3/ Here's some more data- why did life expectancy plummet in 1917-1918 (by 10 years!) then rebound completely?
Life expectancy is the average number of years a group of infants would live if they were to experience prevailing age-specific death rates throughout their life
4/ In other words, if the baby were to live life as if it were the first half of 2020, FOR EVERY YEAR OF THEIR LIFE, they would live to 77.8 years on average (can you imagine a more horrible existence?)
[side note- I would totally read that sci fi novel]
5/ So, when we get past this effing pandemic (and we WILL), then the age-specific death rates should go back to where they were- we have not erased a decade of progress.
And that should also go for the widened racial disparities in life expectancy too
6/ As my 9th grader put it- if there were an extra 500,000 deaths a year for the next 60 years, then a child born today would have one fewer year of life expectancy, as lived.
This doesn't minimize the catastrophe that is COVID- its to appreciate the miracle of public health
7/ That also shows how hard it is to ADD a year to life expectancy
Public health has added millions of years of life to born and unborn children over the past century
Through a cleaner environment
Through sanitation
With vaccines
And yes, by attacking smoking, and car safety
8/ I love my mom, and I missed her birthday today.
She lost a sister before her fifth birthday, to pertussis.
A baby girl born in Iran in 1940 had a life expectancy of 27 years. A baby born today can expect 76 years.
Don't take that progress for granted.
Public health 🙏
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1/ The Denmark variant story was pointed out by several people as being quite concerning- this line struck me - "Cases involving the variant are increasing 70 percent a week in Denmark, despite a strict lockdown"
But the actual data was hard to pin down- so I dug it up
2/ "The U.K. variant was 2 percent of sequenced coronavirus cases the last full week of 2020. By the second week of January, it had risen to 7 percent."
But in the context of declining cases what does that mean?
3/ But those aren't actually the true cases, cause despite the headline "Denmark is sequencing all coronavirus samples..." while they are *trying* to sequence all, the number of cases with a genome of sufficient quality relative to the total number of cases ranges w-w from 10-36%
2/ What's the natural response then, from those all the way down the distribution chain, from state administrators to hospital execs worried about "wrong people" getting vaccinated first?
You spend more time collecting data, parsing into finer and finer gradations
You slow down
3/ Hospitals and nursing homes don't release more to staff until every i has been dotted.
States don't release more to hospitals and nursing homes until they've used up allotment
feds don't release more to states
Amidst a vaccine shortage, available supply sits in warehouses.
1/ Opening schools in the midst of a COVID surge is a hard problem with unavoidable tradeoffs.
There are absolutist statements on either side of the debate, so I expect passionate rebuttals, but let me lay out a decision-making framework, from an epidemiologists' perspective
2/ First off, we have to make sure that the schools have the resources and space to implement the 5 key mitigation
strategies correctly and consistently.
Not a given.
*Masks
*Social distancing
*Contact tracing
*Hand hygiene
*Cleaning and disinfection
first 2 >> last 2
3/ Let's say we have some resources for testing, how does that contribute?
What we are trying to achieve?
Do you think the goal is Screening (identify asymptomatic infectious cases before they can expose others) or Surveillance (understand incidence to inform policy)?
1/ It's indescribable seeing results from NYC EMS ambulance runs showing how cardiac arrests skyrocketed during COVID
(I started a program to monitor these symptoms in real time--among the very first application of syndromic surveillance in public health, 2 decades ago)
2/ Every day, crews from @FDNY are called to 20 to 30 patients who have collapsed, and attempt resuscitation. Can you imagine?
It's never like the movies. Most patients die, ribs cracked. 75% of the time you never get a heart rate back.
On April 6, there were 305.
305.
3/ In the dry language of medical research the researchers describe the horrible statistics.
During the peak, most patients had nonshockable presenting rhythms of asystole and pulseless electrical activity. 92.2% of the time they called off the resuscitation without a pulse.