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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 […]