COVID-19: Profile of a killer, new IFR estimate from Germany, and Merkel accelerates reopening

Profile of a killer: the complex biology powering the coronavirus pandemic David Cyranoski, writing in Nature, offers what I think might be the single best summary of what we know about SARS CoV-2. Interestingly, Klaus Stöhr, who was head of the World Health Organization’s SARS research and epidemiology division, offers some perspective that echoes my…

COVID-19: The forgotten victims

I’ve written previously about the massive public health impact of government responses to the pandemic: The United Nations estimates that global poverty trends will be reversed for the first time since 1998, pushing “half a billion people into destitution.” The World Health Organization recently warned that lockdown-induced shortages and disruptions in vaccine distribution (reported in…

Worth reading: Suicidality is increasing in the US

More bad news. Between 2005 and 2015, the suicide fatality rate in the US increased 13% among those aged 20-64. Suicide attempts increased among all age groups. “Suicide attempts increased in females, adolescents, and older people, while suicide fatalities (mainly shootings and hangings) increased in those aged 20 to 64. The finding that both incidence…

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 —…

Sara Crager on right heart failure

Although I’ve been a religiously devoted listener of Scott Weingart’s EMCrit podcast for over five years, I haven’t previously shared an episode here on the blog. EMCrit recently featured a grand rounds lecture from Sara Crager on right heart failure that’s among the best lectures I’ve heard. Dr. Crager brilliantly distills complex physiology into a…

Worth reading: On Schmaltz

An article on lost heritage and Jewish identity by the pediatrician Daniel Summers. On Schmaltz How a Jewish cookbook helped me recover my lost heritage I was fortunate enough not to have struggled with identity in the same way pediatrician Daniel Summers did in his childhood, realizing that he was gay in an evangelical, fundamentalist…

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…

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…

Worth reading: The Case for Waking

Poetry and medicine, from Janis Lou Harrington in JAMA: https://jamanetwork.com/journals/jama/article-abstract/2757230 The Case for Waking “I. Beside my husband’s ICU bed, I plead my case for waking, hold my palm flat as a bible, place his warm hand on mine. His face inscrutable beneath a bandage wreath, he breathes on his own, his heart pumps, his…

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…