Why the United States is having a coronavirus data crisis

 ‘Political meddling, disorganization and years of neglect of public-health data management mean the country is flying blind...

‘Almost every day for the past seven months, the Korea Centers for Disease Control and Prevention has updated its website with near-real-time information on local outbreaks. The site also reports several COVID-19 statistics for every region of the country. Data dashboards in Singapore and New Zealand offer similar windows into how the coronavirus is spreading within their borders. This helps policymakers and citizens determine how to go about daily life, while reducing risks—and provides researchers with a wealth of data. 

‘By contrast, the United States offers vanishingly few details on how the disease is spreading, even as people increasingly socialize and travel, and authorities reopen schools and businesses. This state of affairs is frustrating data researchers, who want to help authorities make decisions that can save lives...

‘Although information isn’t the only tool that can be used against a pandemic, South Korea’s attention to data correlates with its overall success at controlling the outbreak: the country has had about 3.5 cases per 10,000 people overall, and there have been around 2 COVID-19 deaths per week over the past month. By contrast, the United States has had 175 cases per 10,000 people overall, and about 7,000 people have died of the disease every week for the past month.’

Read here (Scientific American, August 26, 2020)

Why do some people weather coronavirus infection unscathed?

‘Asymptomatic cases are not unique to Covid-19. They occur with the regular flu, and probably also featured in the 1918 pandemic, according to epidemiologist Neil Ferguson of Imperial College London. But scientists aren’t sure why certain people weather Covid-19 unscathed. “That is a tremendous mystery at this point,” says Donald Thea, an infectious disease expert at Boston University’s School of Public Health...

‘Disease tolerance is the ability of an individual, due to a genetic predisposition or some aspect of behavior or lifestyle, to thrive despite being infected with an amount of pathogen that sickens others... At least 90 percent of those infected with the tuberculosis bacterium don’t get sick. The same is true for many of the 1.5 billion of people globally who live with parasitic worms called helminths in their intestines...

‘...there are countless disease tolerance pathways. “Every time we figure one out, we find we have 10 more things we don’t understand,” King says. Things will differ with each disease, he adds, “so that becomes a bit overwhelming.”

‘Nevertheless, a growing number of experts agree that disease tolerance research could have profound implications for treating infectious disease in the future. Microbiology and infectious disease research has “all been focused on the pathogen as an invader that has to be eliminated some way,” says virologist Jeremy Luban of the University of Massachusetts Medical School. And as Ayres makes clear, he says, “what we really should be thinking about is how do we keep the person from getting sick.”

Read here (Scientific American, August 25, 2020) 

Evidence for convalescent plasma coronavirus treatment lags behind excitement

‘But so far, there’s little evidence that plasma actually helps patients, and the decision could confound efforts to study its effects, says former FDA commissioner Robert Califf, who now heads clinical policy and strategy at Verily and Google Health in South San Francisco, California... Convalescent plasma has been tested only in small trials without the statistical power to provide firm conclusions... “It’s a potential therapy that could work, and I don’t think it’s out of bounds to make it available” with an authorization, says Califf. “But we ought to be really emphasizing in public-service announcements that participation in randomized trials is a first priority.” 

[This story was written before the US Food and Drug Administration issued an emergency-use authorisation on August 23 to treat COVID-19 with convalescent plasma.]

Read here (Scientific American, August 24, 2020)

The 1918 flu faded in our collective memory: We might ‘forget’ the coronavirus, too

‘This year is not the first time a new pandemic has prompted reexamination of the one in 1918. The 20th century saw two more flu pandemics, which occurred in 1957 and 1968. In both cases, “suddenly the memory of the Great Flu reoccurs,” Beiner says. “People begin looking for this precedent; people begin looking for the cure.” Likewise, during the avian flu scare in 2005 and the swine flu pandemic in 2009, Google searches worldwide for “Spanish flu” spiked (though both increases were dwarfed by the one that occurred this past March). All the while a growing body of historical research has been fleshing out the story of the 1918 flu, providing the foundation for a significant resurgence of its memory in the public sphere.’

Read here (Scientific American, August 13, 2020) 

Nine important things we’ve learned about the coronavirus pandemic so far

Here are nine of the most important things we’ve learned about SARS-CoV-2 in the past seven months and why we didn’t fully understand or appreciate them at first.

1. Outbreaks of COVID-19 can happen anywhere
2. COVID-19 can sicken and kill anyone
3. Contaminated surfaces are not the main danger
4. It is in the air
5. Many people are infectious without being sick
6. Warm summer weather will not stop the virus
7. Masks work
8. Racism, not race, is a risk factor
9. Misinformation kills

Read here (Scientific American, August 4, 2020) 

Lessons for Covid-19 from the early days of AIDS

‘Thirty-six years ago, we were, like today, in the midst of a new and still somewhat mysterious global pandemic. In the U.S. alone, more than one million people were infected with HIV, and 12,000 had already died of AIDS. At the time, we were just beginning to understand how the virus worked. But that didn’t stop some leaders from making wildly optimistic claims about an AIDS vaccine being delivered within two years.

‘Now, with COVID-19, we are in a remarkably similar spot: 2.7 million people have been infected across the U.S., and 128,000 have died of the disease. Despite our limited understanding of how the novel coronavirus works and what it does to the human body, many are putting what I consider a disproportionate amount of faith in the possibility of a COVID-19 vaccine by 2021. My feelings today echo my feelings a third of a century ago: yes, a vaccine may be possible, but it is by no means a certainty.’

