1,014 Matching Annotations
  1. Oct 2020
    1. A 2016 Lancet study found that universal breast-feeding would prevent 800,000 child deaths a year across the globe and yield $300 billion in savings from reduced health care costs and improved economic outcomes for those reared on breast milk.

      Pure corruption here. Protectionism to prop up profits of approximately 630 million versus major benefits and savings of 300 billion. Even if you look at the calculus of the entire industry of 70 billion it becomes a no brainer.

    1. She reached behind her to her bookshelf, which held about a dozen blue bottles of something called Real Water, which is not stripped of “valuable electrons,” which supposedly creates free radicals something something from the body’s cells.

      I question her credibility to market claims like this. I suspect she has no staff scientist or people with the sort of background to make such claims. Even snake oil salesmen like Dr. Oz are pointedly putting us in hands way too make a buck.

    1. Bad economic times could lead to deaths of people with low income who are most vulnerable to an economic downturn.

      This is the most likely place that governments and the richer ruling elites are likely to fail their societies. Even the United States is like to do this and one need look no further than their response to the hurricane aftermath in Puerto Rico to see this.

    1. many Indians continue to defecate in the open. Bangladesh’s government and charities have built latrines, too, but they have worked harder to stigmatise open defecation. Often they install latrines for the poor and then prod richer folk into following their example. A new, surprising, finding is that this works better than expecting people to copy their social superiors.
    2. Many lives have been saved by parents doing something simple. Beginning in the 1960s American military doctors and researchers in Dhaka developed a therapy for acute diarrhoea—a sweet, salty oral rehydration solution. This is now dirt cheap and widely available. At the last count, fully 84% of Bangladeshi parents with stricken children fed it to them (only a third saw a doctor). Thinly populated African countries are struggling to match that. One promising idea is to distribute the sachets along with Coca-Cola—which gets everywhere.

      amazing the reach of Coca-Cola!

    1. To find a cure for what ails America, Chetty will need to understand all of this wild variation. Which factors foster opportunity, and which impede it? The next step will be to find local interventions that can address these factors—and to prove, with experimental trials, that the interventions work

      I suspect that racial inequalities like Redlining, school support, and public housing issues (including evictions and predatory lending) will overlay these unmobile areas. cf Scarlet E series from On the Media.

    1. How this phenomenon translates into absolute, rather than relative, risk, however, is a bit thorny. A large study published in 2018, for instance, found that among women who had children between 34 and 47, 2.2 percent developed breast cancer within three to seven years after they gave birth (among women who never had children, the rate was 1.9 percent). Over all, according to the American Cancer Society, women between 40 and 49 have a 1.5 percent chance of developing breast cancer.

      The rates here are so low as to be nearly negligible on their face. Why bother reporting it?

    1. They’re mostly things that everyone was supposed to be doing all along, such as ensuring that bathrooms have exhaust fans and that air filters are changed regularly and of high-enough quality to catch the virus. That means they should be high-efficiency particulate air (HEPA) filters or MERV-rated 13 or 14, which are essentially the N-95 masks of air filters.
    2. During the SARS coronavirus outbreak, in 2003, a cluster of cases in Hong Kong was attributed to one person with diarrhea in a poorly ventilated apartment building.

      toilet plume, two words everyone just loves!

    1. “We ought to have a social compact: If you’re sick, whether you’ve got Covid-19 or not, you should separate yourself from society,” Mr. Gostin said. “That’s your part of the bargain, you’re doing it for your neighbors, your family and your community.”“In exchange,” he said, “we as a nation owe you the right to a humane period of separation, where we meet your essential needs like medicine, health care, food and sick pay.”
    1. Reporting on a study at Queensborough Community College, also in the CUNY system, Sheila Beck notes that the library’s reserve textbook collection is “heavily used,” however, staffing and other concerns have prompted librarians to consider “less labor intensive and less costly alternatives.“ Beyond textbook reserves, academic librarians can help students to locate required course readings in other ways: older editions of their required textbook, pre- or post-prints of articles in institutional repositories, articles or other texts in databases subscribed to by the library, or readings that may be in the public domain or otherwise available on the open web.

      The basic economics of this system would indicate (especially as classes become larger and larger) that more careful consideration of choice, economics, accessibility, availability, etc. on a larger institutional level creates larger marginal gains for those in the class. If a staff librarian, teacher, or someone else within the system does the leg-work up front and does it well, then the dozens or even hundreds of students in the course don't need to spend (read: waste) their own time re-inventing the proverbial textbook wheel once they're in the class.

