July 2020 Archives

Post-infection cardiac damage found in 78% of recovering COVID19 patients

That's 78% of a cohort, average age 49, of whom 67% had recovered at home (ie. disease was not categorized as severe enough to need hospitalization). Cohort was normalized with respect to other risk factors relative to uninfected patients. Diagnosis by MRI. Looks reasonably solid, at first glance, publication in JAMA Cardiol. (Journal of the American Medical Association, cardiology). Study coordinated via a German hospital.

Reason for "no comment necessary" is that this suggests most COVID19 survivors—including mild disease survivors—suffer cardiac damage.

You don't want to get this virus.

On April 16—gosh, it feels like an entire year ago—I made some predictions about where we were going. How do they hold up?

  1. Vaccine development will take a flat minimum of 12 months.

Too soon to tell; it's only been two and a half months. A few people have signed up for testing, but we won't know if the prototype vaccines have provided any protection for months yet. (I haven't seen any reports of them killing the guinea pigs though, so there's that.)

Manufacturing of vaccine adjuvants and the little extras required to turn a raw product into a deliverable medical treatment are in progress, though.

  1. Lockdown can't be sustained more than 1-2 weeks after peak ICU occupancy passes, so it will be lifted in mid-May in the UK and possibly as early as May 1st in the USA.

I am really glad I got this wrong. Lockdown lasted until the end of May in the USA; it began being relaxed in England in mid-June, and here in Scotland non-essential shops are due to lift in July. The English government (that is, the Westminster parliament governing England: Scotland is run by the Holyrood parliament in respect of domestic affairs such as public health and education) tried to convince schools to re-open, but that mostly flopped; Scottish schools are, I believe, staying shut until the next academic year (the Scottish school year ends earlier than the English one by a couple of weeks).

Incidentally, Scotland is broadly coping better than England per this dashboard: there have been no new COVID19 cases confirmed in the past 4-5 days. However, Westminster's desire to dink with the statistics in order to justify a premature re-opening is making it hard to tell just WTF is going on.

  1. Trump is shooting for May 1st because he's been told the economy will take 6 months to recover ... 1-4 weeks later there will be a secondary surge in infections and it'll follow the same exponential growth

Because the US lockdown didn't really begin to lift until June, the USA is hitting this secondary surge right now, and some states are trying to lock down again. Red states with Republican governors who are in complete denial are getting hit badly, though—notably Texas and Florida.

  1. Extra Lulz in the UK

Boris clung on to power and is now visible again, busy pulling levers and waffling in public, Cthulhu help us. His main approach to COVID19 is to treat it as a public relations project, so he's going with patriotic rah-rah rhetoric rather than coolly rational choices. Because he's not a planner he delegates everything to Dominic Cummings, who is in the process of purging the top ranks of the civil service and replacing the current leadership with those willing to swear a loyalty oath to Brexit.

It'd be hilarious if I wasn't trapped in the back of the bus these clowns are driving towards a cliff.

  1. Wildcards: we might conceivably find a simple and effective medical treatment.

Hydroxychloroquine is a bust (snake oil is about what you can expect from a snake oil salesman). Dexamethasone improving the prognosis for ICU patients is a welcome finding, but it's not a magic bullet—it just reduces the death toll by up to 30% among people who require mechanical ventillation. Trump buying up the global supply of remdesivir (even though it's not very effective) is exactly the kind of Milo Minderbinder act you'd expect of the guy. Prediction: it won't work, but it'll make Trump lots of enemies and a little bit of money.




What did I miss?

I missed: the rest of the world, where populist authoritarian leaders everywhere are trying to make Trump and Johnson's handling of COVID19 look magisterial and professional, from Brazil's Bolsonaro to Russia's Putin.

I totally didn't see Black Lives Matter turning into a global protest movement. To be fair, George Floyd was brutally murdered by the Minneapolis police department on May 25th, and the predictive blog entry I'm referring back to was posted more than a month earlier. (I've only posted once since then, prior to this, and that last blog entry was about brainstorming a fiction idea, not current affairs.) In retrospect I should have anticipated that heavy-handed racist policing of lockdown would lead to numerous flashpoints worldwide. There have been other side-effects: illegal raves and parties in the UK, for example. Widespread flouting of social distancing and/or masking guidelines, and the emergence of anti-mask rhetoric among Trump loyalists as a very disturbing kind of political statement.

There's a growing, seemingly global, sense that we can't or shouldn't go back to the status quo ante—in many ways, this sentiment ehoes earlier occasions when pressure for major social change emerged during and after world wars. The long term global economic effects, and possibly the death toll, are clearly in the same order of magnitude as a 20th century global war: it may be that such wars (or in this case a frightening pandemic) provide the trigger for the sort of societal change more normally associated with revolutions. (This certainly happened in 1917-19, and again in 1945-49.)

A new world is being born. I just hope I live to see it, and that there's room in it for someone like me to exist.

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