Infectious Disease Ethics

Bioethicist | Doctor | Own views, with data | Personal account @_euzebiusz_

[Infectious Disease Ethics @ID_ethics]

📰New paper: ethics of shorter antibiotic courses

Antibiotic course length has been dictated by two questionable ideas:

1⃣ longer courses ➡️ better cure rates

2⃣longer courses ➡️ less drug resistance

Commentaries on our ethics paper are welcome👇

https://t.co/Ggbd2Zyw2R

[Ethox Centre @Ethox_Centre]

Job alert-Researcher in Ethics & Infectious Disease.
Work as part of the Oxford–Johns Hopkins Global Infectious Disease Ethics Collaborative(GLIDE) & Pandemic Sciences Institute researching ethical issues in infectious disease & pandemics.
Closing 30th Oct
https://t.co/OVD2Pm9gXQ

[Infectious Disease Ethics @ID_ethics]

What are your favourite papers / trials on duration of antibiotics in febrile neutropaenia?

(For a talk about the ethics of shorter courses of antibiotics for this patient group - thanks in advance!)

@VPrasadMDMPH @Timothee_MD @Eddie_Cliff @ABsteward @BradSpellberg

[Tess Johnson @drtessjohnson.bsky.social @drtessjohnson]

New paper out! Raising ethical questions with uses of metagenomics for diagnosis. @ID_ethics @Ethox_Centre @PSIOxford Read it at: https://t.co/p6DeJA3UOX

[David Robertson @equal_ibrium]

@ID_ethics and I on herd immunity to endemic diseases like covid-19:

"..a large number of infectious diseases continue to circulate[.] It would be a mistake, however, to confuse the lack of elimination for the idea that herd immunity does not occur[.]"
https://t.co/IOBwmZ3qM3

[Adam Gaffney @awgaffney]

Notable development on the Long Covid front: consistent with previous studies, a randomized trial in ⁦@bmj_latest⁩ found that an exercise-based physical & mental health rehabilitation program improved outcomes for those with Long COVID. https://t.co/EFuebeWqa0

[Anita Leirfall @anitaleirfall]

Hawking was wrong: Philosophy is not dead, and it has kept up with modern science | By ⁦@danwilliamsphil⁩

Some recommendations for those interested in learning about the philosophy of science. https://t.co/WR8zVETULM

[Infectious Disease Ethics @ID_ethics]

Two false dogmas of clinical infectious diseases:

"1⃣traditional durations of antimicrobial therapy and
2⃣the necessity of intravenous (IV) antibiotics

These dogmas based on uncontrolled case series from >50 years ago, amplified by the opinions of eminent experts"

[Infected Terran, MD @Infected_Terran]

What a gem

https://t.co/hDTVV45U9y

[Infectious Disease Ethics @ID_ethics]

😷🏥What is the effect of stopping hospital mask mandates?

"Using a robust quasi-experimental approach, we found no evidence that removal of a staff/visitor mask-wearing policy had a significant effect on the rate of hospital-acquired SARS-CoV-2"

https://t.co/kKw1rnUDFO

[Infectious Disease Ethics @ID_ethics]

Candida auris: a high risk fungal pathogen

This genomic study (pre-print) tracks introduction & spread of C. auris in & between UK hospitals

➡️# on arrows = between hospital transmissions
⏹️# in squares = in-hospital transmissions

https://t.co/1xtpQ8LirF

[Prof Peter Collignon @CollignonPeter]

Many people still think that children and schools are the major factor in the spread of Covid.
This is from Victoria Health, showing deaths (and the effect of Covid waves there).
What you can’t see is any obvious relationship to children returning to school after holiday breaks.

[David Eyre @drdavideyre]

Has performance of COVID lateral flow tests changed over time, variants & vaccination roll-out? Short answer: they consistently pick up most infections, particularly those that transmit, but work best in people with symptoms & higher amounts of virus, see https://t.co/W54RLHIQVe

[Infectious Disease Ethics @ID_ethics]

Scientists took one of my favourite videos of all time, featuring Kurt Vonnegut explore "the shapes of stories",

and turned it into a paper analysing the shape of >1000 stories

https://t.co/5sWhYEq06b

[Nathan Baugh @nathanbaugh27]

In 2016, researchers at the University of Adelaide tested Kurt Vonnegut's theory that, "There’s no reason why the simple shapes of stories can’t be fed into computers."

They took the emotional arcs of 1300+ novels from Project Gutenberg, turned that into data, used modern tech to analyze the emotional arcs, and then identified 6 patterns seen over and over again in western storytelling.

