jm + covid-19   57

Vitamin D supplementation recommended to help fight COVID-19 in Ireland
'Epidemiological studies, including several meta-analyses, have shown that people with low vitamin D levels have a higher risk of acute respiratory tract infection and community-acquired pneumonia.
While these data do not necessarily infer causality, multiple molecular mechanisms have been identified by which vitamin D deficiency impairs resistance to viral respiratory tract infection.

There are also a significant number of studies, including several meta-analyses, which have indicated that vitamin D supplementation may reduce the likelihood of acute respiratory tract infection, and decrease its severity and duration where such infection does occur. These respiratory tract infections may include Covid-19.

Proposed Protective Mechanisms against Covid-19: In this regard, vitamin D supplementation has been shown to suppress CD2614, a cell surface receptor which is thought to facilitate entry of the Covid-19 virus into the host cell.

There is also good evidence that enhanced vitamin D status may protect against the critical immunological sequelae which are thought to elicit poorer clinical outcome in Covid-19 infection. These include prolonged interferon-gamma response, and persistent interleukin 6 elevation, a negative prognostic indicator in acutely-ill pneumonia patients, including those with Covid-19.'
covid-19  health  medicine  vitamins  vitamin-d  supplements 
yesterday by jm
Unified research on privacy-preserving contact tracing and exposure notification for COVID-19 - Google Docs
'This document has been created to share information across the numerous projects that are working to create mobile apps to help contact tracers fight COVID-19. Many technologists who are designing privacy-preserving apps and tools for this process are new to contact tracing, and want to ensure that their work is solidly grounded in the work that public health professionals are doing around the world. This document aims to collate questions, statistics and experiences to ensure that apps are relevant and well-designed.'
docs  gdocs  contact-tracing  privacy  apps  coding  tech  covid-19  collaboration 
yesterday by jm
Fangcang shelter hospitals
... a novel public health concept. They were implemented for the first time in China in February, 2020, to tackle the coronavirus disease 2019 (COVID-19) outbreak. The Fangcang shelter hospitals in China were large-scale, temporary hospitals, rapidly built by converting existing public venues, such as stadiums and exhibition centres, into health-care facilities. They served to isolate patients with mild to moderate COVID-19 from their families and communities, while providing medical care, disease monitoring, food, shelter, and social activities.
fangcangs  hospitals  covid-19  buildings  architecture  emergencies  china  pandemics  medicine 
yesterday by jm
Aarogya Setu
via Amit Agarwal on Twitter -- India's COVID-19 contact-tracing app, using GPS location and Bluetooth.
ble  bluetooth  contact-tracing  via:amit-agarwal  india  apps  android  ios  covid-19 
2 days ago by jm
COVID-19 Practical Advice
lhl's giant list of COVID advice. This is exhaustive and well-researched. (via Waxy)
via:waxy  lhl  covid-19  health  medicine  advice  self-treatment 
2 days ago by jm
Proprietary reagents are blocking COVID-19 testing worldwide
Workers Solidarity on Twitter: "HSE briefing last night revealed the limit on number of #cornoravirus tests that can be carried out is due to companies keeping the manufacturing process for a key reagent secret" -- top twitter thread.

Proprietary IP rights over COVID-19 reagents are liable to kill thousands, if not millions. It's time to put these into the commons for the public good.
wsm  twitter  threads  hse  covid-19  reagents  testing  chemicals 
3 days ago by jm
PEPP-PT
Yet another privacy-preserving contact tracing app system, this time from a pan-European consortium:
Pan-European Privacy-Preserving Proximity Tracing
(PEPP-PT) makes it possible to interrupt new chains of SARS-CoV-2 transmission rapidly and effectively by informing potentially exposed people. We are a large and inclusive European team. We provide standards, technology, and services to countries and developers. We embrace a fully privacy-preserving approach. We build on well-tested, fully implemented proximity measurement and scalable backend service. We enable tracing of infection chains across national borders. 

(via Cory)
coronavirus  tracing  gdpr  covid-19  privacy  contact-tracing  apps  europe  via:doctorow 
3 days ago by jm
COVID-19 and the NHS—“a national scandal” - The Lancet
Bloody hell, the UK is heading for a disaster.

