Trump spends his weekends golfing, and Majority Leader Mitch McConnell sent the Senate home for Thanksgiving vacation a day early, even though the Centers for Disease Control and Prevention just advised against holiday travel. 

I wish medical workers could take vacation days, too. I ran out of those months ago, when I contracted Covid-19 treating patients in the ICU. I'm exhausted. I'm angry. I'm sick of watching patients die. I'm tired of comforting families feeling guilty over the birthday party that cost their loved one's life. 

I finally hit my breaking point and recently quit doing direct patient care in a hospital setting. Without sufficient personal protective equipment and staffed hospital beds, a national plan for testing and sufficient relief for those hardest hit by the virus, including hospitals, I didn't have the strength to continue...


Prime movers of this initiative.

Notwithstanding that I'm Irish, I have always dug the hell out of Latinx music. The Estefans are totally awesome.

Below, my friends' band in Las Vegas. Eclectic top-shelf salsa / funk / jazz. I'd love to see Emilio and Gloria sit in with them.

Read a review in Science. Had to get it.
In 2019, the Global Health Security (GHS) Index ranked the United States as the most prepared country in the world for a pandemic. Just over a year later, the United States has not only failed to control coronavirus disease 2019 (COVID-19), many consider the nation's response to the pandemic to be one of the worst in the world. Was the GHS Index biased? Or did the country's preparedness change drastically during this period?

Answering these questions requires understanding the pandemic as a complex system— one that reveals our greatest strengths and most debilitating weaknesses. In his provocative new book, Apollo's Arrow, Nicholas Christakis uses such an approach, drawing on his experience as both a hospice physician and a leading network scientist to integrate societal, technological, and biological data into a single cohesive narrative of the unfolding pandemic. Not surprisingly, the book is far-ranging, covering relevant aspects of epidemiology, human behavior, social networks, technology, immunology, and applied mathematics...

...There is no shortage of books that argue that pandemics are complex or ones that discuss the public health issues raised in Apollo's Arrow, and it is unlikely that there will be a shortage of future works that dissect domestic and international responses to the COVID-19 pandemic. What sets Christakis's work apart is that it was written in real time by an expert who astutely shows how pandemics are as much about our societies, values, and leaders as they are about pathogens.


Friday, November 20, 2020

Tuesday, November 17, 2020

Covid19 vaccine(s)? Science?

"...It’s better to get a cancer diagnosis from a radiologist than from a Ouija Board. It’s better to learn about the age of the universe from an astrophysicist than from a Rabbi. The New England Journal of Medicine is a more reliable source about vaccines than the actress Jenny McCarthy. These preferences are not ideological. We’re not talking about Fox News versus The Nation. They are rational, because the methods of science are demonstrably superior at getting at truths about the natural world.

I don’t want to fetishize science. Sociologists and philosophers deserve a lot of credit in reminding us that scientific practice is permeated by groupthink, bias, and financial, political, and personal motivations. The physicist Richard Feynman once wrote that the essence of science was “bending over backwards to prove ourselves wrong.” But he was talking about the collective cultural activity of science, not scientists as individuals, most of whom prefer to be proven right, and who are highly biased to see the evidence in whatever light most favors their preferred theory.

But science as an institution behaves differently than particular scientists. Science establishes conditions where rational argument is able to flourish, where ideas can be tested against the world, and where individuals can work together to surpass their individual limitations. Science is not just one “faith community” among many. It has earned its epistemological stripes. And when the stakes are high, as they are with climate change and vaccines, we should appreciate its special status."


WHY should we trust science? Again, here's why.


We'll see.

"...Both vaccines also have a good safety profile so far. They have the usual vaccine side effects such as irritation at the vaccine site, fatigue, fever, and aches. So far no serious adverse events that would doom the vaccine. The FDA wants at least two months of safety follow up for at least half of the subjects enrolled in each trial, and this will happen by the end of November. Then the FDA will review the data and consider granting an emergency use authorization (EUA). Final approval will come later after the trials are complete. This means the companies will be able to start manufacturing and distributing millions of doses by the end of the year. Significant vaccination of the general population will likely not happen until the Spring of 2021, with life returning to normal by the Winter of 2021 if all goes well."
Some good news for a change.

BTW, I just checked JHU, 2.2 million new US Covid cases in November thru the 17th.

Charitably, assume that perhaps 25,000 of those losses were inevitable even given an actual A+ federal response effort.


Pretty cool cover art. Click the imsge.

Saturday, November 14, 2020

Buckle up and batten down, America

"Cases, Cases, Cases" continued...

Friday, Nov 13th, 184,514 new Covid19 cases reported by JHU.

1,579,137 new cases since Nov 1st.
I keep having to re-scale my Y-axis.

We're probably not far from new state-level lockdown orders. My Governor Hogan has already ordered new scale-back measures. We're approaching 250,000 US Covid19 deaths—most of them avoidable given a concerted federal public health response.

It's all getting really tiresome. For everyone, I'm sure.

