Mask resistance during a pandemic isn’t new – in 1918 many Americans were ‘slackers’

“Those who cannot remember the past are condemned to repeat it.”

George Santayana

 

It is difficult to ascertain the effectiveness of the masks used in 1918. Today, we have a growing body of evidence that well-constructed cloth face coverings are an effective tool in slowing the spread of COVID-19. It remains to be seen, however, whether Americans will maintain the widespread use of face masks as our current pandemic continues to unfold. Deeply entrenched ideals of individual freedom, the lack of cohesive messaging and leadership on mask wearing, and pervasive misinformation have proven to be major hindrances thus far, precisely when the crisis demands consensus and widespread compliance. This was certainly the case in many communities during the fall of 1918. That pandemic ultimately killed about 675,000 people in the U.S. Hopefully, history is not in the process of repeating itself today.

  Mask resistance during a pandemic isn’t new – in 1918 many Americans were ‘slackers’

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SARS-CoV-2 Transmission and Infection Among Attendees of an Overnight Camp — Georgia, June 2020

A total of 597 Georgia residents attended camp A. Median camper age was 12 years (range = 6–19 years), and 53% (182 of 346) were female. The median age of staff members and trainees was 17 years (range = 14–59 years), and 59% (148 of 251) were female. Test results were available for 344 (58%) attendees; among these, 260 (76%) were positive. The overall attack rate was 44% (260 of 597), 51% among those aged 6–10 years, 44% among those aged 11–17 years, and 33% among those aged 18–21 years (Table). Attack rates increased with increasing length of time spent at the camp, with staff members having the highest attack rate (56%). During June 21–27, occupancy of the 31 cabins averaged 15 persons per cabin (range = 1–26); median cabin attack rate was 50% (range = 22%–70%) among 28 cabins that had one or more cases. Among 136 cases with available symptom data, 36 (26%) patients reported no symptoms; among 100 (74%) who reported symptoms, those most commonly reported were subjective or documented fever (65%), headache (61%), and sore throat (46%).

SARS-CoV-2 Transmission and Infection Among Attendees of an Overnight Camp — Georgia, June 2020

Citation for this article: Szablewski CM, Chang KT, Brown MM, et al. SARS-CoV-2 Transmission and Infection Among Attendees of an Overnight Camp — Georgia, June 2020. MMWR Morb Mortal Wkly Rep. ePub: 31 July 2020. DOI: http://dx.doi.org/10.15585/mmwr.mm6931e1external icon.

This quoted material comes directly from the MMWR article.  The attack rate is impressive but we need to see follow up for all of the campers who tested positive.  Are we looking at merely mild symptoms as reported in the article or will we see more severe presentations of Covid-19 infection?

Statin Usage is Linked to a Lower Death Rate in Hospitalized COVID-19 Patients

A new study led by Chinese researchers in collaboration with UCLA’s Dr. Yibin Wang, PhD, has shown that people hospitalized with COVID-19 who took statin drugs were less likely to die and less likely to need mechanical ventilation than those who did not take the cholesterol-lowering drugs. Hospitalized patients taking statins had a 5.2% mortality rate, compared to a 9.4% mortality rate in patients not taking statins from two groups of COVID-19 patients with matching clinic characteristics except statin usage. Statin use also was linked to lower levels of inflammation, and a lower incidence of acute respiratory distress syndrome and admission to intensive care units.

The researchers looked back at the records of 13,981 COVID-19 patients admitted to 21 hospitals in the Hubei Province, China. Of those patients, 1,219 were given statins for an average of 25 days during hospitalization. Among patients with hypertension, 319 used statins combined with ACE inhibitors or ARBs, and 603 used statins combined with other antihypertensive drugs. Researchers analyzed mortality rates as well as secondary outcomes, including the need for mechanical ventilation, admission to intensive care units and acute respiratory distress syndrome. They also measured the levels of three inflammation biomarkers – circulating C reactive protein, interleukin 6 and neutrophil counts – selected to represent the overall status of systemic inflammation in the body.