'The NHS has been wholly unprepared for this pandemic. It's impossible to understand why. Based on their modelling of the Wuhan outbreak of COVID-19, Joseph Wu and his colleagues wrote in The Lancet on Jan 31, 2020: “On the present trajectory, 2019-nCoV could be about to become a global epidemic…for health protection within China and internationally…preparedness plans should be readied for deployment at short notice, including securing supply chains of pharmaceuticals, personal protective equipment, hospital supplies, and the necessary human resources to deal with the consequences of a global outbreak of this magnitude.”

This warning wasn't made lightly. It should have been read by the Chief Medical Officer, the Chief Executive Officer of the NHS in England, and the Chief Scientific Adviser. They had a duty to immediately put the NHS and British public on high alert. February should have been used to expand coronavirus testing capacity, ensure the distribution of WHO-approved PPE, and establish training programmes and guidelines to protect NHS staff. They didn't take any of those actions. The result has been chaos and panic across the NHS. Patients will die unnecessarily. NHS staff will die unnecessarily. It is, indeed, as one health worker wrote last week, “a national scandal”. The gravity of that scandal has yet to be understood.'
covid-19  government  uk  disasters  nhs  the-lancet  pandemics  ppe  scandals 
3 days ago by jm
How they flattened the curve during the 1918 Spanish Flu
How some cities ‘flattened the curve’ during the 1918 flu pandemic
Social distancing isn’t a new idea—it saved thousands of American lives during the last great pandemic. Here's how it worked.


(via Vipul Ved Prakash)
via:vipul  covid-19  history  coronavirus  pandemics  flu  1918  social-distancing 
3 days ago by jm
'Estimating the number of infections and the impact of nonpharmaceutical interventions on COVID-19 in 11 European countries'
new paper from the Imperial College COVID-19 epidemiological team:

'Following the emergence of a novel coronavirus (SARS-CoV-2) and its spread outside of China, Europe
is now experiencing large epidemics. In response, many European countries have implemented
unprecedented non-pharmaceutical interventions including case isolation, the closure of schools and
universities, banning of mass gatherings and/or public events, and most recently, widescale social
distancing including local and national lockdowns.

In this report, we use a semi-mechanistic Bayesian hierarchical model to attempt to infer the impact
of these interventions across 11 European countries. Our methods assume that changes in the
reproductive number – a measure of transmission - are an immediate response to these interventions
being implemented rather than broader gradual changes in behaviour. Our model estimates these
changes by calculating backwards from the deaths observed over time to estimate transmission that
occurred several weeks prior, allowing for the time lag between infection and death.'
covid-19  papers  europe  uk  lockdowns  pandemics  social-distancing  modelling  medicine 
4 days ago by jm
'They are leading us to catastrophe': Sweden's coronavirus stoicism begins to jar | World news | The Guardian
A petition signed by more than 2,000 doctors, scientists, and professors last week – including the chairman of the Nobel Foundation, Prof Carl-Henrik Heldin – called on the government to introduce more stringent containment measures. “We’re not testing enough, we’re not tracking, we’re not isolating enough – we have let the virus loose,” said Prof Cecilia Söderberg-Nauclér, a virus immunology researcher at the Karolinska Institute. “They are leading us to catastrophe.”
sweden  fear  covid-19  europe  politics  science 
4 days ago by jm
'Production of 3D printed components for ventilation systems: practical hints'
Notes from the front lines in Italy:

