Mar 17: French doctor Didier Raoult et al publish a paper suggesting that hydroxychloroquine and antibiotic azithromycin could be effective against the disease. (1/6)
Several public figures like @elonmusk jumped on the bandwagon promoting the drug based on results from basic research (not randomized trials, not even observational studies). (2/6)
And, obviously, the President also chimed in...(3/6)
Recent evidence shows surge in chloroquine prescriptions, likely due to off-label prescriptions for COVID-19 and “President Trump’s support of the drug”. Fills increased from 2208 in 2019 to 45 858 prescriptions (that’s a 1977.0% increase!) (4/6) jamanetwork.com/journals/jama/…
We now have strong evidence (study of 96,032 individuals) that chloroquine with or without a macrolide likely do not help and might even cause more harm than benefit. Studies are still ongoing and stronger evidence will accrue. (5/6)
So if you have large followings and think you must join the scientific discussion, pls adhere to the same stringent principles as real scientific journalists do and don't promote potentially harmful drugs (@realDonaldTrump & @elonmusk). (6/6) #firstprinciples
How a former Secretary of Defense will turn your kid into a genius problem-solver.
Thread 🧵 (1/11)
(2/11) In a 2002 news briefing about the lack of evidence linking [[Iraq]] to the supply of [[weapons of mass destruction]] to terrorist groups, former secretary of defense, [[Donald Rumsfeld]], coined a famous expression...
Pitfall #1: We don‘t know how many people have been truly infected. [1/4]
Pitfall #2: We remain uncertain about the extent of protective immunity, which greatly impacts the course of the epidemic.
Pitfall #3: What’s the extent of transmission and immunity among ppl with no or minimal symptoms (and children) [2/4]
Pitfall #4: It‘s very hard to measure and model contact rates between susceptible and infectious ppl nodt only under phys distancing but also in various reopening scenarios. [3/4]
New meta-analyisis estimates: (1) proportion of truly asymptomatic #COVID19 cases and (2) proportion of #SARS_CoV_2 transmission from asymptomatic or pre-symptomatic individuals [1/3] medrxiv.org/content/10.110…
Overall, proportion of people who become infected with #SARS_CoV_2 and remain asymptomatic through the course of infection estimated to be 15% [2/3]
40-60% of #SARS_CoV_2 infections are the result of transmission from pre-symptomatic individuals. The contribution from asymptomatic individuals seems to be much smaller estimated at around 6% (but wide confidence intervals). [3/3]
@JohnsHopkinsSPH measured the prevalence of serious psychological distress in 1468 adults aged 18 years or older in Apr 2020 & compared it with an identical measure from the 2018 National Health Interview Survey (NHIS). Thread (1/6)
In April 2020, 13.6% of US adults reported symptoms of serious psychological distress, relative to 3.9% in 2018. That’s a 3.5-fold increase. (2/6)
Age: symptoms of psychological distress were highest among young adults aged 18 to 29 years. Distress decreased with increasing age in 2020. Previously, no effect of age on distress. (3/6)
Great review of neuropathogenesis and neurologic manifestations of #covid19 published in JAMA Neurology on May 29 by @SpudichLabYale (THREAD, 1/10)
How does #sarscov2 get into the CNS? ACE2 receptors are expressed in multiple regions & on multiple cels of the human brain. (2/10)
Viral invasion of the CNS could happen in one of three ways. Nr 1: via the olfactory nerve (i.e., the transcribrial route). Olfactory nerve infection could also explain the common findings of loss of smell (anosmia) and loss of taste (ageusia). (3/10)