      Portions of the situation here make me wonder if we might pull a page from Dr. Peter Pronovost's playbook in the health care space and create a simple checklist of what to do when planning for textbooks and readings. Checklists that include things like:

      • will the texts actually be used?
      • will they be primary to the subject or are they supplementary?
      • What are their prices?
      • Are alternate materials available?
      • Are older editions available?
      • are public domain or open web versions available?
      • are there copies in the library? reserves? pirated versions? pre/post prints?
      • etc.

      Once such a checklist is available, institutions should require that it be available along with syllabi and other course listings.

      cross references:

    1. CDC reverses course on testing for asymptomatic people who had Covid-19 contact

      Take Away

      Transmission of viable SARS-CoV-2 RNA can occur even from an infected but asymptomatic individual. Some people never become symptomatic. That group usually becomes non-infectious after 14 days from initial infection. For persons displaying symptoms , the SARS-CoV-2 RNA can be detected for 1 to 2 days prior to symptomatology. (1)

      The Claim

      Asymptomatic people who had SARS-CoV-2 contact should be tested.

      The Evidence

      Yes, this is a reversal of August 2020 advice. What is the importance of asymptomatic testing?

      Studies show that asymptomatic individuals have infected others prior to displaying symptoms. (1)

      According to the CDC’s September 10th 2020 update approximately 40% of infected Americans are asymptomatic at time of testing. Those persons are still contagious and are estimated to have already transmitted the virus to some of their close contacts. (2)

      In a report appearing in the July 2020 Journal of Medical Virology, 15.6% of SARS-CoV-2 positive patients in China are asymptomatic at time of testing. (3)

      Asymptomatic infection also varies by age group as older persons often have more comorbidities causing them to be susceptible to displaying symptoms earlier. A larger percentage of children remain asymptomatic but are still able to transmit the virus to their contacts. (1) (3)

      Transmission modes

      Droplet transmission is the primary proven mode of transmission of the SARS-CoV-2 virus, although it is believed that touching a contaminated surface then touching mucous membranes, for example, the mouth and nose can also serve to transmit the virus. (1)

      It is still unclear how big or small a dose of exposure to viable viral particles is needed for transmission; more research is needed to elucidate this. (1)

      Citations

      (1) https://www.who.int/news- room/commentaries/detail/transmission-of-sars-cov-2- implications-for-infection-prevention-precautions

      (2) https://www.cdc.gov/coronavirus/2019- ncov/hcp/planning-scenarios.html

      (3) He J, Guo Y, Mao R, Zhang J. Proportion of asymptomatic coronavirus disease 2019: A systematic review and metaanalysis. J Med Virol. 2020;1– 11.https://doi.org/10.1002/jmv.26326

  2. Sep 2020
  3. Aug 2020
    1. Lozano, R., Fullman, N., Mumford, J. E., Knight, M., Barthelemy, C. M., Abbafati, C., Abbastabar, H., Abd-Allah, F., Abdollahi, M., Abedi, A., Abolhassani, H., Abosetugn, A. E., Abreu, L. G., Abrigo, M. R. M., Haimed, A. K. A., Abushouk, A. I., Adabi, M., Adebayo, O. M., Adekanmbi, V., … Murray, C. J. L. (2020). Measuring universal health coverage based on an index of effective coverage of health services in 204 countries and territories, 1990–2019: A systematic analysis for the Global Burden of Disease Study 2019. The Lancet, 0(0). https://doi.org/10.1016/S0140-6736(20)30750-9

    1. Independent SAGE {@independentSage} (2020) LIVE now: Independent SAGE's weekly briefing. Please join us for latest analysis & questions from the press & public. All welcome! Twitter. Retrieved from: https://twitter.com/IndependentSage/status/1296787775354630146

    1. Harper, Craig A., and Darren Rhodes. ‘Ideological Responses to the Breaking of COVID-19 Social Distancing Recommendations’, 19 August 2020. https://doi.org/10.31234/osf.io/dkqj6.

    2. Harper, Craig A., and Darren Rhodes. ‘Ideological Responses to the Breaking of COVID-19 Social Distancing Recommendations’, 19 August 2020. https://doi.org/10.31234/osf.io/dkqj6.

    3. Harper, Craig A., and Darren Rhodes. ‘Ideological Responses to the Breaking of COVID-19 Social Distancing Recommendations’, 19 August 2020. https://doi.org/10.31234/osf.io/dkqj6.