'The current emergency allows exceptions to the use of not certified medical devices, if it is proved
that no certified choices are available and in accordance with the local ethical committee.
Furthermore, due to the short time required for the production, it is not possible to run extensive
testing campaigns on the components, but each [additive manufacturing] operator must pay attention to the selection of
materials and technologies that are suitable for the specific application, considering the risk
classification of the components and the operational environment.
In the following we summarize the workflow we applied at 3D4Med (http://www.3d4med.eu) – the
Clinical 3D Printing Laboratory of San Matteo Hospital in Pavia – and Protolab – its engineering
counterpart – to produce some of the requested components, along with some practical examples.'
3d-printing  emergencies  italy  covid-19  medicine  healthcare  3d4med  ventilators  cpap 
5 days ago by jm
Notes From the Battlefield March 30, 2020 - SAGES
'Despite that devastation from the disease still continues, and being too early to draw any definitive conclusions, there are some signs that the slope of COVID-19 new cases in Italy may be starting to slow down. Italian epidemiologists feel it is the result of the strict physical distancing measures. As health care providers, this appears to be the best preventive measure to emphasize and possibly the only intervention currently available to overcome this epidemic.'
pandemics  covid-19  italy  medicine  social-distancing 
5 days ago by jm
Medtronic releases PB560 Ventilator Design and Manufacturing docs
Schematics, manuals, manufacturing docs for the Medtronic PB560 ventilator, released under a permissive license. Awesome stuff.

'We appreciate your interest in using the design specifications for the Medtronic PB560 ventilator system to help address the shortage of ventilators due to the COVID-19 pandemic. We invite manufacturers, engineers, and other innovators to use these files as inspiration for their own innovations.'
medtronic  ventilators  covid-19  specifications  hardware  manuals  medicine 
5 days ago by jm
What happened with the UK's "herd immunity" COVID-19 strategy
"I'll tell you what happened in the UK. Over the past decade, eminent figures in public health developed complex models that would help inform the UK response to a pandemic. The response plan would allow slow spread through a population and a number of deaths that would be deemed acceptable in relation to low economic impact. Timing of population measures such as social distancing would be taken, not early, but at a times deemed to have maximal psychological impact. Measures would be taken that could protect the most vulnerable, and most of the people who got the virus would hopefully survive. Herd immunity would beneficially emerge at the end of this, and restrictions could relax. This was a ground-breaking approach compared to suppressing epidemics. It was an approach that could revolutionise the way we handled epidemics. Complex modelling is a new science, and this was cutting edge.

But a model is only ever as good as the assumptions you build it upon. The UK plan was based on models with an assumption that any new pandemic would be like an old one, like flu. And it also carried a huge flaw - there was no accounting for the highly significant variables of ventilators and critical care beds that are key to maintaining higher survival numbers."

Amazing. The sheer arrogance and hubris of assuming the model was right! Somebody will have to pay for this, it's shocking.
herd-immunity  hubris  arrogance  covid-19  uk  uk-politics  pandemics  models  data-science  epidemiology 
7 days ago by jm
Carl T. Bergstrom on Twitter
"a personal thread about the experience of working at the intersection of infectious disease modeling and the study of misinformation during the worst pandemic in a century:
the fight against misinformation is not merely a scientific communication issue. It's a vital public health necessity. [...] In all the years of studying infectious disease and planning for this day, I never dreamed that when it came I'd be opposed by my own federal government, a non-trivial fraction of my fellow citizens, and as yet undetermined fraction of hostile foreign actors.
disinformation  misinformation  propaganda  trump  covid-19  scicomm  science  public-health  social-media  twitter  pandemics 
9 days ago by jm
Ireland COVID19 GeoHive
the official ArcGIS dashboard for Ireland's COVID-19 response
covid-19  dashboards  arcgis  geohive  data  ireland 
11 days ago by jm
What’s the Evidence on Face Masks? What You Heard Was Probably Wrong
According to research on the SARS epidemic, face masks were the most consistently effective intervention for reducing the contraction and spread of SARS. In a Cochrane Review on the subject, 6 out of 7 studies showed that face masks (surgical and N95) offered significant protection against SARS. Hand washing was also very effective, supported by 4 out of 7 studies in a multivariate analysis.
Although most of the studies in the Cochrane Review were on medical workers in a hospital setting, one study followed community transmission of SARS in Beijing. It found that consistently wearing a mask in public was associated with a 70% reduction in risk of catching SARS. Additionally, the authors of the paper noted that most people in the community wore simple surgical masks, not N95 respirators.
cochrane-reviews  health  medicine  face-masks  covid-19  germs  masks  transmission  sars 
12 days ago by jm
We Need A Massive Surveillance Program (Idle Words)
The most troubling change this project entails is giving access to sensitive location data across the entire population to a government agency. Of course that is scary, especially given the track record of the Trump administration. The data collection would also need to be coercive (that is, no one should be able to opt out of it, short of refusing to carry a cell phone). [...]

