TWIV Podcast: Evidence-Based Science and Medicine for Covid-19: TWIV 606

TWIV 606: Evidence-Based Science and Covid-19 [Listen to the podcast; get more info and links mentioned in the episode.]




As a Medical Librarian living and working in the current time of Coronavirus,  I've been struggling with what to send people asking for research on Covid-19, when the best available "evidence" is only just emerging and appears on pre-print servers and hasn't had time to perk through all the usual peer review and filters of fully-formed evidence-based practice.  In other words, it's not what we're used to as gold-standard evidence.  What we are seeing is much lower on the evidence pyramid. 

On the one hand, it's an exciting time to see the research emerge and evolve, to witness so many people around the world working to solve this emerging and evolving pandemic-sized infectious disease. It's also more than a little alarming to see the state of the evidence ...

Researchers and physicians are willing to try something/anything if it might help solve some small part of the Covid-19 puzzle.  If they put together very small studies with no control to compare outcomes, what is that study really worth?   

I'm not the only one with these concerns, which is why I was glad to see the TWIV podcasters addressing this topic.   Give it a listen ...    at least the first 45 minutes where
Dr. Daniel Griffin gives a nice description of how physicians make decisions, running the gamut from the ultimate goal of evidence-based practice to all these other varieties we've seen since the onset of Covid-19: 

• Experience-based medicine (including experience bias)
• Vehemence-based medicine
• Eloquence-based medicine (More spin than science.)
• Diffidence-based medicine ("No good answers here.")
• Defensive-based medicine
• Careful observation and experience based medicine 
• Did it help or hurt?  Stand there and think about it.  Did it work?
• Evidence-based medicine

Always remember, Physicians are human.  They are subject to the same stress and overwhelm everyone else gets.  Early on in this pandemic, there was an emotional, anxious, desperate response to do something/anything to make a difference in outcomes for Covid patients.  Do everything and see what sticks ...   Now Dr Griffin's advice is to "Don't just DO something: Stand there ... and see if it worked."

What are you listening to to keep up with Covid-19 developments?

The Wisconsin (Covid) Alternative Care Facility Opens Today

Enjoy This Time Lapse Video of the Wisconsin Alternative Care Facility Being Built

• Governor Evers announced that the U.S. Army Corp of Engineers would develop an alternative care facility (ACF) on the Wisconsin State Fair Park grounds in West Allis.
• This facility is an 'insurance policy' to ensure sufficient beds will be available for COVID-19 patients, should the need arise. While local hospitals have significantly increased their capacity, the ACF will be prepared to care for nearly 750 additional patients, if needed.
• Ascension Wisconsin "alumni" are on the team leading this effort. Debra Standridge, who served as president, north region, is the facility's CEO; Tim Richman, who served as president of Ascension Elmbrook and Ascension St. Joseph, is the facility's chief operating officer; and Celia Shaughnessy, who served as vice president, human resources, is the facility's chief human resources officer.
• The site is scheduled to open today.

Articles to read on the rough days

We're currently living through a situation unlike anything most of us have ever encountered before.  And no matter how you're experiencing it, some days are probably better than others.  Here are a few articles that have been helping me get through the bad days.

For those terrible and unproductive days that feel like nothing can be salvaged, Aisha S. Ahmad offers some advice in the Chronicle of Higher Education.

For those days when you're feeling alone and afraid, Wired senior correspondent Adam Rogers offers some inspiring words on how science helps us understand the world together.

And for those days when all the news is unbearably terrible, here's a nice uplifting story about a therapy dog and his person bringing care packages to hospital workers.

Check out https://www.instagram.com/coupdegracefarris/ for more comics like this!

New England Science Bootcamp for Librarians: FREE Virtual Conference June 11

The organizers of the New England Science Bootcamp for Librarians have confirmed that this virtual conference is FREE and open to ALL library professionals (not limited to those in the New England area). I have seen these announcements in the past, and wished I could attend in person, so I'm thrilled to see it offered online.  

Depending on the final speakers, the tentative topic areas could be relevant for hospitals.

We are pleased to announce that New England Science Bootcamp for Librarians will host a FREE virtual conference on June 11, 2020, from 9am – 4pm.

 Topics MAY include, depending on speaker availability:

• Vaccine research & manufacture
• Virology
• Making Health Devices in non-industrial settings
• IRB and human subjects research  in the shifting landscape

Tentative Schedule

• 9-10am     Session A
• 10:15-10:45     Interstitial - Front Lines Stories
• 11-12         Session B
• 12-1         Lunch
• 1-2         Session C
• 2:15-2:45     Interstitial - Front Lines Stories
• 3-4         Session D

The schedule of topics will be finalized and sent to all registrants soon.

