THREAD
1/ Of all the articles I read this week on #COVID19, this @nytimes ⬇️ really caught my eye.
It was an interview w/ Dr. Bruce Aylward, the lead on the @WHO team that visited China to examine their response.
It surprised me for multiple reasons.
nytimes.com/2020/03/04/hea…
1/ Of all the articles I read this week on #COVID19, this @nytimes ⬇️ really caught my eye.
It was an interview w/ Dr. Bruce Aylward, the lead on the @WHO team that visited China to examine their response.
It surprised me for multiple reasons.
nytimes.com/2020/03/04/hea…
2/ The first surprise was the speculation by many that the case fatality rate will be much lower once we find all of these “mild” and “asymptomatic” cases, which you don’t as easily pick up early on in an outbreak.
Apparently the data @WHO has doesn’t support this theory.
Apparently the data @WHO has doesn’t support this theory.
3/ The team went back & tested 320,000 samples originally taken for flu and other screening; only 0.5% returned positive.
Is this a perfect way to know if we had missed mild/asymptomatic cases? No.
But is it another point of data. Yes.
Is this a perfect way to know if we had missed mild/asymptomatic cases? No.
But is it another point of data. Yes.
4/ Another surprise: the Chinese data where the 80% “mild” cases number comes from —that was not a “mild cold”.
That was: you have a fever, possibly even a full pneumonia. Not your run-of-the-mill sniffles.
“Severe” (which was ~15%) meant you were on oxygen or a ventilator.
That was: you have a fever, possibly even a full pneumonia. Not your run-of-the-mill sniffles.
“Severe” (which was ~15%) meant you were on oxygen or a ventilator.
5/ Another point: is Chinese data accurate? Per what the team saw on the ground, visiting many testing sites, the demand seemed to have slowed drastically.
Does this mean every number is exactly correct? No.
Is it significant that the trends are showing a slowed epidemic? Yes.
Does this mean every number is exactly correct? No.
Is it significant that the trends are showing a slowed epidemic? Yes.
6/ The digital reorganization of the Chinese medical system as described here is remarkable.
-People could easily talk to doctors online
-order meds for delivery online
-essentially stop any unnecessary movement outside for critical tasks such as their medical care.
-People could easily talk to doctors online
-order meds for delivery online
-essentially stop any unnecessary movement outside for critical tasks such as their medical care.
7/ Their use of CT scanners as a screening test is also unreal.
200+ scans per machine per day.
That’s a scan every 6-7 minutes.
That is on level that most Western countries probably cannot/will not be able to replicate.
(Separate thread on testing ⬇️)
200+ scans per machine per day.
That’s a scan every 6-7 minutes.
That is on level that most Western countries probably cannot/will not be able to replicate.
(Separate thread on testing ⬇️)
8/ They also got their PCR turn around time to 4 hours.
I believe in the US it is still at least 2-3 times as long (maybe more, I’m not sure).
The people tested would wait for their result.
If positive, and mild, you went to an isolation center like a gym or large stadium.
I believe in the US it is still at least 2-3 times as long (maybe more, I’m not sure).
The people tested would wait for their result.
If positive, and mild, you went to an isolation center like a gym or large stadium.
9/ Hospital-level strategy was smart too.
Certain hospitals were designated just for #COVID19 cases.
They also moved where the wards were in the hospital to minimize in-hospital spread.
Oh- & built entire new hospitals.
Remember- this is all in a few *weeks*.
Unreal.
Certain hospitals were designated just for #COVID19 cases.
They also moved where the wards were in the hospital to minimize in-hospital spread.
Oh- & built entire new hospitals.
Remember- this is all in a few *weeks*.
Unreal.
10/ On top of all of this:
-the testing was completely free
-if your insurance coverage ran out, the government paid for the rest.
You didn’t have to wonder if you were going to be able to afford to get the care you needed. This was bigger than profits.
-the testing was completely free
-if your insurance coverage ran out, the government paid for the rest.
You didn’t have to wonder if you were going to be able to afford to get the care you needed. This was bigger than profits.
11/ The government reassigned workers to focus on #COVID19.
A former receptionist was taught, and then was teaching people how to gown properly.
Other provinces sent thousands of workers to come help.
And here we are fighting with each other over who “the experts” are.
A former receptionist was taught, and then was teaching people how to gown properly.
Other provinces sent thousands of workers to come help.
And here we are fighting with each other over who “the experts” are.
12/ They used technology in smart ways.
They took advantage of social media platforms to push out what is described as accurate information systematically and quickly to everyone.
Obtaining essentials like food was all done online.
They took advantage of social media platforms to push out what is described as accurate information systematically and quickly to everyone.
Obtaining essentials like food was all done online.
13/ What do we make of all of this? It is one person’s report of what he saw.
It’s not a large dataset or a Harvard Business School case study. But it is what we have right now.
We are fighting an epidemic and we need to figure out what to do. And China seems to have done it.
It’s not a large dataset or a Harvard Business School case study. But it is what we have right now.
We are fighting an epidemic and we need to figure out what to do. And China seems to have done it.
15/ Other #COVID19 THREADS I’ve made which people have found useful
My summary of the early @NEJM and @JAMA_current studies on #COVID19 ⬇️
My summary of the early @NEJM and @JAMA_current studies on #COVID19 ⬇️
16/ Thoughts on how to deal w/ information/misinformation during #COVID19, notably the difference b/w FACTS v OPINIONS
17/ Thoughts on what it means to be a #COVID19 “expert” - and why we need to work together, not try to take a siloed ownership over an epidemic
18/ Thoughts on why young, healthy patients who have mild symptoms need to avoid emergency rooms & call their doctors (or public health hotlines) instead to discuss first ⬇️