But the public health potential of commandeering surveillance advertising is so great that we can’t dismiss it out of hand. I am a privacy activist, typing this through gritted teeth, but I am also a human being like you, watching a global calamity unfold around us. What is the point of building this surveillance architecture if we can't use it to save lives in a scary emergency like this one?


+1000.
surveillance  advertising  contact-tracing  contact-tracking  tracking  location  smartphones  covid-19  pandemics\ 
12 days ago by jm
Professor Sara Sawyer's Decon Station Instructions
If you are sheltering-in-place and feel that you need to take extra precautions for a high-risk member of your household, you can decontaminate things before they come into your house.  Read on if you want to know how. This post addresses common questions that I am getting about mail, fruits, groceries, etc.

The following advice is my own, tailored for this specific situation, and is the best advice I can come up with based on the extensive biosafety training that I have received as a research scientist who works with human viruses.


(via Pam)
biosafety  viruses  covid-19  decontamination  sterilising  sterilizing  health  via:pam 
12 days ago by jm
Jen Heemstra on Remdesivir
'At this point, you’ve probably heard a ton about chloroquine and hydroxychloroquine and how they may be effective in treating COVID-19. I wanted to tell you about a different molecule that’s getting less attention but may have good potential – Remdesivir.'

How Remdesivir works to inhibit viral replication. Fascinating stuff
remdesivir  viruses  science  chemistry  medicine  drugs  covid-19  treatment 
12 days ago by jm
Anosmia could be a symptom of COVID-19
ENT UK on Twitter: "There is the potential to reduce COVID-19 transmission by requesting that individuals with new onset of anosmia self-isolate. A lost sense of smell as marker of COVID-19 infection..."
covid-19  smell  senses  symptoms 
13 days ago by jm
Open Source COVID19: Our Intent, Needs, and Your Role - Google Docs
'PPE (Personal Protection Equipment) is critical to the protection of healthcare workers, acting as a barrier and therefore controlling exposure to COVID-19. Some of the most fundamental items comprising PPE include gloves, goggles, surgical masks, respirators, protective gowns, and disinfectant. Many of these crucial PPE items are now in short supply due to interruptions in the supply chain, and also from the massive demand as the number of patients infected continues to grow exponentially.
Numerous medical devices are required to treat the COVID-19 patient and will also fall into short supply (e.g. ventilators). Shortages of necessary PPE and medical devices will continue to pose a significant problem for healthcare workers and patients around the globe.'
open-source  covid-19  ppe  medicine  3d-printing  makers  volunteers 
14 days ago by jm
Rapidly manufactured ventilator system specification - GOV.UK
This is a specification of the minimally (and some preferred options) clinically acceptable ventilator to be used in UK hospitals during the current SARS-CoV2 outbreak. It sets out the clinical requirements based on the consensus of what is ‘minimally acceptable’ performance in the opinion of the anaesthesia and intensive care medicine professionals and medical device regulators.

It is for devices, which are most likely to confer therapeutic benefit on a patient suffering with ARDS caused by COVID-19, used in the initial care of patients requiring urgent ventilation. A ventilator with lower specifications than this is likely to provide no clinical benefit and might lead to increased harm, which would be unacceptable for clinicians and would, therefore, not gain regulatory approval.
disease  covid-19  crowdsourcing  hospitals  medicine  3d-printing  ventilators 
14 days ago by jm
TraceTogether
The Singapore government's version of the anonymised-ids-with-BLE local contact tracing app for COVID-19. This has a fancy video! (via Dorothy)
contact-tracing  singapore  contacts  ble  bluetooth  covid-19  pandemics 
14 days ago by jm
Coronavirus: Deaconess asks public to sew medical face masks
Shortages of specialized masks moved federal health officials this month to liberalize their recommendations about which face protection front line health-care workers should use to ward off the highly contagious disease stemming from coronavirus.

