Worth reading: Our history is a battle against the microbes. We lost terribly before science, public health, and vaccines

Welcome perspective from Max Roser of the excellent ourworldindata.org, a website I consider essential reading for everyone. The public health impact of vaccines simply cannot be overstated (as shown below). While infectious diseases like tuberculosis continue to claim lives, the death tolls of the past were almost unimaginable. Thanks to vaccination, countless lives have been…

COVID-19: Major study shows dexamethasone improves mortality among ventilated patients

The use of corticosteroids in systemic inflammatory response syndrome (SIRS) and multiple organ dysfunction syndrome (MODS) isn’t new, so it isn’t surprising that treatment of critically ill COVID-19 patients in the ICU has increasingly involved dexamethasone. Nevertheless, the first major results showing improvement in survival among ventilated COVID-19 patients given dexamethasone comes as very welcome…

COVID-19 is not the “great equalizer”

Maria Abi-Habib writing for NYT, “For the first time since 1998, the World Bank says, global poverty rates are forecast to rise. By the end of the year, half a billion people may be pushed into destitution, largely because of the pandemic, the United Nations estimates. … Since 2000, Bangladesh brought 33 million people —…

Worth reading: Less is more in intensive care

Catherine Auriemma et al. writing in Intensive Care Medicine: “The notion that ‘less is (or may be) more’ in intensive care medicine has been contemplated by experts for decades. However, not until Kox and Pickkers’ review in 2013 had there been careful consideration of the evidence supporting this theory.1 Their thought-provoking article focused specifically on…

Worth reading: Communicating ICU Prognosis

A randomized trial published today in JAMA Network Open, with the useful visual abstract below. TL;DR: Participants who viewed videos using indirect or redirection language perceived the physician to be more optimistic than those who viewed a video of the physician answering the question directly. This is troubling because it suggests that that the families…

“My only crime is my face,” Perspective from Mary Oyama Mittwer and Miné Okubo

While browsing through an online museum exhibit, I came across an excerpt from this compelling article written during the internment of Japanese Americans in World War II. I managed to find a scan of the full article hosted by the UC Berkeley Library. The writer describes her family’s internment experience until their release in 1943,…

COVID-19: Did the Spanish Flu kill “an estimated 2 to 3 percent of those infected”?

Within the past few weeks, as the COVID-19 pandemic spread across the world, commenters in news media have propagated a meme that’s now firmly embedded in the public consciousness. It’s best summed up in an article in Vox that’s typical of the trend, “Did the coronavirus get more deadly? The death rate, explained.”1 The Vox…

Coronavirus in Italy – Report From The Front Lines

A JAMA livestream from March 13: Insights from Maurizio Cecconi, MD, of Humanitas University in Milan, at the epicenter of the pandemic where the overwhelming majority of Italy’s COVID-19 cases are being treated. Some important points: Despite reports from China, the Italian experience so far is that the clinical picture is like any other interstitial…

Hildegard von Bingen – Canticles Of Ecstasy

The medieval music ensemble Sequentia created what I think are the most enjoyable renditions of the music of Hildegard von Bingen. I’m currently listening to Canticles of Ecstasy, one of nine albums of von Bingen’s music recorded by Sequentia. I reviewed her book Scivias in a previous blog post. From Sequentia’s Hildegard von Bingen Project,…

Covid-19 — Navigating the Uncharted

Just published today (February 28, 2020) in the New England Journal of Medicine, from Anthony Fauci and Clifford Lane (director and deputy director, respectively, of the NIH’s National Institute of Allergy & Infectious Disease) and Robert Redfield (director of the CDC). A clear, concise report on what is currently known about the SARS-CoV-2 outbreak from…