What Adam Is Reading
What Adam Is Reading

What Adam is Reading - 03-02-2021

Medicine & Clinical CareCOVID (2020–21)Bonus

Several members of my household developed upper respiratory symptoms this past weekend. Sinus congestion, low-grade fevers, sneezing. No cough, no breathing issues, and one of them tested negative for COVID via rapid antigen testing on Sunday and is now symptom-free. All data points to something other than coronavirus (PCR testing is pending). And yet, I wonder how long it will be before the little voice in my head stops screaming about every sniffle? And, given our masking, distancing, and handwashing - from where did this virus come? As one friend commented, it is a tiny version of Jurassic Park - with viral life finding a way.

-----Latest Data---

Global-View:
https://www.ft.com/content/a2901ce8-5eb7-4633-b89c-cbdf5b386938

Nationally:
https://ig.ft.com/coronavirus-chart/?areas=usa&areas=gbr&areasRegional=usny&areasRegional=usca&areasRegional=usfl&areasRegional=ustx&areasRegional=usco&cumulative=0&logScale=0&perMillion=1&values=casesf

Also, look at:
https://covidtracking.com/data

The U.S. Regionally - N.Y. Times:
https://www.nytimes.com/interactive/2020/us/coronavirus-us-cases.html

About the data:
https://covidtracking.com/about-data/visualization-guide

is the best resource to understand data visualization and data integrity.

Vaccine Tracker

https://www.bloomberg.com/graphics/covid-vaccine-tracker-global-distribution/

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J&J Vaccine, approved over the weekend by the FDA for emergency use, started shipping yesterday. While it is important to keep expectations in check, having a single-dose vaccine that requires less stringent storage is very advantageous.

https://www.nytimes.com/live/2021/02/28/world/covid-19-coronavirus

A couple of pre-print articles of note - keep in mind these are not yet peer-reviewed but offer comforting data (that have a chance of being incorrect).

1) Despite fears about the AZ vaccine being less effective in older adults, pre-print data from the U.K. implies this is not the case. The data demonstrate that both AZ and Pfizers vaccines protect against death, even earlier than 14 days after the 1st dose. It is a confusing article, but the bottom line is good news - both Pfizer and AZ vaccines help protect older adults. Complete dosing (i.e., two doses) and time increase the protection.

https://twitter.com/hildabast/status/1366472321909710852

Here is what is at stake:
https://www.bbc.com/news/world-europe-55901957

2) There have been several articles looking at the humoral immune response to the new coronavirus strains, indicating some decreased antibody binding to B.1.1.7, Brazilian, and South African variants. This data is mostly benchtop and not real clear how the real world fairs. However, a few small studies demonstrate a robust cellular immune response (CD4/CD8 T-cells) in either convalescent or mRNA-vaccinated patients exposed to COVID variants. These data are preliminary but offer hope that coronavirus mutations will not significantly impact the real world. Time will tell.

https://www.biorxiv.org/content/10.1101/2021.02.27.433180v1.full.pdf+html

and

https://twitter.com/hildabast/status/1366601329141948416

You should re-activate that Medscape account I encouraged you to sign up for last spring to read the comments about the article "Exhaled aerosol increases with COVID-19 infection, age, and obesity." This type of research generates seemingly valuable data, but the headline's hype may over-shadow the clinical usefulness. It is an excellent example of bias through provocative wording - "older obese patients are super spreaders!"

Research:
https://www.pnas.org/content/118/8/e2021830118.long

Commentary

https://www.medscape.com/viewarticle/946599

Infographic of the day - Let's go work for Lego

On average, those Danish seem to have the best work-life-pay balance. Not everyone in Denmark works for Lego, though, right?

https://www.smartadvocate.com/News/Blog/countries-ranked-by-hours-worked-per-week-1

Billund, here I come.

https://www.thecrazytourist.com/15-best-things-billund-denmark/

Bonus Round - History of Medicine Highlights Round 2

I remember when Barney Clark received the first implantable artificial heart in 1982.

https://healthcare.utah.edu/healthfeed/postings/2012/12/120212ArtificialHeart30YearsLater.php

But take a look at the timeline - 40+ years from idea to execution and the interval steps in engineering. And, many cows were involved. (N.B. - the website is published by a company that manufactures artificial hearts, but it is a quick read and good overview)

https://syncardia.com/artificial-heart-timeline/

And from 2008-2018, there are even more developments - smaller devices, mechanical/biological hybrid versions:
https://www.medicaldirector.com/news/future-of-health/2018/05/5-artificial-heart-technology-innovations

What's the point? I am still blown away by the fact that we (humans) developed 6+ highly effective vaccines - from ideation to delivery in under 14 months.

Clean hands and sharp minds team,
Adam

Adam