Survival strategies

Statins Can Save Lives

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They examined the records of nearly 300,000 adults in the U.S. who had an initial atherosclerotic cardiovascular disease event between 2007 and 2016. These were divided into three groups: coronary heart disease, ischemic stroke or transient ischemic attack, or peripheral artery disease.

When people left the hospital or emergency department in 2007 following a first diagnosis in one of these categories, about half began taking statins within 30 days. By 2016, statin use increased to approximately 60%.

“Based on the guidelines, we hoped to see a much higher uptake among this entire group,” says Dr. Noseworthy. “Statin intolerance was only noted for 4%-5% of the patients, which means as many as 35% of patients are not receiving treatment according to the guidelines.”

Mayo Clinic. “Statins can save lives; are they being used?.” ScienceDaily. http://www.sciencedaily.com/releases/2020/12/201201144030.htm (accessed December 2, 2020) — https://www.sciencedaily.com/releases/2020/12/201201144030.htm

Journal Reference:

Xiaoxi Yao, Nilay D. Shah, Bernard J. Gersh, Francisco Lopez-Jimenez, Peter A. Noseworthy. Assessment of Trends in Statin Therapy for Secondary Prevention of Atherosclerotic Cardiovascular Disease in US Adults From 2007 to 2016. JAMA Network Open, 2020; 3 (11): e2025505 DOI: 10.1001/jamanetworkopen.2020.25505

Shhh…Want to help stop COVID? Be quiet.

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There’s another extremely simple thing that might help reduce COVID transmission – quieting down.  This is a bit of a sensitive topic, because we all talk.  And sometimes we all talk too loudly.  But hospitals are filling up so, well, it’s time to talk about talking.

Human beings are wind instrument that generate aerosols.  Small particles are produced as exhaled gas rushes past vibrating vocal cords.  As this gas passes further through the tongue, lips, and teeth, sounds from the vocal cords are modulated – generating additional particles.​1​ Aerosol generation is exacerbated by speaking at higher volumes and at higher pitches.​2,3​ Scientists have dissected this down to specific sounds which generate more particles than others.​4​

There’s no solid, RCT-level evidence that being quiet reduces the spread of COVID. Nor will there ever be (some things are just too difficult to study with an RCT). But quieting down makes sense and it’s very easy and safe to do. There is literally zero cost or risk involved.

PulmCrit – Want to help stop COVID? Be quiet — https://emcrit.org/pulmcrit/quiet-covid/

Shhh…

Failure to Launch – 2020

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Failure to Launch was a movie released in 2006 starring Matthew McConaughey. Failure to Launch 2020 version is summarized in this chart:

Failure to Launch 2020 – Over Half of U.S. Young Adults Now Live With Their Parents – https://www.visualcapitalist.com/us-young-adults-living-with-their-parents/

On a related note see Scary Charts 08.08.20 – Surge In Number of Americans Moving In With Older Family Members and Older Adults Living with Younger People Face Increased Risk for COVID-19 Mortality (if you’re Swedish)

“Everybody has a plan until they get punched in the mouth”

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“Everybody has a plan until they get punched in the mouth.”

Mike Tyson

The drop in the volume of employment in a given sector always has a ripple effect in the national economy. The loss of so many high-paying jobs in a short time will be a dent in the coffers of Los Angeles County and for New York state in the short term. Michele Evermore, senior policy analyst for the Washington, D.C.-based National Employment Law Project, says it hits at a time when other industries are undergoing similar sweeping realignments with huge human toll.

“Nobody’s got a plan for how to transition these massive sectors of the workforce into a different thing,” Evermore says.

Hollywood Grapples With Mass Layoffs as the Biz Redefines Itself for Streaming Future — https://variety.com/2020/tv/news/hollywood-layoffs-streaming-future-1234838650/

I sat for a few minutes thinking about what to write next when Charlie Hunter popped into my head. Hunter titled one of his albums with the Tyson quote.

Which was then followed by some great advice from Charlie on his strategy for success and survival in the years to come.