This conference will run throughout the day, with access via a single link for the whole day that attendees will receive after registering. You may tune in as you have time or for the topics that interest you the most. More information and a detailed schedule will be available closer to the date of the event. Please register to get the most updated information sent to you.

Registration is available at https://forms.gle/whfu1H9nY2e8X3gS9

[If this link does't work, go to their conference website and look for the Registration link.]

We look forward to seeing you online for a fun and informative conference! While we had to cancel our in-person conference this year, we hope you will take advantage of this free professional development opportunity. While this conference is being organized in New England, we welcome attendance for anyone and anywhere.

The coronavirus wreaked extensive damage (yellow) on the lungs of a 59-year-old man 

who died at George Washington University Hospital, as seen in a 3D model based 

on computerized tomography scans.

 

GEORGE WASHINGTON HOSPITAL AND SURGICAL THEATER

How does coronavirus kill? Clinicians trace a ferocious rampage through the body, from brain to toes

By Meredith Wadman, Jennifer Couzin-Frankel, Jocelyn Kaiser, Catherine MatacicApr. 17, 2020 , 6:45 PM

Science’s COVID-19 reporting is supported by the Pulitzer Center.

This article does a nice job of pulling together the disparate pieces of the Coronavirus/Covid-19 puzzle--of what we know so far.  And it's just the beginning ... 

Multiple medical specialists are seeing different manifestations throughout the body, 

in multiple body systems--not just the lungs, but GI, kidney, brain ...

One thing is clear: This is not the average flu, and it's not the average common cold.  

We are only beginning to understand the lengths and depths of it's power 

to wreak havoc with the human body.  

Managing anxiety

Feeling more anxious and stressed than usual lately?  You're not alone!  This is a weird and scary time for everyone.  We need to stay informed and connected, but sometimes reading the news or scrolling through social media makes us feel even worse.  NPR's Life Kit podcast recently interviewed Dr. Judson Brewer, a neuroscientist and psychiatrist from Brown University.  He explains what our brains are doing when we feel anxious and offers some practical ways to cope.  For example, take a deep breath or feel your feet.

PubMed Essentials: Free, On-Demand CE Class

Are you looking for a way to kick start your PubMed search skills?

PubMed Essentials is made up of 10 very short video-modules (2-3 minutes each) 

with interactive exercises built into each video-module so you can explore PubMed 

at your own pace.

PubMed Essentials is an on-demand, online class that is available 

via Moodle 24/7 (upon registration).

For more information and to register, follow this link:

https://nnlm.gov/class/pubmed-essentials-2020-demand/23191

Thank you,
Rebecca Brown, MLS, AHIP, CPACC
Training Development Specialist
National Network of Libraries of Medicine Training Office (NTO)

Fred and the Avenging Chicken

Maybe I'm a little late to the party, but I was just introduced to Fred and the Avenging Chicken.  This blog gave me a much needed laugh today.

WHSLA sharing and checking in call - recording now available

If you missed the WHSLA sharing and checking-in call from April 7, the audio recording is now available. 

*Listen to your fellow WHSLA members talk about how they're handling COVID-19, furloughs, working from home, pandemic baking and more. (*After clicking the link, enter your name and email and you'll be able to listen.)

Why You Ain't Getting a Covid-19 Vaccine in Time

Dr. Zubin Damania, (aka ZDoggMD and Doc Vader--and yes, he's a real doctor) explains why we'll be waiting a while for a Covid-19 vaccine ...  It's a serious discussion on why we can't expect a quick fix and why getting a vaccine right doesn't happen overnight.  

You may know him from the ZDogg rapper medical music videos or the Doc Vader videos, expressing the dark side of medicine and the American health care system.  He channels anger into humor in the hopes of making a better world. He also has a serious side where he does these educational videos about health care topics in plain language.  He also offers serious programs and discussions where physicians can get CME credits, too.  

• Who is ZDoggMD?   Dr. Zubin Damania leads a passionate tribe of healthcare professionals towards a vision of Health 3.0, with in-depth conversations with medical thought leaders, merciless and uncensored satire, and takedowns of pseudoscientific nonsense spread by celebrities in the lay media. ZDoggMD Industries is the digital production studio behind Incident Report LIVE, the Interweb’s #1 medical news and entertainment show.

