Coronavirus #TotalHarmMinimization

A Proposed Framework for Risk-based Interdiction of Coronavirus

Dr. Katz responds to the coronavirus crisis:

Dr David Katz on the left and Sarah Hiner on the right, green background with Coronavirus molecules. Orange band below with "Thriving in a germ-filled world" title.

Putting COVID-19 in Perspective in a Germ Filled World—Bottom Line Inc’s Sarah Hiner Talks with Dr. David Katz. Watch on YouTube or listen to the podcast, June 1, 2020

Spencer Bailey and Andrew Zuckerman of At a Distance podcast interview Dr. Katz on Understanding Covid-19 in a Big-Picture Context, May 21, 2020 Also available on Apple Podcasts, Spotify, Google Podcasts, and Stitcher

Michael Moynihan Asks Dr. Katz: Is Our Cure Causing Another Disease?
on Showtime’s VICE, May 17, 2020

Seana Smith of Yahoo Finance asks Dr. Katz about the new CDC guidelines for reopening. Shown is Dr. Katz inset on right, stock ticker on left, Dr. Katz' title below

Seana Smith, Anchor, Yahoo Finance, Discusses Newly-Released CDC Guidelines for Reopening with Dr. David Katz, May 15, 2020

Dr. Oz interviews Dr. Katz on the effects of Vitamin D on the Coronavirus. Dr. Oz is on the left and Dr. Katz on the right.

Dr. Oz Interviews Dr. Katz on the Effects of Vitamin D on #COVID19, May 7, 2020

Colorful cartoon of many people walking closely together in different directions, all wearing white cloth facemasks.

The Choreography of Contagion Interdiction: Dr. Katz visits the Rich Roll Podcast, May 7, 2020

US Senate Committee on Homeland Security and Governmental Affairs testimony: Dr. Katz videoconferences in from his library. Beneath his video is a list of the other witnesses.

Roundtable – COVID-19: How New Information Should Drive Policy, U.S. Senate Committee on Homeland Security and Governmental Affairs, May 5, 2020

Dr. Katz is interviewed by Bill Maher. Dr. Katz on the left, Bill Maher on the right.

Dr. Katz explains: “If all we do is flatten the curve, you don’t prevent deaths, you just change the dates,” on Real Time with Bill Maher, April 24, 2020.

Clip from the interview: Dr. Katz in his library, book shelf in background, "Dr. David Katz, Yale-Griffin Prevention Research Center Founding Director" caption at bottom.

Dr. Katz, board-certified specialist in preventive medicine and public health, joins Mark Levin on Life, Liberty & Levin, April 19, 2020. Watch Part 1 of the interview here.

Boston Public Radio website screenshot with title: "Dr. David Katz on a Targeted Response to Coronavirus Pandemic." Below the title an image of a woman in the refrigerated section of Trader Joe's

Boston Public Radio hosts Jim Braude and Margery Eagan ask Dr. Katz about his plan for a targeted response to the Coronavirus pandemic, March 30, 2020. Listen to the podcast here.

Dr. Katz, interviewed remotely from his library by Fareed Zakaria GPS, answers the question: Can we limit the economic cost of COVID-19?

Part 1 of Dr. Katz’ interview on CNN’s Fareed Zakaria GPS, March 29, 2020: Fareed asks Dr. Katz, “Can we limit the economic cost of COVID-19?” The interview is also available on Apple Podcasts.

Dr. Katz, interviewed remotely from his library by CNN's Fareed Zakaria GPS, recommends implementing a data-driven approach to public health policy.

Part 2 of Fareed Zakaria GPS interview: CNN Global Economic Analyst Rana Foroohar discusses possible worsening of economic turmoil, and Dr. Katz recommends implementing public health policy that is data driven.

Dr. Katz on the left screen, being interviewed from his home library. Michael Smerconish on the right screen.

Dr. David Katz is asked, Should virus shutdown be modified to prevent other fallout? on CNN’s Smerconish, March 28, 2020.

Dr. David Katz discusses his New York Times op ed, ‘Is our fight against coronavirus worse than the disease?’ on the KTLA 5 Morning News, March 27, 2020.

Dr. Katz is interviewed remotely from his home library

Dr. David Katz on balancing medical risk and economic pain, PBS News Hour, March 24, 2020.

David L Katz MD on CNNs Anderson Cooper 2020-03-23. From left to right: Sanjay Gupta, Anderson Cooper, David L. Katz

Dr. Katz discusses his proposed framework for risk-based interdiction of Coronavirus on Anderson Cooper 360. Click to listen to the episode’s podcast: on Apple podcasts or Player.fm. Dr. Katz appears at 17 minutes into the podcast. Click here to read a transcript of the interview.

Gov. Andrew Cuomo of NY on left, outline of David Katz' Coronovirus Risk Interdiction on right.

Governor Cuomo cites Dr. Katz for his plan to manage the Covid pandemic.