“Prior to modern disposable masks, washable fabric masks were standard use for hospitals,” said Dawn Rogers, MSN, RN, FNP-C, Patient Safety & Infection Prevention Office in a release to media.  “We will be able to sterilize these masks and use them repeatedly as needed. While it’s less than ideal, we want to do our best to protect our staff and patients during this pandemic.” 
facemasks  covid-19  shortages  pandemics  medicine  emergency 
15 days ago by jm
Safe Paths
Another privacy-preserving COVID-19 contact-tracing app, this one from MIT:
The news: An app that tracks where you have been and who you have crossed paths with—and then shares this personal data with other users in a privacy-preserving way—could help curb the spread of Covid-19, says Ramesh Raskar at the MIT Media Lab, who leads the team behind it. Called Private Kit: Safe Paths, the free and open-source app was developed by people at MIT and Harvard, as well as software engineers at companies such as Facebook and Uber, who worked on it in their free time.  
mit  contact-tracing  privacy  apps  smartphones  android  ios  covid-19  epidemics  pandemics 
17 days ago by jm
Global MediXchange for Combating COVID-19 - Alibaba Cloud
The Jack Ma Foundation and Alibaba Foundation, together with the First Affiliated Hospital of Zhejiang University, jointly established the Global MediXchange for Combating COVID-19 (GMCC) programme, with the support of Alibaba Cloud Intelligence and Alibaba Health, to help combat the global outbreak of the novel coronavirus, COVID-19. This platform was established to facilitate continued communication and collaboration across borders, as well as to provide the necessary computing capabilities and data intelligence to empower pivotal research efforts. The platform can provide frontline medical teams with the necessary communication channels to share practical experience and information about fighting the pandemic.


They've put together a handbook of COVID-19 preventation and treatment, based on the Chinese experience.
treatment  medical  covid-19  china  jack-ma  alibaba  medicine  health 
17 days ago by jm
Open Source COVID19 Medical Supplies | Facebook
A very active group of makers sharing designs and plans for open source face masks, ventilators, etc.
covid-19  open-source  facebook  medicine  face-masks  ppe  hardware  3d-printing 
17 days ago by jm
Medical company threatens to sue volunteers that 3D-printed valves for life-saving coronavirus treatments - The Verge
This is absolutely appalling behaviour. People are dying -- free the blueprints!
A medical device manufacturer has threatened to sue a group of volunteers in Italy that 3D printed a valve used for life-saving coronavirus treatments. The valve typically costs about $11,000 from the medical device manufacturer, but the volunteers were able to print replicas for about $1 (via Techdirt).

A hospital in Italy was in need of the valves after running out while treating patients for COVID-19. The hospital’s usual supplier said they could not make the valves in time to treat the patients, according to Metro. That launched a search for a way to 3D print a replica part, and Cristian Fracassi and Alessandro Ramaioli, who work at Italian startup Isinnova, offered their company’s printer for the job, reports Business Insider.

However, when the pair asked the manufacturer of the valves for blueprints they could use to print replicas, the company declined and threatened to sue for patent infringement, according to Business Insider Italia. Fracassi and Ramaioli moved ahead anyway by measuring the valves and 3D printing three different versions of them.
covid-19  ip  patents  italy  3d-printing  hardware  ip-rights  law 
17 days ago by jm
Specifications for simple open source mechanical ventilator
from Julian Botta, Johns Hopkins Emergency Medicine Resident PGY-3 , Twitter: @julianbotta

'This is a living document intended to give non-clinicians/non-respiratory therapists an idea of key ventilator features and one proposed simplified design. I encourage other healthcare professionals who are very familiar with ventilators and their use to give me feedback using the comments feature to improve these specifications.'
specifications  ventilators  open-source  covid-19  medicine  hardware 
17 days ago by jm
'Impact of non-pharmaceutical interventions (NPIs) to reduce COVID19 mortality and healthcare demand'
This is the report from the Imperial College COVID-19 Response Team which, it seems, *finally* got the UK and US to realise that this is going to require a massive social-distancing and lockdown to avoid killing millions. The graph on the last page in particular is a kicker.
covid-19  health  pandemics  epidemics  medicine  social-distancing  imperial-college  uk 
17 days ago by jm
COVID-19 Risk App

