March 1st Links

Still thinking about WuFlu, hope to write about it sometime soon. (See previously guest posts by @pdxsag.) Other good accounts to monitor: @Barton_options, @tvrb, @evdefender, @toad_spotted, @DrEricDing,@timeofmonsters_, and @DavidBCollum.

Here is an early start on the week's Links:

• The hypothesis presented herein is that salicylate therapy for influenza during the 1918–1919 pandemic resulted in toxicity and pulmonary edema, which contributed to the incidence and severity of early ARDS-like lungs, subsequent bacterial infection, and overall mortality. Pharmacokinetic data, which were unavailable in 1918, indicate that the aspirin regimens recommended for the "Spanish influenza" predispose to severe pulmonary toxicity. A confluence of events created a "perfect storm" for widespread salicylate toxicity. The loss of Bayer's patent on aspirin in February 1917 allowed many manufacturers into the lucrative aspirin market. Official recommendations for aspirin therapy at toxic doses were preceded by ignorance of the unusual nonlinear kinetics of salicylate (unknown until the 1960s), which predispose to accumulation and toxicity; tins and bottles that contained no warnings and few instructions; and fear of "Spanish" influenza, an illness that had been spreading like wildfire. [link]
• Loose hypothesis from a chat, and thread of implications: primary transmission channel is via fecal/fluid particles attaching to shitty air particles, shutting down factories is what brought spread rate down in Wuhan, "r0" seems to be v variable bc it's not classically spreading person to person, it's effectively a miasma, ditto some of the "asymptomatic transmission", "just a bad flu" vs "requires ventilation" may well depend on initial viral load, ie, how many particles you're huffing, transmission channel via bad apartment block (or cruise ship) plumbing would give you localized exponential growth, but movement of ppl would then not give you *severe* outbreaks in new areas unless you had same particulate concentration. Explains no new cases from plague ship [Twitter]
• There is evidence that, in human populations, SARS CoV is excreted in feces, vomit, respiratory secretions and urine. One outbreak cluster (the Amoy Gardens in Hong Kong), which affected 329 people and caused 42 deaths, was characterized by rapid spread of the infection between occupants of apartments in a multi-tower block complex. Modeling and simulation studies revealed that this spread was linked to fecal droplet transmission, which could be traced back to inadequately maintained water traps and reduced water use for bathroom cleaning, resulting in non-functional water locks of floor drains. This, combined with air movement instigated by overpowered bathroom extractor fans, created conditions that were highly conducive to virus transmission. [link]
• The problem is that in the real world, the world is dynamic not static. All else is not held constant, and the actions and reaction-functions of economic actors focusing on the micro-level factors in their own businesses can change emergent macro factors in unanticipated ways. In the case of the shale sector, what actually happened dynamically is that as individual shale O&G producers pushed to ramp up volumes in order to enhance fixed-cost absorption, the supply of oil and gas rapidly increased, which resulted in a significant decline in O&G prices. Every single producer held every other producers' behaviour constant, and assumed only their own would change, and what was rational at the level of the individual turned out to be irrational at the level of the collective. [LT3000]
• The Institute of Medicine recommendation for adults younger than 70 years of age is 600 IU of vitamin D daily. We are told that this would achieve a level of 50 nmol/L in greater than 97.5% of individuals. Regrettably, a statistical error has resulted in erroneous recommendations by the Institute of Medicine leading to this conclusion and it might actually take 8800 IU of vitamin D to achieve this level in 97.5% of the population. This is a serious public health blunder. A colleague of mine and I have introduced vitamin D at doses that have achieved greater than 100 nmol/L in most of our patients for the past number of years, and we now see very few patients in our clinics with the flu or influenzalike illness. In those patients who do have influenza, we have treated them with the vitamin D hammer, as coined by my colleague. This is a 1-time 50 000 IU dose of vitamin D3 or 10 000 IU 3 times daily for 2 to 3 days. The results are dramatic, with complete resolution of symptoms in 48 to 72 hours. One-time doses of vitamin D at this level have been used safely and have never been shown to be toxic. We urgently need a study of this intervention. The cost of vitamin D is about a penny for 1000 IU, so this treatment costs less than a dollar. [link]
• Beginning Thursday, we will eliminate the ability to freely comment on every story on cleveland.com and will remove comments from old posts. We want our site to contribute to the greater good. It's why we've cut way back on using mug shots that perpetuate racial stereotypes. It's why we have been a leader with our Right to be Forgotten policy, in which we remove names from dated stories about embarrassing things people have done. [Cleveland]