Don’t wait until you get punched in the mouth to make your Plan B. And while you’re at it you might want to come up with a Plan C as well.

First It Was Masks; Now Some Refuse Testing for SARS-CoV-2

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Test avoidance appears to be a growing problem, at least anecdotally. Many of the same people who dismiss the need to test feel the same way about wearing a mask, in part because they think no one has the right to tell them to do either.

First It Was Masks; Now Some Refuse Testing for SARS-CoV-2 – JAMA. 2020;324(20):2015-2016. doi:10.1001/jama.2020.22003 – https://jamanetwork.com/journals/jama/fullarticle/2772860

I am speechless.

Taking a Road Trip? Here’s Your Checklist

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This article has not been edited and the article was originally published on The Conversation. https://theconversation.com/planning-a-road-trip-in-a-pandemic-11-tips-for-before-you-leave-on-the-road-and-when-you-arrive-149620

Planning a road trip in a pandemic? 11 tips for before you leave, on the road and when you arrive
November 26, 2020

Author – Thea van de Mortel
Professor, Nursing and Deputy Head (Learning & Teaching), School of Nursing and Midwifery, Griffith University

As restrictions ease around the country and the prospect of travel beckons, many of us will be planning road trips for the holiday season.

To ensure your trip is memorable in the best rather than the worst way, here are some things you and your fellow travellers can do to reduce the risk of becoming infected with, or spreading, COVID on your trip.

Before you go

  1. Check for any travel or other COVID-specific restrictions or rules in the areas you will be travelling through or to, before you go. These can change rapidly and may include restrictions on how far you can travel, how many people per square metre are allowed in public spaces, and whether you need border passes or to wear a mask. Each state or territory has its own health department or government COVID website you can check.
  2. Don’t take COVID with you. If anyone in your group has COVID-like symptoms, however mild, it is important to be tested and cleared for COVID before leaving. Common symptoms may include fever or chills, muscle aches, sore throat, cough, runny nose, difficulty breathing, new loss of taste or smell, and vomiting or diarrhoea.
  3. Pack masks, disinfectant wipes and hand sanitiser. The two most likely ways of catching COVID are inhaling viral particles an infected person sheds when they cough, sneeze, laugh, talk or breathe; and ingesting particles by touching contaminated objects and then touching your face or food. Masks (and social distancing) can help reduce the former risk, while avoiding touching your face, frequent hand hygiene and cleaning surfaces can reduce the latter. So pack masks, wipes and hand sanitiser. Hand sanitiser should contain at least 60% alcohol.
  4. Pack your own pillows and linen. We know people infected with SARS-CoV-2, the virus that causes COVID, can shed virus onto linen and pillows (and other surfaces), even when asymptomatic. We also know respiratory viruses can penetrate pillow covers and get into the microfibre stuffing. So you might want to consider bringing your own pillows and linen.

On your trip

  1. Use disinfectant wipes to clean high-touch surfaces in your hire car. These would include door and window handles or buttons, light switches, seat adjuster controls, radio controls, the steering wheel, glove box button, gear/drive and handbrake levers, rear-view mirrors and mirror controls.
  2. How about singing in the car? The more vigorous the activity, the greater the opportunity to release droplets and aerosols and the further these will travel. So, laughing and singing will release more of these than talking, and talking will release more than breathing. However, if you are travelling in a family group, or with your housemates, then you have been in close contact with one another at home and the additional risk would be low.
  3. Maintain social distancing at service stations. Leave at least 1.5 metres between you and the next person while paying for fuel, ordering food and when using the bathroom. Make sure you wash or sanitise your hands after touching surfaces such as petrol pumps, door handles, bathroom taps, and before getting back in your car.
    Filling car up with petrol at service station
    Wash or sanitise your hands after using the petrol pump. Shutterstock
  4. Pay with cards rather than cash to avoid touching money. Many people can handle bills and coins over a long duration of time, providing many opportunities to transfer disease-causing microbes from one person to the next. Using contactless payment also helps maintain social distancing.
  5. It’s safer to eat outdoors than indoors if stopping for a snack or lunch. That’s because large volumes of air dilute the density of viral particles in the air. Evidence from a study of COVID clusters in Japan suggests the chance of transmitting COVID is more than 18 times higher inside than outside.

