Day 172: Red Tape and Turf Battles

The world's case count has reached 15 million; the US is at 4 million. California has made the news by hitting 400,000 cases, making it a real contender to take the #1 spot away from New York. Florida isn't far behind at 369,000 cases. Massachusetts is up a fifth of a percentage point again today, not to gloat.

The coronavirus news is mostly on repeat. The New York Times documents "red tape and turf battles" over temporary hospitals in New York City. But like previous reports of other coronavirus boondoggles, this one is high on anecdotes of failure and low on explanations for it. Not unlike the pandemic in general, it reads like an Ayn Rand novel sans the plot.

Bloomberg opines that even college students belong back in school. A seroprevalence study in Delhi found a lot of prevalence. There's yet another preprint out about the protection provided by childhood BCG vaccination, though this one is titled in the form of a question: "Do low TB prevalence or lack of BCG Vaccination Contribute to Emergence [sic] Multisystem Inflammatory Syndrome?"

A paper in Annals of the Rheumatic Diseases has once again shown steroids useful; in fact it showed glucocorticoids extremely useful, but the randomization was a bit hacked up after the fact using historical data, and much of the improved outcome seemed to result from the steroid patients not being put on ventilators. Because of the time lag between the control group and the experimental group, there is no real guarantee that the same standard of care was used to decide on mechanical ventilation. (Also, a relatively small effect from the steroids would have an outsized positive outcome, if it was enough to prevent mechanical ventilation.) The authors were unwilling to do a truly randomized trial of their miracle cure at the time, and even question the medical ethics of doing one without the pandemic pressures they were under. So don't hold your breath for the truly randomized trial results.