A Covid-19 update from Dr. Nicholas A. Christakis, Sterling Professor of Social and Natural Science at Yale

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Pulled from my April 4 Covid-19 update on Twitter

People who are dying of Covid-19 will need first-rate palliative (hospice) care. This is going to be especially the case for people who are denied ventilators or who are taken off of them (i.e., who are “extubated”). Let’s talk about this painful and poignant fact.

It’s not just a question of “optimal” triage polices for access to ventilators or ICU beds (policies that are now tragically being promulgated in hospitals around the USA, though we have not yet reached the stage of implementing them). …


A Covid-19 update from Dr. Nicholas A. Christakis, Sterling Professor of Social & Natural Science at Yale

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Pulled from my March 17 Covid-19 update on Twitter

For a contrarian take on the worldwide response to Covid-19 by a very smart scientist, John Ioannidis at Stanford, see his article in STAT. Ioannidis argues that we may be over-reacting.

He rightly points out that we are making huge decisions with crappy data, and he is right that we should (immediately) put into place surveillance for Covid-19 (with widespread testing). Many smart scientists are working full time to assemble such data and to fill in holes in the data we do have.

Given all the data uncertainties, according to Ioannidis…


A Covid-19 update from Dr. Nicholas A. Christakis, Sterling Professor of Social and Natural Science at Yale

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Pulled from my March 4 Covid-19 update on Twitter

Let’s talk about school closures during Covid-19. It’s a tough topic, scientifically and pragmatically. It’s hard to estimate the benefits precisely. And closing schools can have costs, such as health care workers having to stay home (when they are needed most), or kids missing subsidized lunches, and so on.

Yet studies show that school closures are one of the most beneficial ‘non-pharmaceutical interventions’ (NPI) that can be employed, more effective even than reactive quarantines or the banning of public gatherings. …


A Covid-19 update from Dr. Nicholas A. Christakis, Sterling Professor of Social and Natural Science at Yale

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Pulled from my March 3 Covid-19 update on Twitter

Americans should begin social distancing (no handshaking, eliminate non-essential travel and meetings). The reason is not so much to get practice or to reduce personal risk as to reduce the imminent intensity of the Covid-19 epidemic and spare health care system.

If we reduce the spread, even if we ultimately have the same total number of cases, we can ‘flatten the curve,’ which means that, at any given time, our health care system can cope with the Covid-19 cases, hopefully.


A Covid-19 update from Dr. Nicholas A. Christakis, Sterling Professor of Social and Natural Science at Yale

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Photo by suyab ahmed on Unsplash

Pulled from my March 6 Covid-19 update on Twitter

Let’s talk about how the weather affects epidemics and about how, relatedly, there are waves of deaths across time during epidemics. It may seem early to think about this, but we are just at the beginning of the first wave of Covid-19, but likely not the last.

Epidemics have always been with us. Here is a long and sad well-curated list. Why epidemics end altogether is itself an interesting question (for another day, related to the onset of herd immunity and the common evolution of pathogens and other factors). …


A Covid-19 update from Dr. Nicholas A. Christakis, Sterling Professor of Social and Natural Science at Yale

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Pulled from my March 5 Covid-19 update on Twitter

Let’s look at how flu actually spreads, day by day during an outbreak, in a defined population, such as at a college. While many transmissions are cryptic (and nowadays identified genetic tracking of transmitted pathogens), many transmissions occur via observed social network connections between people interacting face-to-face.

In 2009, there was a (limited) pandemic of H1N1 flu. It struck locales around the world, including colleges such as at Harvard. …


A Covid-19 update from Dr. Nicholas A. Christakis, Sterling Professor of Social and Natural Science at Yale

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Photo by Volodymyr Hryshchenko on Unsplash

Pulled from my March 7 Covid-19 update on Twitter

During epidemics (for example, Covid-19), vulnerable populations (such as the elderly, homeless, chronically ill, or those who are institutionalized) are at risk of infection and of being reservoirs of infection. On both accounts, they need our care. Let’s talk about a particularly vulnerable group: our fellow citizens with End-Stage Renal Disease (ESRD) who are on dialysis.

In the U.S., there are 468,000 people receiving dialysis, and they must go to a dialysis center roughly three times per week. Without dialysis, such patients will simply die, often within 14 days.

There are…


A Covid-19 update from Dr. Nicholas A. Christakis, Sterling Professor of Social and Natural Science at Yale

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Photo by Kelly Sikkema on Unsplash

Pulled from my March 12 Covid-19 update on Twitter

People are asking whether patients with Covid-19 who don’t have symptoms, e.g. cough or even just fever, can transmit the disease to others. The answer seems to be yes. Alas, this is not good news, but we can still take rational steps. Let’s talk about this “quarantine loophole.”

Should you avoid getting near symptomatic relatives? Yes, alas. What about college students or travelers returning home who aren’t showing symptoms? That’s harder. If they could have been exposed, you should practice physical distancing for a while, even if they’re asymptomatic.

If people…


A Covid-19 update from Dr. Nicholas A. Christakis, Sterling Professor of Social and Natural Science at Yale

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Photo by Macau Photo Agency on Unsplash

Pulled from my March 9 Covid-19 update on Twitter

If we want to understand how powerful an opponent SARS-CoV-2 (the virus that causes Covid-19) is, let’s take a look what has been required to stop it in China. The Chinese government has essentially used a social nuclear weapon in its efforts. Let’s talk about this, to understand what U.S. is facing.

The Chinese had the most Covid-19 cases for weeks (the U.S. now has the most, as of April 1), but the number of new cases in China has dropped from 100’s per day a month ago to about 46…


A Covid-19 update from Dr. Nicholas A. Christakis, Sterling Professor of Social and Natural Science at Yale

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Photo by Markus Spiske on Unsplash

Pulled from my March 19 Covid-19 update on Twitter

Let’s talk about what happens if you get Covid-19 and recover. Are you immune to the disease? How long does the immunity last? And what does that mean for your life and for the public health and economy of our society?

Probably as many as 40% of humans will be exposed to Covid-19 over the next two to three years, judging from past pandemics. Not everyone will actually get it. Only some (probably <1.0%) of those who get it will die. The rest will recover. …

Nicholas A. Christakis, MD, PhD, MPH

Sterling Professor of Social & Natural Science at Yale. Physician. Author of Blueprint: The Evolutionary Origins of a Good Society. twitter: @NAChristakis

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