1/ Covid (@UCSF) Chronicles, Day 31
Things remain stable here: @UCSFhospitals 17 Covid pts, 2 on vent; ZSFG has 27 pts, 10 on vents. SF overall, 1058 cases, up 39. Sadly, 20 deaths in city, up 3. Still a far cry from NYC's ~9000
Things remain stable here: @UCSFhospitals 17 Covid pts, 2 on vent; ZSFG has 27 pts, 10 on vents. SF overall, 1058 cases, up 39. Sadly, 20 deaths in city, up 3. Still a far cry from NYC's ~9000
2/ It’s been 1 mth since I launched Covid tweets. We were entering a phase I thought would be apocalyptic; I never dreamed I’d be chronicling SF’s remarkably good fortune. For nostalgia’s sake, here’s my 1st post (3/18) bit.ly/2ROIujU & 2nd (3/19) bit.ly/2KfAV1y
3/ @ucsf, we were in crisis mode, scrambling to make scores of weighty decisions daily, from PPE policies to clinical workflow, steeling ourselves for a tsunami – one that, thankfully, never came. I fully expected we were heading into a hell like the one that actually hit NYC.
4/ It’s hard to appreciate NYC’s last mth without being there. Closest I’ve come is @nytimes diary of @drhelenouyang, an ER doc who deftly chronicled her experience nyti.ms/2XIZQ5z. Truly devastating, for the clinicians, patients, families, everyone. Couple of clips below
5/ Predictable that when to lift lock-down would become political football. But so sad: all rational people are trying to balance health w/ economy, even if the relative priorities & strategies vary a bit. Fine piece on Trump plan by Zeke & colleagues: nyti.ms/2xDRr90….
6/ …But NOT tough call to realize that opening Florida beaches today, as they have decided to do in Duval County (Jacksonville), is wildly irresponsible. Data from fab @ucsf-built #dataviz site covidcounties.org That’s not a curve that says its time to go back to the beach
7/ Remdesivir data still making news. You’ll recall @statnews obtained leaked video in which @UChicago researchr told early results of trial – sounded promising bit.ly/2ylT2jI Here’s nice piece on journalistic ethics of the leaks bit.ly/2zaXq5D by @garyschwitzer
8/ No doubt, as Gary says, we should “slow down our giddyup” on remdesivir. That said, if (as reported) it's true that 113 pts w/ Covid got IV remdesivir (presumably, all sick enough to be in the hospital) & only 2 died, and most left hospital in <6 days, that’s take-notice stuff
9/ 2 new studies add a bit of context. 1) @nejm paper from @nyphospital/@WeillCornell reported outcomes of 383 Covid pts (variety of treatments) admitted to 2 hosps in NY bit.ly/2Kbnksf Of 383, 130 (33%) had resp. failure &, after 22 d, only 1/3 of them were extubated
10/ Lengths of stay not reportd, but we know @ end of 3 wk study period 260 pts (66%) had been dischargd; rest died (40, 10%) or still in hospital; so few out in <6 d. Again, many caveats viz leaked study (anecdotal/no controls) but contrast betwn those rslts & @nejm # s striking
11/ Second is preprint of @NIH study treating Covid-19 in rhesus monkeys with remdesivir (I didn’t know monkeys got Covid, but there you go) bit.ly/3coEChB Drug prevented disease progression in the lungs. Usual caveats that animal results don’t always equal human ones.
12/ But all this puts remdesivir in pole position viz therapies. Not, as misleading headline @thestreet hawked, “Coronavirus Cure” (@gileadscience stock up 10%, BTW), but maybe Rx that could prevent some ICU/death. If so, might alter risk-benefit calculus for opening up society
13/ You'll recall Olive & Mabel, dogs of @MrAndrewCotter. We met them for an eating contest bit.ly/3c9ABNT & then in “Game of Bones” bit.ly/2VBoZwt with best line ever: “Olive, closing in on victory & that coveted prize of being told that she’s a very good dog.”
14/ At 0:48 in Bones, Olive makes move dubbed “high tariff.” Huh? I finally got translation from UK pals. From @marydixonwoods, gr8 quality researchr: High tariff “refers to complex manoeuvres capable of getting you a high score on sports like gymnastics & diving.” I feel better!
15/ Given (slightly) falling volume of news, stability in SF & @ucsf, & fact that writing on deadline is exhausting (I still have a day job), I’ll dial back next wk to posting M-W-F, with 1 more Thurs if we have a grand rounds.
Take time to cherish the good things. More Monday.
Take time to cherish the good things. More Monday.
