Like everyone else, I read a lot of news, and the headlines are grim. But when I want to read the really hard news, I go to a curated Twitter list of epidemiologists. I have avoided that list for a good week because sometimes the hard news is too hard. But statements like this always provide a modicum of comfort.
“Three months ago, we knew almost nothing about this coronavirus. Collectively, we have learned an enormous amount. And every day, we learn more", says @DrTedros.— Kai Kupferschmidt (@kakape) April 1, 2020
We have learned a lot more. For instance, we now know that dogs are better than cats. Actually, we have always known that, but in the context of our current environment, we have also learned that the virus replicates better in cats than in dogs. Damn cats.
"We found that SARS-CoV-2 replicates poorly in dogs, pigs, chickens, and ducks, but efficiently in ferrets and cats."— Colin J. Carlson, Ph.D. (@wormmaps) April 1, 2020
Putting aside the implications for spread now-
This is a pretty nice test of whether pigs had anything to do with the initial spillover. https://t.co/qgOAo40Wnh
There is also a fairly comprehensive study out of America, based on American patients (as opposed to the unreliable Wuhan numbers) that explicitly shows what we could already see: The virus hits hardest those who are older or who have underlying health conditions, specifically diabetes, heart disease, or lung disease. The biggest takeaway, I think, from the study is this:
Among patients aged ≥19 years, the percentage of non-ICU hospitalizations was higher among those with underlying health conditions (27.3%-29.8%) than among those without underlying health conditions (7.2%-7.8%); the percentage of cases that resulted in an ICU admission was also higher for those with underlying health conditions (13.3%-14.5%) than those without these conditions (2.2%-2.4%).
The takeaway here is that if you have one of those underlying conditions — or you are in one of those high-risk age groups — stock up on medicine and food and stay the hell inside. Actually, that’s true for everyone.
Meanwhile, there are glimmers of good news in California and Washington, both of which adopted strict social-distancing requirements early on, and are now seeing the curve-flattening benefits of that. Florida Governor Ron DeSantis is way the hell behind, but he’s finally instituted a statewide lockdown today.
Social distancing efforts are crucial (and shame on Florida and Texas for lagging), because they get us to the other side. I know the focus now should be on how to get through the next three to four weeks, which we all know will be grim, but it’s knowing that there will be an other side to get to that keeps a lot of us focused on doing what’s most important now.
Personally, I don’t really understand the logic of how “the other side of this” works, but the epidemiologists, the former FDA commissioner, and even Bill Gates suggests the same plan of action: We get to the peak, and then see a sustained reduction in new cases for at least 14 days; we test like hell; we quarantine and isolate; we go back to school/work in June, everyone starts wearing masks, and we maintain many of those same social distancing efforts. We don’t shake hands, we don’t hug, we don’t go to baseball games, and older folks and those with underlying conditions limit their time in the community until there’s a vaccine. We may also be able to lift some of those physical distancing requirements if some of the scores of clinical trials currently underway succeed in finding a therapeutic. (The experts also add that Phase 4 is rebuilding and readying ourselves so that we are actually prepared for the next pandemic).
At this point, we’re still behind on testing capabilities, but we’re slowly catching up. Apparently, we are producing around 100,000 tests a day, and I know here in Maine, Abbott is producing 50,000 15-minute tests a day (and our state just got 2,500 of them). We’re gonna need a lot more because we are learning that 18-30ish percent of those with the virus are completely — or almost completely — asymptomatic. If you are one of those asymptomatic people, that’s great for you! It’s not so great for anyone you are around if you have no idea that you are infectious. It’s a real dick of a virus.
One other note: The Daily podcast this morning was about the race to find a vaccine, and while Trump and China and maybe a couple of others are trying to make this an arms race, the scientific community is like, “Screw that.” The scientific community around the globe are working together, sharing notes, and using their combined knowledge to come together on a solution. That is heartening.
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