    1. Sherrard-Smith, E., Hogan, A. B., Hamlet, A., Watson, O. J., Whittaker, C., Winskill, P., Ali, F., Mohammad, A. B., Uhomoibhi, P., Maikore, I., Ogbulafor, N., Nikau, J., Kont, M. D., Challenger, J. D., Verity, R., Lambert, B., Cairns, M., Rao, B., Baguelin, M., … Churcher, T. S. (2020). The potential public health consequences of COVID-19 on malaria in Africa. Nature Medicine, 1–6. https://doi.org/10.1038/s41591-020-1025-y

    1. Though important, social distancing could be reduced to one metre instead of 2m

      Take away: As with most things in nature, there are always exceptions – transmission occurring at greater distances than 3 ft and evidence of aerosolization have been reported.

      Discussion: In scientific terms, this virus is still very new so the data supporting an optimal physical distance to prevent transmission remains scarce. In the absence of data, public health agencies have used what they understand about this virus and similar viruses to infer a “best” answer. Public health agencies try to simplify the recommendation to a single answer, but the reality is much more complex.

      According to reports the WHO bases their recommendation for 1 meter (~3 ft) distancing off of an understanding that SARS-CoV-2 behaves like similar respiratory viruses that are primarily transmitted via larger droplets (as opposed to smaller aerosols). Assuming most spread is via droplets, the WHO reportedly follows the results of a 1934 study indicating most respiratory droplets fall to the ground within 3 feet.

      However, as with most things in nature, there are always exceptions – transmission occurring at greater distances than 3 ft and evidence of aerosolization have been reported.

      The evidence basis for the CDCs guidance for 6 feet of separation is less clear, but probably reflects lower risk tolerance, or greater weight to evidence of aerosolization or wider droplet spread.

      Even with further study, there may never be a clear answer for optimal physical distancing. This is because, (1) the area of high risk for transmission is probably dependent on the specific conditions of the interaction (e.g. loud talking, windy environment), and (2) the “optimal” distance is based on risk tolerance. There is no single distance between individuals where risk of transmission drops off precipitously to zero.

      All evidence indicates that greater distances are safer but, for example, consider how restrictive a physical distancing recommendation of >50 ft would be. In the end, because we can’t control how far others stand away from us, we ask governments to consider these tradeoffs and deliver a “best” answer to guide their citizenry.

    1. @who published a massive review/meta-analysis of interventions for flu epidemics in 2019, found "moderate" evidence AGAINST using masks.

      Take away: In their 2019 report the WHO actually recommended for, not against, the use of masks in severe influenza epidemics or pandemics, contrasting the statement made in this tweet. Further, recent evidence overwhelmingly supports the benefit of masks for preventing the spread of SARS-CoV2, the virus that causes COVID-19.

      The claim: Overall the claim here appears to be that masks are ineffective against the spread of SARS-CoV2, the virus that causes the clinical syndrome known as COVID-19. The evidence used in support of this claim is that “the WHO found ‘moderate’ evidence AGAINST using masks” in their 2019 report on the use of non-pharmaceutical interventions for mitigating influenza pandemics.

      The evidence: This overall claim is poorly supported by data and the evidence used to support this claim is incorrectly characterized by the claimant. Narrowly, the claim that the WHO recommended against mask use is patently false. In their report, the WHO reviewed 10 separate studies and did conclude that there was scant evidence that masks significantly decreased spread of the flu. However, they found no evidence that masks increased spread, and based on mechanistic plausibility (i.e. masks are barriers that prevent droplets from passing between people) and the low risk/high reward, they made a conditional recommendation for mask use in severe influenza epidemics or pandemics.

      While influenza does not behave exactly like the SARS-CoV2 virus, the similarities in mode of transmission make it reasonably likely that masks would also have protective effects against the spread of this virus is well. The best evidence is hard data, and that too increasingly points to the benefit of masks for slowing down or preventing the transmission of SARS-CoV2. A recent summary of that data is available here.

  4. Jul 2020
    1. Seow, J., Graham, C., Merrick, B., Acors, S., Steel, K. J. A., Hemmings, O., O’Bryne, A., Kouphou, N., Pickering, S., Galao, R., Betancor, G., Wilson, H. D., Signell, A. W., Winstone, H., Kerridge, C., Temperton, N., Snell, L., Bisnauthsing, K., Moore, A., … Doores, K. (2020). Longitudinal evaluation and decline of antibody responses in SARS-CoV-2 infection. MedRxiv, 2020.07.09.20148429. https://doi.org/10.1101/2020.07.09.20148429