COVID-19 has a relatively long infectious incubation period, averaging five days but potentially up to two weeks, during which there may be asymptomatic transmission. In other words, there may be a period of time in which people who carry COVID-19 don't necessarily show symptoms and may not even realise they are infected, but are still capable of infecting others. This makes it harder for health professionals and epidemiologists to trace who has come into contact with infected persons ('contact tracing'), which in turn makes the virus more difficult to effectively contain.

Many people, however, now carry GPS-enabled smartphones which already track their location over time - most mapping apps, like Google Maps or MapQuest, already collect this data by default. We believe that this information could be used to rapidly and automatically perform a type of contact tracing, helping limit the spread of COVID-19 and other infectious diseases. These phones are usually also Bluetooth-enabled, allowing them to track and record which other phones they're in proximity to.

We believe that together, these two pieces of information can be used to inform and empower our users in a range of ways. Firstly, we can generate heatmaps of high-risk areas from demographic data, known cases, and epidemiological modelling, allowing users to adjust their behaviour accordingly. Secondly, we can use Bluetooth connections between users to enact cryptographically secure contact tracing and alerting them if we learn that they have been exposed to COVID-19, without revealing the identities or infection status of any other users.
covid-19  contact-tracing  apps  android  ios  smartphones  privacy  location 
18 days ago by jm
'Sustainable containment of COVID-19 using smartphones in China: Scientific and ethical underpinnings for implementation of similar approaches in other settings'
China have enforced a variety of measures aimed at social distancing including lockdowns, restrictions on movement and cordon-sanitaires, as well as the Alipay Health Code smartphone application (an add on to the WeChat app system) now adopted in over 200 cities and by 90% of individuals in one Chinese province. A separate system has been implemented in South Korea, and both have come under public scrutiny over issues of data protection and privacy.
We sought to design a broadly acceptable version of this platform, leveraging commonly used smartphone functionality. This system is currently in development, and based on a very simple algorithm, that we show through mathematical modelling will enable public health agencies to prevent a COVID-19 epidemic while minimizing social and economic disruption.

This also introduced me to a new concept, "herd protection", which is described as "Ronald Ross's great discovery: you don't need to stop all infections to stop an epidemic, you need to get and keep R<1."
papers  toread  covid-19  herd-protection  social-distancing  movement  cordons  quarantine  epidemics  pandemics  china  smartphones  location 
18 days ago by jm
If You Go Out Now, You Might Feel Guilty Later. I Do.
Others have written eloquently of the importance of social distancing. But the scale and scope of this is something every single one of us is having to grapple with. Things that felt like a dumb overreaction a week ago — “Canceling vacation? Really?” — now feel hilariously quaint. Or if they don’t, they will soon.

If you still can’t quite believe that you need to take these measures, or that people’s lives may hang in the balance, or if you still think that it will be okay because the numbers where you live aren’t so bad yet, I am not here to scold you.

But if you do go out, and you do risk infecting somebody else, you may feel the guilt — and the fear — that I’m struggling with right now. Trust me, it’s not worth it.
social-distancing  covid-19  isolation  quarantine  infection  pandemics 
20 days ago by jm
Project Open Air
We are working on medical devices, such as open source ventilators, to have a fast and easy solution that can be reproduced and assembled locally worldwide. If you have any skills that you consider might help, join the Helpful Engineering group.
health  medicine  ventilators  devices  hardware  design  engineering  covid-19 
20 days ago by jm
The Paradox of Preparation
Chris Hayes on Twitter: "A doctor I spoke to today called this the “paradox of preparation” and it’s the key dynamic in all this. The only way to get ahead of the curve is to take actions that *at the time* seem like overreactions, eg: Japan closing all schools for a month with very few confirmed cases".