  Statin Usage is Linked to a Lower Death Rate in Hospitalized COVID-19 Patients

 

‘Staggering’ Increase in COVID-Linked Depression, Anxiety

Since the start of the COVID-19 pandemic, there has been a dramatic increase in depression, anxiety, psychosis, and suicidality, new research shows.

The most profound health problems were found among adults younger than 25 years. Roughly 90% screened positive for moderate to severe depression, and 80% screened positive for moderate to severe anxiety.

One of the most alarming findings was that in June, 25,498 participants who screened positive for depression reported thinking of suicide or self-harm on “more than half of days to nearly every day.” A total of 14,607 participants said they had these thoughts every day.

‘Staggering’ Increase in COVID-Linked Depression, Anxiety

Sadly, not surprising.

It’s Now Time to Worry About Long-Term Cardiac Consequences of COVID-19 — The Skeptical Cardiologist

A study published yesterday in JAMA has the skeptical cardiologist very concerned about the long-term cardiac effects of COVID-19 infection. The investigators performed cardiac MRI (CMR) on 100 patients with documented COVID-19. Cardiac MRI is now considered the gold-standard for noninvasively measuring pathologic changes in cardiac muscle. In this study of a cohort of German…

via It’s Now Time to Worry About Long-Term Cardiac Consequences of COVID-19 — The Skeptical Cardiologist
Thank you Dr. Pearson.

And the following is a link to the Medscape article:

Heart Damage Even After COVID-19 ‘Recovery’ Evokes Specter of Later Heart Failure

Covid-19 – Truth vs Lies and Misinformation

The strongest weapon we have against pandemic is telling the truth.

I continue rounding on my other COVID patients, recalling an article that I’d just read about how coronavirus didn’t affect the 17,000 children infected with it in Florida because coronavirus doesn’t affect children.

  “COVID doesn’t affect children.” You may want to rethink that.

Naturally I tend to focus on infection numbers where I live.  The 17,000 number in Florida shocked me so I went online to verify the number.

But these figures continue on the rise. According to state data released by the Florida Department of Health, Florida has tested 173,520 state residents under the age of 18 for COVID-19, the illness caused by the novel coronavirus. Of those tests, the number has gone up from 17,000 reported last Friday to 23,170 tests that came back positive.

UPDATED: More Than 23,000 Children Have Tested Positive for COVID-19 in Florida

I was wrong.  The number of children infected with Covid-19 in Florida is higher than 17,000.  I wish I had more cheerful news on this Sunday but the truth must be told.  We all need to cut through the noise to see the truth.

After a unanimous vote at a commissioner’s meeting to make masks mandatory, residents of Palm Beach County in Florida erupted in anger, which included threatening to arrest a doctor for “crimes against humanity” for their vote. Two Twitter accounts — BadMedicalTakes and BadCOVID19Takes – a YouTube study, and Facebook posts promoting bogus COVID-19 cures highlight some of the public health misinformation being spread on social media platforms. The political nature of wearing face masks for public health safety has resulted in misinformation about their effectiveness. Those who wrongly believe face masks have detrimental respiratory effects are interfering with the ability to scale our nation’s public health response. During this unprecedented time of dealing with a viral outbreak and its economic effects on such a large scale, our nation should be experiencing strong unity in championing public health safety measures. Instead, the decision to wear a mask outside the home is influenced by gender, political party, and education level.

COVID-19 misinformation is a public health crisis

It came as a complete surprise that I would stumble upon my calling and purpose on this Sunday.  I’m not young anymore and I’ve been thinking a lot about how to structure my retirement.  I admit to reading a lot (maybe too much) and the pandemic has tightened my focus on the virus.  I never envisioned my reading/research and sharing on social media would become my calling at this stage in life.

But it’s what I do.  I hope you benefit from my work and that it helps you cut through the bullshit making this pandemic way worse than it ever should have been.

