Discordant Data from the Diamond Princess

Diamond Princess (ship)One of the first concentrated outbreaks of COVID-19 was on board the cruise ship Diamond Princess, one of whose passengers tested positive for COVID-19 in Hong Kong on 2020-02-01.  The patient had onset of symptoms on 2020-01-19, one day before boarding the ship and disembarked at Hong Kong on 2020-01-25.  When the ship returned to Yokohama, Japan on 2020-02-03, it was held in quarantine, during which time a total of 3,063 PCR tests were performed on the 3,711 passengers and crew.  By 2020-02-20, there were 634 confirmed cases on-board, of which 328 were asymptomatic (positive on the PCR test, but with no self-reported symptoms as of that date, although symptoms may have developed subsequently).

A detailed analysis of this outbreak by eleven authors from the London School of Hygiene and Tropical Medicine, “Estimating the infection and case fatality ratio for COVID-19 using age-adjusted data from the outbreak on the Diamond Princess cruise ship” [PDF] has been posted on the medRxiv preprint server.  The paper has not been peer-reviewed.... [Read More]

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Radioactive Quackery Is Back!

 

Radioactive symbolIn the early years of the 20th century, there was a craze of medical quackery following the discovery of radioactivity in 1896 and the isolation of radium in 1898.  Radioactive quackery quickly spawned numerous products which claimed to have a variety of medical benefits.  Many of these products were completely bogus, but some, to the detriment of their buyers, were actually genuine.  Radithor, for example, was a patent medicine composed of distilled water containing at least one microcurie of radium salts.  Wealthy U.S. industrialist Eben Byers, who ingested large quantities of the stuff, died in 1932 of a variety of cancers and degeneration of his bones.  He was buried in a lead-lined coffin.... [Read More]

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“The Nurse Will See You Now” (but you won’t know it’s a nurse!) – Internecine Warfare in Anesthesia

 

Introductory note on language: In the US, an anesthesiologist is a physician, an M.D. with 4 or more years specialty training in the field after completion of medical school; with rare exceptions, all are board certified by rigorous examination by the American Board of Anesthesiology. An anesthetist is a nurse, a C.R.N.A. (certified registered nurse anesthetist). New graduates have a BSN (bachelor of science nursing and a MSN (master of science nursing); a total of six years of schooling plus one year working in ICU,  for a total of 7 years. A significant number still practicing have neither degree, but are ‘grandfathered’ under the less rigorous former standard. Not so in the United Kingdom, where ‘anaesthetist’ generically  describes whoever is administering ‘anaesthesia.’ Until recently, as far as I know, anesthesia was administered only by physicians in the UK, but the “anesthesia care team” (more below, and likely the best) model has been introduced and is growing in prevalence in order to extend physician manpower.... [Read More]

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This Week’s Book Review – I’m Dr. Red Duke

I write a weekly book review for the Daily News of Galveston County. (It is not the biggest daily newspaper in Texas, but it is the oldest.) My review normally appears Wednesdays. When it appears, I post the review here on the following Sunday.... [Read More]

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Saturday Night Science: Bad Blood

“Bad Blood” by John CarreyrouThe drawing of blood for laboratory tests is one of my least favourite parts of a routine visit to the doctor’s office. Now, I have no fear of needles and hardly notice the stick, but frequently the doctor’s assistant who draws the blood (whom I’ve nicknamed Vampira) has difficulty finding the vein to get a good flow and has to try several times. On one occasion she made an internal puncture which resulted in a huge, ugly bruise that looked like I’d slammed a car door on my arm. I wondered why they need so much blood, and why draw it into so many different containers? (Eventually, I researched this, having been intrigued by the issue during the O. J. Simpson trial; if you’re curious, here is the information.) Then, after the blood is drawn, it has to be sent off to the laboratory, which sends back the results days later. If something pops up in the test results, you have to go back for a second visit with the doctor to discuss it.

Wouldn’t it be great if they could just stick a fingertip and draw a drop or two of blood, as is done by diabetics to test blood sugar, then run all the tests on it? Further, imagine if, after taking the drop of blood, it could be put into a desktop machine right in the doctor’s office which would, in a matter of minutes, produce test results you could discuss immediately with the doctor. And if such a technology existed and followed the history of decline in price with increase in volume which has characterised other high technology products since the 1970s, it might be possible to deploy the machines into the homes of patients being treated with medications so their effects could be monitored and relayed directly to their physicians in case an anomaly was detected. It wouldn’t quite be a Star Trek medical tricorder, but it would be one step closer. With the cost of medical care rising steeply, automating diagnostic blood tests and bringing them to the mass market seemed an excellent candidate as the “next big thing” for Silicon Valley to revolutionise.... [Read More]

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TOTD 2018-06-08: An End to Downs Syndrome?

I understand the concern about the increase in abortion of Downs Syndrome fetuses. That clearly has all kinds of ethical problems, and opens a giant can of worms – what genetic abnormalities get the axe?  That’s not what I am talking about here.  This is about something different. Continue reading “TOTD 2018-06-08: An End to Downs Syndrome?”

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