COVID-19 Is Out of Control. What Can We Do?

We need a one-two punch to knock the virus down and then keep it down.

Thomas R. Frieden

Former director of the U.S. Centers for Disease Control and Prevention

The coronavirus is growing out of control. Deaths will likely increase to 2,000 people a day before the end of the year, and the virus will be with us for much of 2021 and possibly longer. Of the many failures of the outgoing administration’s handling of COVID-19, the most destructive has been its failure to communicate honestly and directly from the start. We can’t get our economy back on track and help millions of Americans emerge from extended crisis until we control the virus…

Good piece.

1,745,692 new US cases thus far in November (1st thru 14th). We're 4.3% of world population, with 20.2% of confirmed cases, and 18.5% of fatalities.


Of the visible-enough faces (13), I count one mask (and zero social distancing). Hashtag #MillionMoronMarch.



Wednesday, November 11, 2020

"Cases, Cases, Cases..."

Our first peak of US daily Covid-19 cases was reported on July 16th, at 77,259 (per JHU). A 2nd peak was recorded on Nov 10th—136,325.

Yeah, Mr. President-Reject, "we're rounding the turn. It's going away."

Trump never passed up an opportunity to mockingly slam the media for reporting on "cases, cases, cases." If we simply didn't report it, the pandemic wouldn't exist.

Below: From my Excel sheet, JHU data commencing Oct 1st.

My state (Maryland) and city (Baltimore) are announcing new public gathering snd travel restrictions as the incidence rate continues to rise significantly. We're 4.3% of world population have have 20% of the cases and mortality.

244 daze since my last hoops game. Have to continue to hunker down, I guess.

Everyone, try to stay safe and well.


At some basic level, Americans do seem to agree that the coronavirus is a major threat. Despite attempts to politicize and divide us on the pandemic, we are at least united in anxiety. In September, a survey of almost 4,000 Americans found that only 12 percent disagreed with requiring masks in public. Fully 70 percent wanted the government to do more to protect people, and only 8 percent wanted it to do less.

Since then, though, the government under President Donald Trump has done less. The U.S. has suffered the most documented coronavirus deaths in the world, by far. The Trump administration has continued to downplay and ignore the virus as its spread has accelerated in almost every region of the country. On Wednesday, the U.S. shattered the world record for daily coronavirus cases by topping 100,000 for the first time—only to break the record again each subsequent day until a Saturday high of 128,000. Field hospitals and makeshift morgues are appearing around the country. Daily death counts have risen to more than 1,000...
...If the nation’s public-health and scientific communities assume that the appeal of a quack was some transient aberration—something that will end when Trump is out of office, and that can be remedied with yet more facts—then the Biden administration will fail to reach millions of Americans, no matter how soundly it recites statistics. Its warnings and mandates will go unheeded and become fodder for charismatic outsiders who tell people what they want to hear...
Round that turn, Donald.


Click the image.



Monday, November 9, 2020

Make America Sane Again

Click the image above for link.

Buckle up, America, gird yourselves for an onslaught of grammatically correct complete sentences expressing cogent policy proposals.

Friday, November 6, 2020

US Covid19 new cases explosion

224,719 new US cases on Nov 4th and 5th combined. Two consecutive days above 100,000.

Hopkins graphic, US daily new cases:

On Oct 1st Hopkins reported 44,771 new cases.

I dropped some of these data into Excel and rendered a quick plot.

Current US death toll as of this posting is more than 235,000.


My latest Science Magazine came today.

As if there were any doubt that U.S. President Donald Trump has no respect for scientists, he now refers to public health scholars as “Fauci and all these idiots.” That's how he's describing experts in virology, immunology, epidemiology, and infectious disease. Never mind that after recovering from coronavirus disease 2019 (COVID-19), Trump suddenly became excited about future vaccines and “Regeneron,” which is what he calls monoclonal antibodies in general. (Regeneron Pharmaceuticals, Inc. is probably thrilled to have achieved the product-brand status of Xerox and Kleenex, but Eli Lilly also has developed promising monoclonals, and more are in clinical trials.) Apparently, no one told the president that scientists from these same fields—many of whom live in “Democrat-run cities” or college towns and are immigrants who wouldn't be here under his policies—created these drugs and carried out the decades of science that made them possible. This paradox of loving the drug but hating the science is nothing new. It's just louder this time…

A recent survey from the Pew Research Center found that only 20% of the political right has “a lot” of confidence in scientists. Yet when folks at this end of the political spectrum get sick, they want the best treatments that secular academic medicine can provide. The consequences of this are profound and especially apparent in the COVID-19 crisis. The same politicians who are criticizing public health guidance are praising vaccines and antibodies without acknowledging that they come from the same principles and researchers as masks and social distancing…

H. Holden Thorp, Editor in Chief


Tuesday, November 3, 2020


Trump brings out the worst in everyone, supporters and critics alike. I unhappily include myself in the characterization.


I watched the entire documentary. You should too. Excellent, albeit depressing.


Rounding the Turn...