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…

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: How unusual is the age distribution of deaths?

The University of Oxford’s Centre for Evidence-Based Medicine recently compared the age distribution of COVID-19 deaths with deaths from the 2009 flu pandemic (which is estimated to have killed 150,000-575,000 worldwide).1 One remarkable aspect of the 2009 flu was that it resulted in disproportionately greater mortality among younger and generally healthier people than in a…

COVID-19: Have high hospitalization rates made things worse?

While the 2002-2004 SARS coronavirus typically led to more severe clinical presentation than seen with COVID-19 (14-20% of patients required ventilatory support, and the case fatality rate was 9.2% compared to 4.1% and 5.6% respectively for COVID-19),1 this actually contributed to effective containment of the outbreak. High rates of nosocomial transmission and severity of presentation…

COVID-19: Oxford’s Centre for Evidence-Based Medicine estimates global infection fatality rate of 0.29%

The University of Oxford’s Centre for Evidence-Based Medicine offers an extensive assessment of COVID-19 mortality and infection data in its article on Global Covid-19 Case Fatality Rates, updated daily. “Comparison with Swine Flu The overall case fatality rate as of 16 July 2009 (10 weeks after the first international alert) with pandemic H1N1 influenza varied…

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…

COVID-19: Mathematical models in the face of uncertainty

A study recently released by Imperial College London has been heavily reported in the media; the authors estimate that in the absence of mitigation, COVID-19 could claim the lives of 510,000 people in Great Britain and 2.2 million people in the United States by the end of August.1 A collaborative study overseen by Columbia University…

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…

Worth reading: History in a Crisis — Lessons for Covid-19

Much needed perspective from David S. Jones, M.D., Ph.D., in NEJM. www.nejm.org/doi/full/10.1056/NEJMp2004361 An especially worthwhile excerpt: “History suggests that we are actually at much greater risk of exaggerated fears and misplaced priorities. There are many historical examples of panic about epidemics that never materialized (e.g., H1N1 influenza in 1976, 2006, and 2009). There are countless…

Worth watching: Putting COVID-19 in Context

“During SCCM’s (Society of Critical Care Medicine) 49th Critical Care Congress, Amesh Adalja, MD, describes the history of coronavirus infections pre-SARS and post-SARS, describes members of the Coronavirus family and genus, and puts it into context around COVID-19 and how we can understand the clinical management of coronavirus infections.” The conference was held between February…