Category: Covid-19

“A Clinical Hunch by a Lot of Really Smart People”

(p. A1) Thomas Oxley wasn’t even on call the day he received the page to come to Mount Sinai Beth Israel Hospital in Manhattan. There weren’t enough doctors to treat all the emergency stroke patients, and he was needed in the operating room.

The patient’s chart appeared unremarkable at first glance. He took no medications and had no history of chronic conditions. He had been feeling fine, hanging out at home during the lockdown like the rest of the country, when suddenly, he had trouble talking and moving the right side of his body. Imaging showed a large blockage on the left side of his head.

Oxley gasped when he got to the patient’s age and covid-19 status: 44, positive.

The man was among several recent stroke patients in their 30s to 40s who were all infected with the novel coronavirus. The median age for that type of severe stroke is 74.

As Oxley, an interventional neurologist, began the procedure to remove the clot, he observed something he had never seen before. On the monitors, the brain typically shows up as a tangle of black squiggles – “like a can of spaghetti,” he said – that provide a map of blood vessels. A clot shows up as a blank spot. As he used a needlelike device to pull out the clot, he saw new clots forming in real-time around it.

“This is crazy,” he remembers telling his boss.

A SURGE

Reports of strokes in the young and middle-aged – not just at Mount Sinai but in many other hospitals in communities hit hard by the coronavirus – are the latest twist in our evolving understanding of its connected disease, covid-19. Even as the virus has infected nearly 2.8 million people worldwide and killed 195,000 as of Friday, its biological mechanisms continue to elude top scientific minds. Once thought to be a pathogen that primarily attacks the lungs, it has turned out to be a much more formidable foe – impacting nearly every major organ system in the body.

Until recently, there was little hard data on strokes and covid-19.

There was one report out of Wuhan, China, that showed that some hospitalized patients had experienced strokes but many of those were seriously ill and elderly. But the linkage was considered more of “a clinical hunch by a lot of really smart people,” said Sherry H-Y Chou, a University of Pittsburgh Medical Center neurologist and critical care doctor.

Now for the first time, three large U.S. medical centers are preparing to publish data on the stroke phenomenon. The numbers are small, only a few dozen per location, but they provide new insights into what the virus does to our bodies.

For the full story, see:

Ariana Eunjung Cha. “Strokes Are Striking Younger, Symptomless COVID-19 Victims.” The Washington Post (Saturday, April 25, 2020): A1.

(Note: bold in original.)

(Note: some of the above quote may have been continued onto a later page than A1.)

Data Retrieval Does Not Equal Creativity

(p. F2) Steve Jobs once described personal computing as a “bicycle for the mind.”

His idea that computers can be used as “intelligence amplifiers” that offer an important boost for human creativity is now being given an immediate test in the face of the coronavirus.

In March [2020], a group of artificial intelligence research groups and the National Library of Medicine announced that they had organized the world’s scientific research papers about the virus so the documents, more than 44,000 articles, could be explored in new ways using a machine-learning program designed to help scientists see patterns and find relationships to aid research.

. . .

Jerry Kaplan, an artificial-intelligence researcher who was involved with two of Silicon Valley’s first A.I. companies, Symantec and Teknowledge during the 1980s, pointed out that the new language modeling software was actually just a new type of database retrieval technology, rather than an advance toward any kind of “thinking machine.”

“Creativity is still entirely on the human side,” he said. “All this particular tool is doing is making it possible to get insights that would otherwise take years of study.”

For the full commentary, see:

John Markoff. “You Need A.I. to Spell Creative.” The New York Times (Thursday, April 9, 2020): F2.

(Note: ellipsis, and bracketed year, added.)

(Note: the online version of the commentary has the date April 8, 2020, and has the title “You Can’t Spell Creative Without A.I.”)

“Masks Are Pilloried Until They Are Mandatory”

(p. 6) The surreal reality of American cities and towns also mirrors the half-remembered, half-empty approximations explored in sleep, ordered by the same pliable, foggy logic: Masks are pilloried until they are mandatory; liquor stores open early for sexagenarians only; an invisible plague makes people fall gravely ill seemingly at random; touching anything — everything — is banned.

For the full story, see:

Caity Weaver. “The Interpretation of Viral Dreams.” The New York Times, SundayStyles Section (Sunday, April 12, 2020): 6.

(Note: the online version of the story has the date April 11, 2020, and has the title “Why Am I Having Weird Dreams Lately?”)

A City’s Prosperity “Can Be Fickle and Fleeting”

(p. 18) As the world pulls up its drawbridges during a time of pandemic and questions the merits of globalization, Malacca is a reminder that such transoceanic exchange has a long history of bringing both promise and peril.