See also the Millennium Bug, and what's currently (failing) to happen with climate change. This is a great concept, and good to have a name for it.
millennium-bug  paradox-of-preparation  covid-19  pandemics  preparation 
20 days ago by jm
Health expert brands UK's coronavirus response 'pathetic'
There were no strategies for protecting the vulnerable and there had been a failure to engage the public. “We have a superficial prime minister who has got no grasp of public health,” Ashton said. “Our lot are behaving like 19th-century colonialists playing a five-day game of cricket. “This virus will find the weak points. You can’t just plan this from an office in Whitehall. It’s pathetic. The government doesn’t seem to understand classic public health. You need to be out and about. You need to get your hands dirty – though preferably gloved and using frequent gel,” he said.
coronavirus  covid-19  guardian  uk  health  medicine  herd-immunity 
22 days ago by jm
educational/maths resources for your children at home
Another good set of links for the COVID-19 lockdown
education  teaching  maths  math  covid-19  kids 
22 days ago by jm
COVID-19 Notes from UCSF Expert panel - March 10
Superb set of points from a star-studded panel:
Joe DeRisi: UCSF’s top infectious disease researcher. Co-president of ChanZuckerberg BioHub (a JV involving UCSF / Berkeley / Stanford). Co-inventor of the chip used in SARS epidemic.
Emily Crawford: COVID task force director. Focused on diagnostics.
Cristina Tato: Rapid Response Director. Immunologist. 
Patrick Ayescue: Leading outbreak response and surveillance. Epidemiologist.  
Chaz Langelier: UCSF Infectious Disease doc.
covid-19  health  medicine  ucsf  diseases  epidemiology 
22 days ago by jm
COVID-19 may be infectious for 3 days prior to symptoms becoming noticeable
Examination of 124 Wuhan cases with clear contact history showed incubation period of 5 days (range: 1-11 days). It found that 73% of secondary cases were infected *before* onset of symptoms in first case. It estimated the mismatch period to be 3 days.


This is bad news for controlling the spread based on testing only people with symptoms.
covid-19  diseases  health  epidemics 
22 days ago by jm
How to Utilise Twinkl during the Coronavirus Shutdown: A Guide for Schools
Another "what to do with the kids during self-isolation" resource, used by our kids' school apparently
kids  education  self-isolation  covid-19 
23 days ago by jm
"The Italian College of Anesthesia, Analgesia, Resuscitation and Intensive Care just published the most extraordinary medical document I've ever seen"
Unpleasant stuff:
A week ago, Italy had so few cases of corona that it could give each stricken patient high-quality care. Today, some hospitals are so overwhelmed that they simply cannot treat every patient. They are starting to do wartime triage. Here’s the guidance for that.
italy  healthcare  safety  medicine  covid-19  emergencies  triage  hospitals 
24 days ago by jm
Effectiveness of Common Household Cleaning Agents in Reducing the Viability of Human Influenza A/H1N1
Good to know. This is testing against a H1N1 flu virus, but hopefully applies for COVID-19 too.
... Rapid treatment of the virus with hot water had little effect on the virus, reducing the titre by around two-fold, but prolonged incubation at 55°C abolished detectable infectivity. However, the addition of any of 1% bleach, 50% and 10% malt vinegar and 1%, 0.1% and 0.01% washing up liquid were all effective at rapidly reducing viable virus below the limit of detection, while a low concentration of vinegar (1%) was no more effective than hot water alone (Figure 1A). In contrast to the plaque assay results, most agents were ineffective at reducing the number of detectable genome copies as determined by RT-PCR, with only bleach having a significant effect (Figure 2A). The data for the plaque assays and RT-PCR assays are compiled in Tables S1 and S2. Thus, while a strong oxidizing agent such as bleach is effective at reducing both genome detection and virus infectivity, low pH and detergent are equally efficacious virucidal agents. These results also indicate that whilst vinegar and detergent disrupt the viral envelope proteins reducing infectivity, only bleach disrupts the viral genome.


(Via Damien)
via:damien  health  cleaning  covid-19  washing 
24 days ago by jm
low-cost mechanical ventilator prototype
a team of students from MIT has devised a better way to keep patients breathing in places that lack standard mechanical ventilators, or during times of emergency such as pandemics or natural disasters, when normal hospital resources may be overextended. They have designed a system that uses the same widely available manual pump — the same type used for the farmer in India. The new system encases the pump in a plastic box with a battery, motor and controls to take the place of the manual compression process.