Here they are:

1. Rags to Riches (rise)

Your classic underdog tale. A humble, hardworking peasant climbs the mountain to pull the sword from the stone.

• Rocky
• King Arthur
• The Pursuit of Happiness

2. Riches to Rags (fall)

Maybe the saddest story of them all. A journey from the highest of highs to the lowest of lows.

• King Lear
• Citizen Kane
• Scarlet Letter

3. Man in a Hole (fall then rise)

A character’s doing fine, gets herself into a huge problem, but figures out how to overcome it. They often end up better than they started.

“You see this story again and again,” Vonnegut says. “People love it, and it is not copyrighted.”

• The Martian
• The Hunger Games
• Shawshank Redemption

4. Icarus (rise then fall)

The hero goes on a meteoric rise up New York (or some other) society, calls everyone “old sport,” and throws the wildest parties in town. Then reality sets in, and he realizes he’s too close to the sun.

• Macbeth
• Great Gatsby
• Death of a Salesman

5. Cinderella (rise then fall then rise)

I’ll leave this description to Vonnegut:

“We’re gonna start way down here. Worse than that, who is so low? It’s a little girl… the shoe fits, and she achieves off-scale happiness.”

• Red Rising
• Slumdog Millionaire
• The Count of Monte Cristo

This is my personal favorite.

6. Oedipus (fall then rise then fall)

Up until the ~70% mark of the story it looks like things are sunshine and rainbows. Walter White goes from high school teacher to king of the drug lords, if you will. Then all goes wrong. The original fall is often not their doing while the final fall is.

• Hamlet
• Gone Girl
• Breaking Bad

My 3 takeaways:

1. Rags to Riches, Oedipus, and Cinderella rank as the three most popular with consumers. AKA, those books sold the most copies.

2. When you think through a story, give it an emotional shape. Literally draw it.

X axis: Time
Y axis: Ill fortune to good fortune

You might be surprised how much it helps you craft your plot (I was shocked).

3. Vonnegut was a damn genius.

[Infectious Disease Ethics @ID_ethics]

Some immunosuppressed patients with COVID19 can shed infectious virus for weeks or months

Especially patients with:
���Haematologic malignancy or Transplant (S-HT)
🟢Autoimmunity or B cell deficiency

Often➡️difficult ethical questions re: isolation

https://t.co/K8o1WcWTgM

[Jonathan Li @DrJLi]

Have you been perplexed about why some immunocompromised (IC) patients recover from COVID-19 quickly while others can be infected for months? We uncovered some clues in a paper just published in @ScienceTM. Read on to see what we found: 1/ https://t.co/il7GWOo8s6

[Joseph Allen @j_g_allen]

A thread from @TheLancet @CovidCommission on school closures:

--> 195 countries closed schools during the pandemic, affecting more than 1·5 billion children and young people and posing enormous long-term and unrecoverable costs to them, their parents, and the economy.

🧵1/n

[Infectious Disease Ethics @ID_ethics]

"While HEPA filters can reduce viral load in the air, this does not lead to reduced COVID19 prevalence"

[Fiona Russell @Fiona_M_Russell]

This quasi-experimental study in Germany of HEPA filters in kindergartens vs usual IPC found no benefit of HEPA in ⬇️ covid infections in staff or children

Rates/1000 children higher in HEPA gp

Control: 186 (137.8-238.9)

Intervention: 372 (226.6-517.6)

[Infectious Disease Ethics @ID_ethics]

Are you an early career (postdoc) researcher & would you like to be a visiting scholar @Ethox_Centre?

📰Apply below

Broad topics of work can include:
- global health ethics
- clinical ethics
- public health ethics
- research ethics

Closes 21/April/24

https://t.co/W2XIeXLIWz

[Infectious Disease Ethics @ID_ethics]

Preventing RSV spread in hospitals (1980s):

"specially designed eye-nose goggles for staff reduced infection [but] the goggles were not well accepted by staff and eventually were abandoned."

Discussion:
https://t.co/Xl3h9625PP

Original study:
https://t.co/qlCrQZIMqp

[Infectious Disease Ethics @ID_ethics]

Photo from the classic "all night poker game" studies of the transmission of the common cold

https://t.co/IDwuoGnfnN

[Fiona Russell @Fiona_M_Russell]

“Lack of research on how Paxlovid affects outcomes beyond severe Covid — such as duration of illness, how the drug affects transmission, and whether it prevents long Covid”