And the city’s ultimate fate may serve as a warning that the prosperity globalization bestows on some can be fickle and fleeting. A city that once stood at the global crossroads can devolve into a backwater, and a once-thriving culture can face extinction.

Malacca’s port, once one of the richest on earth, silted up, and the city became a historical footnote. The spices that drove the age of exploration — nutmeg, cloves and mace — now molder in dusty cabinets, no longer treasured commodities.

And yes, a contagion struck, too, a plague that weakened the Portuguese hold on the city, paving the way for the Dutch and then the British, who favored other entrepôts and left Malacca to its slow decline.

For the full story, see:

Hannah Beech. “A Rich Melting Pot Centuries Ago, a Globalization Relic Today.” The New York Times, First Section (Sunday, April 12, 2020): 18.

(Note: the online version of the story has the date April 11, 2020, and has the title “500 Years Ago, This Port Linked East to West. Its Fate Was to Fade Away.”)

“The Licensing and Rollout” of Ebola Vaccine Was Accelerated

(p. 4) To combat Ebola in Congo, one of the world’s poorest nations, health workers are taking a multifaceted approach.

They have worked to win over communities that were sometimes uncooperative — even hostile.

They have drawn on technological innovations, notably a transparent enclosure known as the cube that allows medical workers to reach in and treat patients suffering from the contagious disease through plastic sleeves.

And they have used vaccines, developed relatively recently, which have made it possible to limit the spread of the epidemic.

. . .

The “cube” was . . . a big trust builder.

With transparent walls and integrated plastic sleeves and gloves, the air-conditioned chambers allowed medical teams to tend to Ebola patients without having to put on cumbersome protective gear. The cubes also allowed patients and their family members to see each other without risk of infection.

People were afraid of the treatment centers, where so many had died. But the cubes won trust for the health care workers, said Augustin Augier, chief executive of the Alliance for International Medical Action, the nonprofit aid group that developed the chambers.

“We asked the community to come and visit so they could see what was actually happening,” Mr. Augier said.

At least 500 patients were fully treated in the cubes, which could be set up in 90 minutes and reused up to 10 times, Mr. Augier, said.

But the key factor in curbing the spread of Ebola was the introduction of powerful vaccines and lifesaving antiviral drugs.

In early November 2018, the W.H.O. accelerated the licensing and rollout of the injectable Ebola vaccine Ervebo, made by the American pharmaceutical company Merck. Preliminary study results showed a 97.5 percent efficacy rate, prompting Congo, along with Burundi, Ghana and Zambia, to license the vaccine for wider distribution.

Nearly 300,000 doses of the vaccine have been administered in Congo, said Dr. Moeti of the W.H.O.

For the full story, see:

Abdi Latif Dahir. “Congo, Fresh From 2-Year Ebola Battle, Eyes New Virus.” The New York Times, First Section (Sunday, April 12, 2020): 4.

(Note: ellipses added.)

(Note: the online version of the story has the date April 11, 2020, and has the title “Congo Was Close to Defeating Ebola. Then One More Case Emerged.”)

For Venturesome Amazon Toilet Paper Shoppers, “Like Sandpaper” Is “Better than Nothing”

(p. B5) Where name-brand products sell out, off-brand products sold by third-party sellers have filled the void. Many of the top search results for toilet paper with regular Prime delivery were novelty rolls with zombies or the faces of politicians like Hillary Clinton.

In early April, Arielle Ogletree and her mother, who live near Tampa, Fla., were almost out of toilet paper when they turned to Amazon. They found a 16-pack of the large commercial toilet paper rolls found in public restrooms for $42. A few days later, it was at their door.

“It was the only one they had, and we figured it would last a while,” Ms. Ogletree said.

The roll, too big for a regular holder, sits awkwardly on their bathroom counter. Though the single ply feels “like sandpaper,” Ms. Ogletree said, it was better than nothing.

For the full story, see:

Karen Weise. “Confusion And Chaos At Amazon.” The New York Times (Saturday, April 18, 2020): B1 & B5.

(Note: the online version of the story has the date April 17, 2020, and has the title “When Even Amazon Is Sold Out of Exploding Kittens.”)

Covid-19 Pandemic Reduces Appeal of Reusable Bags

(p. B5) An oft-cited study by researchers at the University of Arizona and Loma Linda University found that reusable plastic bags can contain bacteria, and that users don’t wash reusable bags very often.

. . .

In New York, John Flanagan, the top Republican in the State Senate, called for the state this month to suspend the plastic bag ban that went into force on March 1 [2020]. The ban’s enforcement had already been delayed pending a legal challenge unrelated to the virus.

