Perspective on the pandemic from Vinay Prasad

I’ve been a fan of Vinay Prasad (a hematologist-oncologist and researcher on health policy and clinical trials) since coming across his thoughtful commentary on social media years ago. Since then, I’ve been a regular listener of his podcast, Plenary Session, and read his excellent books on medical reversal and cancer policy. A central theme of…

COVID-19: “Cautious optimism” from NIH and BMJ on T cells and immunity

Since May, I’ve closely followed research on T cell cross-reactivity to SARS-CoV-2 in unexposed individuals. This could hint at some degree of pre-existing immunity that’s potentially more widespread than previously believed, leading to a number of hopeful possibilities: Could herd immunity thresholds be lower than believed? Are seroprevalence studies underestimating the number of people infected…

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…

Worth reading: This Hospital Cost $52 Million. It Treated 79 Virus Patients.

More from NYT on New York City’s shocking mismanagement of capacity during the height of the COVID-19 pandemic, discussed previously here. Excerpts below. This Hospital Cost $52 Million. It Treated 79 Virus Patients. “In past disasters, such as during Hurricane Sandy in 2012, the state created a unified system across multiple agencies to transfer patients…

COVID-19: Major vaccine news

Preliminary results just published in The Lancet, what one infectious disease specialist calls “one of the most remarkable scientific achievements of all time.” Safety and immunogenicity of the ChAdOx1 nCoV-19 vaccine against SARS-CoV-2: a preliminary report of a phase 1/2, single-blind, randomised controlled trial Commentary here. Lancet Twitter thread here.

COVID-19: Twitter polarizes our discourse at the worst possible time

It seems to me that there is no worse time for public, scientific discourse to be polarized than in the midst of a deadly pandemic that is affecting us all, directly and indirectly. I’ve decided to share a few examples of what I consider to be unhelpful “friendly fire,” though other examples are sadly too…

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: New paper in Nature on T cell immunity in unexposed individuals

A major paper now available in Nature confirms research I’ve reported on for the past few months, giving us yet more reason to believe that a substantial portion of the population possess pre-existing cross-reactive T cells due to prior infection with common cold viruses and that SARS-CoV-2-specific T cell immunity will be long lasting. Hopeful…

“Conversation is the essence of palliative care”

A recent episode of Scott Weingart’s excellent EMCrit podcast featured a thoughtful discussion with Kei Ouchi, MD, on one of the most important aspects of emergency medicine and critical care; conservations regarding end-of-life care. The focus here is on rapid code status conversation. The podcast page offers a slew of useful links, and references the…

COVID-19: Evidence continues to mount on immunity in unexposed & seronegative individuals

In May, I wrote about a number of studies which showed T-cell reactivity to SARS-CoV-2 in individuals who were not previously exposed to the virus (eg in samples obtained in 2015). The past several weeks have seen mounting evidence from independent researchers bolstering the case that a substantial proportion of the population already possess some…