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Uncertainty, evolution, and drug therapy

The two pharma companies, Sanofi and Regeneron, proposed that a drug called Kevzara might help patients with COVID-19 pneumonia. The rationale was that patients with COVID-19 have an exaggerated immune response, a phenomenon called a cytokine storm, that is responsible for the lung and organ pathology in COVID-19. The logic […]

What does high altitude have to do with COVID-19?

I recently became aware of Cameron Kyle-Sidell, an emergency physician and intensivist in NYC because of his videos describing his experience with COVID-19 patients. Sidell has argued that COVID-19 appears less like traditional ARDS (acute respiratory distress syndrome) and features more in common with high altitude illness. He argues that […]

Virulence evolution in SARS-CoV2

In a recent report, healthcare workers accounted for 11% (1,689 of 15,194) of reported cases. It is clear that being a healthcare worker is a risk factor for symptomatic COVID-19 disease. It is less clear if health care workers get sicker than the general population when infected.  Severe disease in […]

Strokes and COVID 19

The Washington Post today ran a piece entitled Young and middle aged people, barely sick with COVID-19, are dying from strokes. “Doctors sound alarm about patients in their 30s and 40s left debilitated or dead. Some didn’t even know they were infected.” From the article: Sherry H-Y Chou, an intensive […]

Misinformation in a pandemic

“Despite the evidence that fever can serve a protective function, old habits die hard, ” so wrote Blumenthal in 1997. Old habits about fever are indeed hard to shake, and this may be particularly so in a pandemic, where history’s lessons and hard-earned knowledge from epidemiology, evidence-based medicine, and good […]

Evolutionary epidemiology and Covid-19

I don’t usually teach evolutionary medicine in the Spring. In fact, I was originally scheduled to be in Kauai, hiking the Kalalau trail with a group of wilderness medicine students this April. Alas, that trip, and this year’s whole wilderness medicine elective, were not to be. Many students who would […]

Initial thoughts on COVID-19

When I first started reading about the coronavirus epidemic in Wuhan China, I had returned from a trip to Japan, and my first thought was: “we will all start wearing masks” as is customary for many Japanese. A few weeks later, I was dismayed to see almost none of my […]

The Bad Microbiome Project

A belated Happy New Year to you, readers of Evolution Medicine! In 2020 I am introducing a new new initiative – the Bad Microbiome Project. Pictured above is a member of the Enterobacteriaceae family – E. coli – a prototypical bad microbe. The bad microbiome project is an exploration of […]

Life History Theory and the microbiome

Life History Theory, a concept first described by Yale evolutionary biologist Stephen Stearns, is the application of evolutionary biology to the entire life cycle from birth to death. It includes the hypothesis that features of life are shaped by natural selection in ways that might have maximized fitness (in the […]