Read here (Scientific American, July 6, 2020)

Coronavirus antibody tests have a mathematical pitfall

‘...such [antibody] tests have been proposed as a way for individuals to find out if they have already been infected with the novel coronavirus. But a mathematical wrinkle makes these tests—and in fact, all screening tests—hard to interpret: even with a very accurate test, the fewer people in a population who have a condition, the more likely it is that an individual's positive result is wrong. If it is, people might think they have the antibodies (and thus may have immunity), when in fact they do not.

‘A positive screening test result for other diseases usually prompts follow-up testing to confirm a diagnosis. But for COVID-19 screening, such follow-up has been rare because testing resources are scarce or because other testing methods are prioritized for the sickest patients. Here's a look at the massive impact infection rates can have on the predictive value of these tests for individuals.’

Read here (Scientific American, July 2020, pre-published in June 19, 2020)

A visual guide to the SARS-CoV-2 Coronavirus

‘In the graphics that follow, Scientific American presents detailed explanations, current as of mid-May, into how SARS-CoV-2 sneaks inside human cells, makes copies of itself and bursts out to infiltrate many more cells, widening infection. We show how the immune system would normally attempt to neutralize virus particles and how CoV-2 can block that effort. We explain some of the virus's surprising abilities, such as its capacity to proofread new virus copies as they are being made to prevent mutations that could destroy them. And we show how drugs and vaccines might still be able to overcome the intruders.’

Read here (Scientific American, June 15 web story for July 2020)

Religion and science in a time of Covid-19: Allies or adversaries?

‘The current zeitgeist tells us that we must pick a side, as we do in sports or politics; one cannot be an adherent of both. Either choose secular science, which is rational and rigorous; or religion, a matter of personal belief.

‘But perhaps this narrative represents a false dichotomy. Does the tension between science and religion really exist? And in the context of COVID-19, is it inconceivable that a scientist can wholeheartedly pray for a cure for a loved one whilst also working to develop a vaccine?’

Read here (Scientific American, June 11, 2020)

What social distancing reveals about East-West differences

‘In short, while the Chinese may not experience social-distancing anxiety as we Americans do, the pandemic seems to have brought out individualistic ways of thinking in some. Of course, divorce rates and rationales can only tell a small part of the sprawling story that is China. Still, might the globalization that has drawn East and West so much closer together physically also, via the pandemic, draw us ever so slightly closer together psychologically as well? It’s possible.’

Read here (Scientific American, June 6, 2020)

Genetic engineering could make a Covid-19 vaccine in months rather than years

‘The established approach is to grow weakened viruses in chicken eggs—or more recently in mammalian or insect cells—and extract the desired pieces. The process can take four to six months to get the right antigens for familiar viruses that change every year, such as influenza. It can take multiple attempts over years for a new germ. That is far too slow to combat a virus that has already spread to pandemic proportions.

‘Instead labs are turning to gene-based vaccines. Scientists use information from the genome of the virus to create a blueprint of select antigens. The blueprint is made of DNA or RNA—molecules that hold genetic instructions. The researchers then inject the DNA or RNA into human cells. The cell’s machinery uses the instructions to make virus antigens that the immune system reacts to. Cells respond to the instructions as a normal part of their daily existence. This is the same trait infectious viruses exploit; they cannot reproduce on their own, so they use a cell’s machinery to make copies of themselves. They burst out of the cell and infect more cells, widening the infection.’

Read here (Scientific American, May 14, preview of June 1, 2020 issue)

What Covid-19 antibody tests can and cannot tell us

‘Dozens of antibody tests for the novel coronavirus have become available in recent weeks. And early results from studies of such serological assays in the U.S. and around the world have swept headlines. Despite optimism about these tests possibly becoming the key to a return to normal life, experts say the reality is complicated and depends on how results are used.

‘Antibody tests could help scientists understand the extent of COVID-19’s spread in populations. Because of limitations in testing accuracy and a plethora of unknowns about immunity itself, however, they are less informative about an individual’s past exposure or protection against future infection.’

Read here (Scientific American, May 5, 2020)

Nurses are playing a crucial role in this pandemic — as always

‘Nursing’s contributions to improving the public’s health during times of crisis dates back to the days of Nightingale, modern nursing’s founder. In 1918 during the disastrous influenza pandemic, nurses were steadfast in modeling the teachings of Nightingale, a staunch supporter of good handwashing, proper sanitation and sound preventive measures. Members of the Visiting Nurses Associations made home visits to patients providing critical nursing care as one of the only treatment measures available during that time. Nurses were vigilant in promoting the benefits of being exposed to fresh air, practicing good hand hygiene and maintaining social isolation while conducting home visits to patients.’

Read here (Scientific American, May 4, 2020)

Covid-19 and the harsh reality of empathy distribution

‘Empathy has a substantial genetic contribution, about half as much as height, a group of researchers found in 2018. Inevitably, some individuals inherit more pro-empathy genes than average. Moreover, since they are likely to be born from empathic parents, such children will also witness empathic behaviors and be rewarded for performing them. Thus, learning and family values reinforce the pro-social neural circuitry. Such individuals are likely to become professional caregivers.’

Read here (Scientific American, May 2, 2020)

The rise of ‘health entertainment’ to convey lifesaving messages in the Covid-19 pandemic

‘An unprecedented global crisis demands unprecedented creativity in the health communication field. The world’s most trusted voices in public health urgently need to be heard by meeting their audiences on social media and capturing their attention through innovative message design. We’ll never come up with impactful, innovative solutions if we stay inside our comfort zone.’

Read here (Scientific American, May 1, 2020)