May 19, 2020

Data matters

I have learned over the years that data matters. How data is collected matters. Why it is collected matters. After the thalidomide tragedy in the late 50’s when it was used for morning sickness but caused severe limb deformities and other birth defects, the FDA became much more involved in drug regulation and approval. Generally, the FDA has been a stickler about data and safety when it comes to approving new treatments. I had the good fortune to be an investigator on several studies for approval of new HIV medications and Hepatitis C treatment, when we lived in Santa Fe. I learned a great deal about the process and the importance of following protocols. A need for a comparison arm is essential. Randomization is key. There are other essential things that go into research as well. It is not a political fight. Approval is done with data on safety and how effective a treatment is. That is why I was troubled to read this article in the New York Times about the struggles of some studies that are looking at treatments for COVID-19. We need data to find out what works and what doesn’t.

We also need data to really know what is happening in each state with infections and deaths. Georgia put out some confusing results that did not really show cases dropping as fast as initially shown as they started opening up. Florida too is not sharing data as readily about deaths and changed its counting system which makes knowing the true number of deaths difficult. These things are problematic, especially if other states are not accurate, we will not know what the risks are in each community. We won’t be able to follow the trends. This is important for the public health and to keep people safe.

Two other articles this week show how social distancing efforts really made a difference. One shows how much SARS-COV-2 decreased in Seattle, with a peak 5-6 days after the shelter-in-place order, which is the usual incubation period before symptoms occur. Since then infections have trended down. I think that is what most of us have felt living here, and nice to see the data confirming that. We will watch carefully for a rise after we start opening up in the next few weeks. Right now I feel the virus is at a low level, so it might be safe to go to Costco this week (with my mask and hand sanitizer and gloves, of course).

The other information was data published in Science that showed the stepwise decrease in infections in Germany with three social distancing measures. Cancelling large events and closing schools each had an effect, but the biggest was closing non-essential stores, which actually stopped the exponential growth. Remarkable data that can help guide our behavior to keep us safe. Now that makes me wonder why I really think I need to go to Costco? Maybe not, after all.

Wash your hands and cover your nose.

And finally, my caveat is that this is my experience and my opinions, which are subject to change as more information is available, and not related to the organization I work for. Thanks for reading.

Bonus article from Rebecca Solnit about not giving up hope is at the bottom.

https://www.nytimes.com/2020/05/19/us/politics/hydroxychloroquine-trump-coronavirus.html

https://en.wikipedia.org/wiki/Thalidomide

https://www.vox.com/covid-19-coronavirus-us-response-trump/2020/5/18/21262265/georgia-covid-19-cases-declining-reopening

https://www.npr.org/2020/05/15/857104962/medical-professionals-in-florida-criticize-governor-for-a-lack-of-transparency

https://www.jwatch.org/na51565/2020/05/18/sars-cov-2-positivity-rate-seattle-area

https://www.jwatch.org/fw116649/2020/05/17/covid-19-social-distancing-effects-multisystem

https://science.sciencemag.org/content/early/2020/05/14/science.abb9789

https://www.npr.org/2020/05/15/857104962/medical-professionals-in-florida-criticize-governor-for-a-lack-of-transparency

https://www.theguardian.com/world/2017/mar/13/protest-persist-hope-trump-activism-anti-nuclear-movement