What a time to be a Fellow at NIAID – especially as a public health student.

SARS-Cov-2 is what the world is dealing with. As you know, we are now facing a pandemic.
Here is what I have to offer:
Everyone is posting this graph with the two peaks. Well, what this is essentially demonstrating is the rate of transmissibility when taking transmission prevention measures vs not – how many people an infected person will likely infect with and without non-pharmaceutical prevention measures (i.e. social distancing, limited social interaction, washing the hell out of your hands, not traveling, working remotely, etc).

Screen Shot 2020-03-12 at 4.09.45 PM.png

Here is something similar – understanding the preventive measures impact in the context of China. R0 = R Naught = redprediction had no preventive measures been taken. Re = Effective Reduction Rate = orange = prediction for preventive measures taken. Blue = actuality.

Screen Shot 2020-03-12 at 4.29.18 PM.png

Source: https://art-bd.shinyapps.io/nCov_control/

Why are so many people dying in Italy? Here are some speculations:
Reactionary prevention measures – aka shutting the city down too late – when it’s already widespread. How much testing is going on? Less than places like S Korea. So, what’s the true denominator? That is, the true prevalence? Preparedness of their healthcare system? Case Fatality Rates (CFR) will appear higher when the denominator is lower than reality – the denominator being the prevalence. 
Why was the case fatality rate in the US ~5% last week but ~3% this week? Here are some speculations.
More testing is occurring now – which means the prevalence # would increase because we’re identifying more cases – thus the denominator would increase = CFR is lower.

The US healthcare system considered a level 3 in preparedness. We do have the personnel, the money, the laboratory capacity, etc. We are extremely prepared to address a pandemic.

But guess what we don’t have that everyone else does?

Healthcare here is NOT free like it is everywhere else. Therefore, preparedness only takes us so far. What happens to those who can’t afford the doctors visit when they have symptoms? What happens when a vaccine is available and those uninsured cannot afford to receive it? Trump HHS admin already said that it will not be affordable for everyone. What happens to those people? Spread of disease perhaps?

We can put 8.3 Billion dollars into vaccine development – but if everyone can’t access it then

…. . . . . .  .  .  .  .  .   .   .   .   .    .     .     .    .   .   .   .   .  .  .  .  . . . . . ….exactly.

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This is a prime example of how problematic not having free healthcare is in this country.

This is also a prime example of how interconnected the world is and how important it is to not be fucking self-centered.

This is also a prime example of how Emerging Infectious Diseases (EIDs), diseases we’ve never dealt with before, as a result of the [[VERY REAL]] climate change could impact the world.

Symptoms? They are similar to getting a cold or flu, most common ones being fever, shortness of breath and cough. Have symptoms? SEE A DOCTOR. DON’T PLAY AROUND. Average incubation for symptoms to be displayed is right around 5 days but could stem anywhere from 2-14 days.

Anyway, please take this pandemic seriously. Here are some links that are informative and also appealing. Utilize them. If the news is telling you the virus is living on surface areas for NINE days – then watch a different news source – because we are still figuring that out. We are still figuring A LOT of things out. Until testing capacity increases, we don’t even know the true prevalence.
Be well!

https://gisanddata.maps.arcgis.com/apps/opsdashboard/index.html#/bda7594740fd40299423467b48e9ecf6

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