antibiotics work only on illnesses caused by bacteria, and the coronavirus is -- you guessed it -- a virus.
• DO make sure someone in your home knows how to clean properly. Studies suggest that coronaviruses can live on sur- faces for a few hours or up to several days. To reduce the chance of spreading COVID-19, wear disposable gloves to clean sur- faces regularly with soap and water, followed by a disinfectant to kill the virus. Effective options include a bleach solution of 5 tablespoons per gallon/4 teaspoons per quart of water, solu- tions with at least 70% alcohol, or one of the EPA-approved items on this list:
https://www.epa.gov/pesticide-registration/ list-n-disinfectants-use-against-sars-cov-2
HOW GOOD IS OUR DaTa ONTHE CORONaVIRUS PaNDEmIC?
As governments around the world grapple with an emerging
pathogen that threatens to overwhelm healthcare systems and stall the global economy, experts have wondered about the qual- ity of the information that’s available to inform those decisions. In an editorial published in STAT, John Ioannidis, MD, a
noted critic of medical research who co-directs the Meta-Re- search Innovation Center at Stanford University, wrote that COVID-19 has been called a once-in-a-century pandemic. “But it may also be a once-in-a-century evidence fiasco.” Ioannidis says we lack reliable information on how many people have been or will be infected. Yet governments have taken dramatic steps to curb the pandemic. While people and businesses may be able to tolerate lockdowns for a short time, we don’t know how long these measures should continue if the virus continues to spread.
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“How can policymakers tell if they are doing more good than harm?” he asks. We talked to two experts about the challenge of acting when
evidence is still developing. Here’s what they had to say about what we know, how firm that knowledge is, and the problem of knowing what to do with it. They are Isaac Bogoch, MD, an in- fectious disease specialist and clinical investigator at the To- ronto General Hospital Research Institute in Canada, and Perry Wilson, MD, an associate professor and expert on evidence-based medicine at the Yale School of Medicine.
WebMD: How difficult is it to be in government right now, to have to make decisions about the COVID-19 pandemic? Isaac Bogoch, MD: Ultimately, we have to make major
decisions in real time without a robust evidence base, and those decisions are going to have significant impact on populations. There isn’t time to wait for a strong evidence base to guide these decisions, so we have to extrapolate from existing data and we also have to factor in common sense and humanity with the policy decisions that are being made. We know for example, how flu pandemics have played out
in the past. We’re drawing on some of that data, but it’s not going to be a perfect fit because this is a brand new virus. We don’t know everything we need to know about it. There are lots of questions. How long can it live on surfaces?
We didn’t know until about a week ago. Do flight restrictions work? We don’t know for this one, but there are data and models from other epidemics. We have to appreciate the strengths and weaknesses of the
data that we’re tapping into and that we’re completely transpar- ent and acknowledge those limitations when we communicate the data. It’s also reasonable to expect that policy will change sig-
nificantly throughout the course of this pandemic because there are growing evidence bases that will help public health policy. One of the issues is communicating to the general public
that policy changes aren’t a failure but represent keeping abreast of the most current evidence base.
WebMD: What about modeling? There is some really good and very fast work being done in modeling right now, but it can also feel pretty scary to see those predictions: Bogoch: Modeling is extraordinarily important, but we have
to remember that those are models and they are used to inform policy but there are inherent weaknesses in any model system. They are not crystal balls, but we need them to help us make decisions.
WebMD: What about the evidence behind drugs and therapeu- tics to treat COVID-19? Perry Wilson, MD: The evidence that we have right now is
not of the quality that we’ve come to expect in the context of the best medical literature. It’s not gold-standard randomized, con- trolled trials. What the coronavirus epidemic has forced us to do is to come to grips with the idea that the perfect is the enemy of the good. Time is simply not a luxury we have right now. It would be unwise of us to throw out the evidence that’s coming in be- cause it’s not top quality. We have to take everything that’s coming in with a grain of
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