WAR IS PEACE

FREEDOM IS SLAVERY

IGNORANCE IS STRENGTH

George Orwell – 1984

Masks are sexy.  Wear a mask.

 

The Latest in COVID-19 News: Week Ending 07.25.20 – NEJM Journal Watch

Click on the link for the NEJM Journal Watch weekly update.  NO paywalls on any of the links in this article.  (paywalls bother me)

The Latest in COVID-19 News: Week Ending July 25

Meanwhile in Imperial County California…

For many decades, a relative few white farmers who tilled vast acreages of winter vegetables, cotton and alfalfa held that power. Ultimately, however, demography shifted power to Latinos, the sons and daughters of field workers from Mexico who are today 80% of Imperial County’s population.

Changing demography didn’t change Imperial County’s basic nature. It exists primarily to grow food and fiber with little economic diversity and always ranks high on California’s lists of unemployment and poverty.

Imperial has another distinction these days — the epicenter of California’s COVID-19 pandemic. Its infection rate is six times as high as California’s as a whole and victims are overwhelming its two hospitals.

Imperial County, the COVID-19 epicenter

 

 

 

 

 

 

 

 

 

 

 

 

 

Nutrition and Obesity in Covid-19

USCOVID19_IMAGE

NEJM

A healthy diet, rich in fruits and vegetables and low in sugar and calorie-dense processed foods, is essential to health. The ability to eat a healthy diet is largely determined by one’s access to affordable, healthy foods — a consequence of the conditions and environment in which one lives. In the United States, poor diet is the leading underlying cause of death, having surpassed tobacco use in related mortality.2 A study of dietary trends among U.S. adults between 1999 and 2012 showed overall improvement in the American diet, with the proportion of people who reported having a poor-quality diet decreasing from 55.9% to 45.6%; additional analyses, however, revealed persistent or worsening disparities in nutrition based on race or ethnicity, education, and income level.3

Covid-19 and Disparities in Nutrition and Obesity

Screenshot_2020-07-19 Covid-19 and Disparities in Nutrition and Obesity NEJM

The BMJ

Global efforts to develop treatments for covid-19 have focused on drug repurposing, immunotherapies including convalescent plasma and monoclonal antibodies, and vaccines. Despite obesity prevalence rates of 40% in the United States, 29% in England, and 13% globally, to our knowledge none of the several thousand clinical studies of covid-19 in international clinical trial registries proactively recruit participants with obesity. On the contrary, several studies consider overweight or obesity as exclusion criteria. We call for proportional representation of people with obesity in clinical trials of drugs and vaccines, including dose finding studies.

Obesity and covid-19: the unseen risks

More from The BMJ

Covid-19: What we eat matters all the more now

our food systems are making us ill.11 The covid-19 outbreaks at meat packing plants have focused minds on the meat industry as a driver for acute and chronic disease.12 Last month Monique Tan and colleagues wrote that the food industry should be held partly accountable “not only for the obesity pandemic but also for the severity of covid-19 disease and its devastating consequences.”13 The government must do more to hold the industry to account.

BMJ 2020; 370 doi: https://doi.org/10.1136/bmj.m2840

Lose weight.  Make better food choices.  Wear a mask.

 

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A Surge in Small Business Bankruptcies is Underway

Re-posted article from Straight Line Logic

More than 500 companies filed for bankruptcy under the small-business bankruptcy rules since February, according to the American Bankruptcy Institute. June was the top month for filings with 131 cases; many were filed in states hit hard by the pandemic like Florida, Texas, California, New York and Illinois.

  A Surge in Small Business Bankruptcies is Underway

Unfortunately this is the tip of the proverbial iceberg.

A lot of people are going to need a lot of help over the upcoming years.  Do what you can, in whatever capacity you have to help.  We have increased our donations to a local charity called The Hope Center and have started sending small sums to the Food Bank of Oklahoma.  Every little bit helps.