“Now is not the time or place,” Mr. Flanagan said in an interview. “This is a state of emergency.” Moreover, “people miss the plastic bags,” he said. “They were very functional and useful. We need to reopen the discussions.”

Libertarian groups have joined the effort. In Albuquerque, the Rio Grande Foundation, which bills itself as New Mexico’s premier free-market think tank, has spearheaded opposition to a move to strengthen the city’s plastic bag ban.

. . .

“Is there a worse idea in this time of Coronavirus,” the group quipped in a recent posting on Twitter, “than a plan to ‘more fully’ ban plastic bags?’”

Some supermarket chains have moved ahead with their own ban on reusable bags. The Midwestern supermarket chain Hy-Vee has said it was no longer accepting reusable bags at their stores. Price Chopper said on Twitter that it was phasing plastic bags back into use at its stores in New York.

For the full story, see:

Hiroko Tabuchi. “Plastics Industry Sees Chance to Undo Bans on Single-Use Bags.” The New York Times (Friday, March 27, 2020): B5.

(Note: ellipses, and bracketed year, added.)

(Note: the online version of the story has the date March 26, 2020, and has the title “In Coronavirus, Industry Sees Chance to Undo Plastic Bag Bans.”)

The “oft-cited study” mentioned above, is:

Williams, David L., Charles P. Gerba, Sherri Maxwell, and Ryan G. Sinclair. “Assessment of the Potential for Cross-Contamination of Food Products by Reusable Shopping Bags.” Food Protection Trends 31, no. 8 (Aug. 2011): 508–13.

“Bludgeoned by Years of Subservience to Their Masters in Beijing”

(p. C2) The salient fact that we have learned about Chinese administrative and managerial practices from this latest outbreak is not that China is capable of impressive infrastructure projects but that its vaunted system of top-down decision-making, state control and central planning is directly responsible in large part for the virulence, intensity and rapid spread of the disease that has already claimed more than 1,300 Chinese lives.

According to reports from Wuhan in this and other news outlets, one of the principal reasons that the virus spread so quickly and infected so many was because officials in Wuhan, bludgeoned by years of subservience to their masters in Beijing, were simply terrified of taking any initiative. Zhou Xianwang, Wuhan’s mayor, told reporters that he didn’t take measures to deal with the epidemic earlier because he needed authorization from his political bosses.

For the full commentary, see:

Gerard Baker. “China’s Crisis Exposes a Badly Flawed Model.” The Wall Street Journal (Saturday, February 15, 2020): C2.

(Note: the online version of the commentary was updated Feb. 14, 2020, and has the title “THE NEW NEW WORLD; A Loyal Chinese Critic Vanishes, in a Blow to the Nation’s Future.”)

Chinese Doctors Wear Adult Diapers to Avoid Taking Off Their One-Per-Day One-Piece Protective Suit

(p. A1) The coronavirus outbreak has exposed the jarring absence in China of a vibrant civil society — the civic associations like business groups, nonprofit organizations, charities and churches that bring people together without involving the government.

. . .

(p. A10) “The traditional management mechanism of ‘big government’ is no longer efficient, and is even failing,” Duan Zhanjiang, a management consultant, wrote in an article about managing the epidemic. “The government is very busy but not effective.

. . .

The Communist Party has never liked or trusted civil society. It is suspicious of any organization that could potentially pose challenge to its rule, including big private enterprises. It has cracked down on nongovernment organizations like rights groups and charities as well as churches and mosques. The party wants nothing to stand between its government and China’s 1.4 billion people.

Big Chinese corporations and wealthy individuals have been donating, many generously. But they also try to keep low profiles for fear of offending a government that is eager to take credit for any success and quick to suspect outside groups of challenging it.

Those gaps are evident on the front lines of the outbreak, where workers have lacked the proper equipment to keep themselves safe. Doctors and nurses wear disposable raincoats instead of protective gowns. They wear ordinary, and inadequate, surgical masks while conducting dangerous throat swab tests. They wear adult diapers because, once they take off their one-piece protective suits, the suits will have to be thrown away. They get only one per day.

For the full commentary, see:

Li Yuan. “THE NEW NEW WORLD; China Blocks Ally in Virus Fight: Its Own People.” The New York Times (Wednesday, February 19, 2020): A1 & A10.

(Note: ellipses added.)

(Note: the online version of the commentary has the date April 5, 2020, and has the same title “THE NEW NEW WORLD; In Coronavirus Fight, China Sidelines an Ally: Its Own People.”)