This article from 2010 notes 'a U.S. government study in 2005 found that in a worst-case pandemic scenario, this country alone might need more than 700,000 mechanical ventilators, while only 100,000 are now in use.'
ventilators  covid-19  breathing  healthcare  hardware  mit  ambu-bag 
25 days ago by jm
Nextstrain / narratives / ncov / sit-rep / 2020-03-05
This is an amazing piece of data -- phylogenetic analysis of the COVID-19 epidemic as it spreads across the globe.

'The following pages contain analysis performed using Nextstrain. Scrolling through the left-hand sidebar will reveal paragraphs of text with a corresponding visualization of the genomic data on the right-hand side. To have full genomes of a novel and large RNA virus this quickly is a remarkable achievement. These analyses have been made possible by the rapid and open sharing of genomic data and interpretations by scientists all around the world (see the final slide for a visualization of sequencing authorship).'
genetics  phylogenetics  nextstrain  covid-19  diseases  epidemics  viruses 
26 days ago by jm
Testimony of a surgeon working in Bergamo, in the heart of Italy's coronavirus outbreak : medicine
Terrifying:
After thinking for a long time if and what to write about what's happening here, I felt that silence was not responsible. I will therefore try to convey to lay-people, those who are more distant from our reality, what we are experiencing in Bergamo during these Covid-19 pandemic days. I understand the need not to panic, but when the message of the danger of what is happening is not out, and I still see people ignoring the recommendations and people who gather together complaining that they cannot go to the gym or play soccer tournaments, I shiver. I also understand the economic damage and I am also worried about that. After this epidemic, it will be hard to start over.
viral  reddit  bergamo  healthcare  covid-19  epidemics  medicine 
26 days ago by jm
Internet Book of Critical Care (IBCC) on COVID-19
Detailed info on COVID-19 diagnosis and treatment for healthcare professionals
medicine  covid-19  coronavirus  diseases  pandemics 
29 days ago by jm
We’re learning a lot about the coronavirus. It will help us assess risk
Early studies on Covid-19 suggest people who have contracted the coronavirus are emitting, or “shedding,” infectious viruses very early on — in fact sometimes even before they develop symptoms. “We do know from shedding studies that people can shed in the pre-symptomatic phase,” Van Kerkhove said, adding that while the data are still preliminary “it seems that people shed more in the early phases rather than the late phases of disease.”


...also: 'This week the WHO said the case fatality ratio currently looks like 3.4% — which is not a reassuring number.'
diseases  coronavirus  covid-19  health  pandemics 
29 days ago by jm
Ciarán Murray on Twitter - another Coronavirus thread - estimating the COVID-19 case fatality rate
'on the basis of what we can learn from the very unfortunate experiment that was the Diamond Princess, the coronavirus is probably at most 13x more lethal than the flu and likely a lot less lethal - probably closer to 5x more lethal (.3% CFR).'
cfr  diseases  covid-19  coronavirus  medicine 
4 weeks ago by jm
Why Some COVID-19 Cases Are Worse than Others
For reasons that aren’t entirely clear, some people—especially the elderly and sick—may have dysfunctional immune systems that fail to keep the response to particular pathogens in check. This could cause an uncontrolled immune response, triggering an overproduction of immune cells and their signaling molecules and leading to a cytokine storm often associated with a flood of immune cells into the lung. “That’s when you end up with a lot of these really severe inflammatory disease conditions like pneumonia, shortness of breath, inflammation of the airway, and so forth.”
covid-19  health  diseases  immune-system  medicine 
5 weeks ago by jm
So you think you’re about to be in a pandemic?
Some concrete advice if COVID-19 hits (which seems very likely), around:

1. Reducing our risk of being infected;
2. Reducing the chance we will run out of essential foods and goods.
planning  pandemic  covid-19  stockpiling  health  medicine  diseases  epidemic 
5 weeks ago by jm

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