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Beijing is shutting down interstate highways today
60% of flights cancelled

beijing-airport.com/pek-departures…
40% flights cancelled yesterday
just for 36 daily new cases (most of them asymptomatic)

while Texas has 80x more daily new cases, and continues to re-open.

txdshs.maps.arcgis.com/apps/opsdashbo…
Over-reaction or not.

the reason behind this is the understanding that

Beijing mayor and party chief will get fired in two weeks, if they don't get this outbreak contained really soon.

accountability works.
contrasting this with Sweden, where no decision maker has been fired for mistakes, you have the sad situation of

COVID patients over 70 being declined hospitalization and given e̵u̵t̵h̵a̵n̵a̵s̵i̵a̵ palliative cocktail (morphine and midazolam) routinely.
Details on how 70+ people in Sweden are m̵i̵s̵ treated for COVID19.

bmj.com/content/369/bm…

and this interview

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Barton
@Barton_options
Many asked me about dexamethasone today.

Sadly, another over-hyped "miracle" drug by certain fame-crazed doctors and science reporters.

the effectiveness of dexamethasone for *severe* COVID patients is neither surprising nor encouraging.
dexamethasone is a long-acting corticosteroid. like most corticosteroids, it reduces inflammation and suppresses immune response, both effects helpful to cope with a cytokine storm.

Other corticosteroids that have been used for COVID19 include methylprednisolone and prednisolone
Using corticosteroids is nothing new, and has always been an option for severe COVID patients as well as for SARS/MERS patients years ago.

covidprotocols.org/protocols/ther…

This methylprednisolone paper was published in March (death rate cut by 2/3)
pubmed.ncbi.nlm.nih.gov/32167524/
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Barton
@Barton_options
2nd wave of COVID19 in the US to be driven by 2nd-tier cities?

example: El Paso, TX has the same # of cases as Austin, TX (3.5x more population)

data: covid19.torchinsight.com
Fatality rate for this wave is likely 1/2-1/3 of the first wave, thanks to better treatment protocols: hospitals are better equipped/informed than they are in the first wave

ICU rate depends on how much early intervention each state is adopting.
Fed/Treasury/Congress are also better prepared this time.

2nd-tier cities/rural areas impact less on FANG, but probably bad for IWM.
Read 5 tweets
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Barton
@Barton_options
1/ UMN hydroxychloroquine PEP trial came out this afternoon.

It is a well-designed study with a fatal flaw.

The conclusion I can draw is HCQ does not prevent *self-reported* COVID19 from developing if taken 1-4 day post exposure.

nejm.org/doi/10.1056/NE…
2/ It does NOT answer the question whether HCQ helps to expedite COVID19 recovery or reduce disease severity.

The authors have a parallel study that I hope can address this question soon with higher quality data.

a quick look at the problem in the NEJM paper today.
3/ The fatal flaw here is that the vast majority (80%) of COVID19 cases as the end point is self-reported by symptoms, not by rtPCR or antibody or CT scans.

Authors acknowledged this too. This practical limit is not their fault, but it does discount the value of the study.
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