When you arrive

  1. Is your hotel or rented accommodation COVID-safe? Ask the accommodation provider what steps they have taken to make the place less conducive to spreading COVID. For example, have they introduced extra cleaning or disinfection?
  2. Use disinfectant wipes in rented accommodation to clean high-touch surfaces such as door handles, light switches, cupboard handles, taps and toilet flush buttons. You can also put dishes and cutlery through the dishwasher on a hot cycle. This is because the virus can remain viable (able to cause infection) on surfaces for many days.

Following these simple steps can help to keep your trip memorable in the best possible way. Happy holidays!

Copyright © 2010–2020, The Conversation US, Inc.

Personality Traits Linked to Toilet Paper Stockpiling

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The most robust predictor of toilet paper stockpiling was the perceived threat posed by the pandemic; people who felt more threatened tended to stockpile more toilet paper. Around 20 percent of this effect was also based on the personality factor of emotionality — people who generally tend to worry a lot and feel anxious are most likely to feel threatened and stockpile toilet paper. The personality domain of conscientiousness — which includes traits of organization, diligence, perfectionism and prudence — was also a predictor of stockpiling.

Max Planck Institute for Evolutionary Anthropology. “Personality traits linked to toilet paper stockpiling: High levels of emotionality and conscientiousness are indicators for stockpiling behavior.” ScienceDaily. http://www.sciencedaily.com/releases/2020/06/200612172227.htm (accessed November 25, 2020).

In case you haven’t noticed it’s happening again. Where’s the toilet paper?

More on Vulvar Melanoma

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Lesions could be angiokeratomas, petechiae, purpura, melanosis, and nevi, for example. Seborrheic keratoses can mimic melanoma. “If it looks odd, don’t be afraid to biopsy it,” said Mauskar, assistant professor of dermatology and obstetrics and gynecology at the University of Texas Southwestern Medical Center in Dallas.

Low Threshold to Biopsy Atypical Lesions May ID Vulvar Melanoma Early, Experts Say — https://www.medscape.com/viewarticle/941157?src=rss

I first became aware of melanoma down there back in June of this year. See Vulvar Melanoma Is Increasing in Older Women

So remember, if it looks odd get it biopsied.

COVID-19: Study Suggests Durable Immune Response After SARS-CoV-2 Infection

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Immune responses to SARS-CoV-2 might last for years, according to a study posted on the preprint server bioRxiv.

Some 185 adults who recovered from COVID-19 (most had mildly symptomatic disease) provided blood samples for analysis. The majority provided a single sample, but roughly 20% provided multiple samples over several months.

The researchers found that levels of spike-specific memory B cells (which make antibodies as needed) increased with time — and were higher at 4–6 months than at earlier time points in most participants who gave multiple samples. In addition, SARS-CoV-2 spike IgG titers were generally stable, showing only modest declines at 6–8 months.

COVID-19: Study Suggests Durable Immune Response After SARS-CoV-2 Infection — https://www.jwatch.org/fw117245/2020/11/17/covid-19-study-suggests-durable-immune-response-after

I hope these findings are replicated in other studies.

Meanwhile in Oklahoma – About That Mask Debate 11.13.20

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Oklahoma Weekly Epidemiology and Surveillance Report 11/6-11/12 2020

In Oklahoma we don’t have a statewide mask mandate. Mask mandate decisions are at the city level. The last time I looked at these numbers I focused on the percent change from 8/1 to the present study date. Today my eyes focused on the Nov. 1 seven day average case numbers mask vs no mask. My small brain is trying to understand what I’m seeing. Under the assumption mask wearing is effective in helping stop the virus from spreading why is the gap narrowing?

Numbers notwithstanding, I’m still going to wear a mask.