• Zubin Damania is an American physician, comedian, Internet personality, musician, and the founder of Turntable Health, a direct primary care clinic in Downtown Las Vegas that was funded by Zappos CEO Tony Hsieh. Before moving to Las Vegas, Damania was a practicing hospitalist at Stanford University for 10 years. Wikipedia

The science of inoculation (TED Radio Hour)

Reposted from NPR:

• Inoculation: Can we protect ourselves from future outbreaks? COVID-19 isn't the first pandemic, and likely not the last. This hour, TED speakers share lessons from past pandemics and what they mean for our future. Guests on the show include science journalist Laura Spinney, anthropologist Heidi Larson, ecologist and animal-borne disease researcher Daniel Streicker, and physician economist Anupam Jena. We also hear some personal stories on coping with COVID-19 from TED speakers Susan Pinker, Leticia Gasca, Dixon Chibanda, and Dawn Wacek.

Matthew McConaughey Teaches Us How to Make a Face Mask

For those of us who don't sew ...

This Week in Virology Podcast

This Week in Virology is a weekly podcast about viruses--the kind that make you sick.

Every week, they pick up a new topic in the field.  Lately, it's been Corona--of course.

This week's episode is: TWiV 598: Who was that masked man? Coronavirus update with Daniel Griffin in which "Daniel Griffin MD returns to TWiV from a hospital parking lot to provide updates on COVID-19 diagnostics, clinical picture, and therapeutics, followed by our coverage of the coronavirus pandemic caused by SARS-CoV-2."

They do offer a subset under Virology 101, if you need to start with the basics.  
Here's what they say about the 101 series: 

• "Now and then we produce a TWiV that is focused on explaining basic aspects of virology. We call this series ‘Virology 101’. All the posts in this series are listed on this page with links back to the original post. If you start from the top, soon you will have a good basic understanding of virology. Repeated listening often fosters better comprehension.
• For those who prefer reading, there is Virology 101 and Influenza 101 at virology blog.
• Topics include virus structure, classification, entry into cells, making viral RNA, making viral DNA, transcription, reverse transcription, etc.

It's written by scientists, so it's well-researched with additional links to scientific papers.

TWiV: This Week in Virology

A podcast about viruses – the kind that make you sick.

Subscribe: iTunes | Google Podcasts | RSS Feed

DIY Face Masks for Coronavirus

DIY Fabric Face Masks

I wrote about making fabric masks in the age of Corona on my personal blog tracking 

my creative life.  This is where the separate streams of my personal and work lives collided.

The post includes links to research, patterns, and tutorials for making fabric masks, and 

my commentary after making some of the masks.

The thinking has evolved on this whole movement from just a month ago 

when I started researching this topic from "last resort for health care workers" with

armies of safe-at-home sewers making fabric masks for health care workers experiencing 

shortages in PPE because "it's better than nothing" to the CDC's recent recommendation 

that masks be worn by everyone in public places.

Coronavirus FAQs: Is a Handmade Mask Effective? And What's the Best Way to Wear One? - NPR

• This article traces the change in public policy.
• It also addresses the question of how to keep them clean, and how often.
• Regular laundry will do, but "Think of a mask as like underwear. 
• It needs to be washed after every use."

Should Everyone Wear a Mask in Public? Maybe--But it's Complicated - Forbes

• Very well-researched article from a public health standpoint.
• Acknowledges that science and circumstances change as we move ahead through the Pandemic.
• Asks some good questions that are still unanswered
• And links to additional articles and studies.

LitCovid: Keep Up with the latest Coronavirus Research

LitCovid  https://www.ncbi.nlm.nih.gov/research/coronavirus/

An open-resource literature hub known as LitCovid curates the most comprehensive collection of international research papers so far on the new coronavirus disease COVID-19 (see go.nature.com/3almd5p). Developed with the support of the US National Institutes of Health’s intramural research programme, LitCovid is updated daily with newly published articles. The aim is to provide timely insight from the scientific literature into the biology of the virus and the diagnosis and management of those who have been infected.

LitCovid has a more sophisticated search function than existing resources. It identifies roughly 35% more relevant articles than do conventional keyword-based searches for entries such as ‘COVID-19’ or ‘nCOV’. Furthermore, the articles are categorized by topic — overview, disease mechanism, transmission dynamics, treatment, case report and epidemic forecasting — as well as by geographic location for visualization on a world map.

Nature 579, 193 (2020)

doi: 10.1038/d41586-020-00694-1

Badger shields

I'm a compulsive news checker, and the amount of time I spend near a computer for both grad school and work hasn't been great for my mental state lately.  But speaking of states, WHSLA's home state has done something we can all be proud of.  To combat shortages of medical face shields, UW Madison's Makerspace is part of a team creating open-source design face shields and helping connect manufacturers with the facilities who need them.  Here's an article from Wired with more detail on how they're being made.