Dr. Katz Articles with Information about Coronavirus

Head shots of 12 people of various ethnicities

There is a trait other than skin pigment that we humans do seem to share all but universally: a rather short attention span. A veritable “moment” before the COVID19 pandemic began rewriting the modern history of public health practice, fixating our attention, and propagating our miscellaneous anxieties, we had declared another epidemic here in the United States a national emergency, after considerable debate and dithering. …Read More

Ficticious angry brown 2-headed fanged tiger-like animal with a split devil-like tail and evil eyes.

One could be forgiven for thinking that however bad it is to be in the middle of one pandemic, it would be worse to be in the middle of two at the same time. In fact, though, we are very much in the middle of two- and at least through one pertinent lens, two pandemics are better than one. …Read More

Three hands holding full glass beer steins and clinking them together to toast.

My fellow Americans- and to be ecumenical about it, my fellow humans- I have two questions for you. Do you have at least half a wit? And, do you have at least half a heart?

If the answers are yes- you have at least half of each- then I contend it’s time to come out of opposing corners and meet in the middle of the COVID infodemic. Enough of the polarizing nonsense that passes for COVID policy debate in this country. Seriously: enough.

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Light switch on gray wall. Switch is "on."

We must, to some extent, be something like flotsam in the currents of culture, debris on the winds of the Zeitgeist; a bit helpless against the buffeting of “now,” in all its particulars.

Perhaps it is the Internet and social media; perhaps the constant immediacy of news cycles. Whatever the reasons intrinsic to “now,” they exert some dominion over our thinking, and seemingly the dictates of now call for: pretty dumb. …Read More

COVID, Hope, and Consternation: screenshot of the "US Senate Committee on Homeland Security and Governmental Affairs" website page with the announcement and link to the "Roundtable - COVID-19: How New Information Should Drive Policy" hearing video.

I have had abundant opportunity to share my various reflections on the COVID19 crisis. This week, I had the chance to do so directly before the Homeland Security Committee of the United States Senate, and at full length and leisure in a podcast interview with my friend, Rich Roll. What’s left?

Hope, and consternation. …Read More

White Paper: Updated estimates of comorbidities associated with risk for COVID-19 complications based on US data.

Abstract

We updated previous estimates (wwwnc.cdc.gov/eid/article/26/8/20-0679_article) of adults with any underlying condition increasing risk of complications from COVID-19 using recent US hospitalization data instead of mortality data from China. This substitutes obesity for cancer in the definition and increased the percentage of adults reporting more than 1 condition to 56.0% (95% CI 55.7-56.4). …Read more

Closeup image of a Coronavirus molecule

This past weekend, the World Health Organization stoked the flames of global anxiety by issuing this in the guise of a reality check: we do not know that getting COVID19, and recovering from it, results in immunity.  …Read more

Dr. Katz in full PPE - mask and shield - and other healthcare workers in the background, working on patients

Having just completed three 12-hour shifts as a volunteer physician at a hospital emergency department in the Bronx, I can tell you this: it would be bad not to get a N95 mask, but getting one is no walk in the park, either! You try wearing one for 12 hours straight, and then let’s talk. …Read more

Thomas L. Friedman headshot

Thomas L. Friedman of The New York Times: With each passing day it becomes more obvious how unlucky we are that one of the worst crises in American history coincides with Donald Trump’s presidency. To get out of this crisis with the least loss of life and least damage to our economy, we need a president who can steer a science-based, nonpartisan debate through the hellish ethical, economic and environmental trade-offs we have to make. …Read more

Sunset at the pyramids.

We are, no doubt, all comparably eager to consign this blighted interval- of coronavirus contagion, social upheaval, recrimination and fear – to the history books. One day, this will all just be a reference in a tale told to grandchildren, an episode stripped of its visceral impacts and neatly archived. …Read more

Sabertoothed tiger looking towards the left side of the camera and roaring ferociusly.

Believe it or not, now- with the acute threat of COVID19 constraining our activities and propagating our anxieties- there may have never been a better time to address and improve the chronic state of our health, both as a population, and as individuals. Timing, timelines, and the newfound time at our disposal- really are of the essence. …Read more

Image of a melting antique brass alarm clock with old-fashioned bells on top, face glass broken, little hand on the 12, big hand broken and lying on the glass on the table.

My native aptitude, if I may presume to say so, is seeing the whole elephant in the room. I have great respect for the targeted expertise many of my colleagues apply to the trees of their special interest and scrutiny. I am an inveterate forest guy. …Read more

America Responds to Pandemic Coronavirus! Image of Dr. Katz with a facemask and a "Make America Safe Again" baseball cap, in front of the US flag

Much has been made of my early contention that the coronavirus could hurt and kill people more than one way, and that we needed to do our best to interdict them all. I called the approach – that would keep those vulnerable to severe infection and the direct harms of the virus away from it, while allowing those more prone to harm through a degradation of services, goods, livelihoods, supply chains and the social determinants of health back to the world early – vertical interdiction. …Read more

Huge wave of blue water and seafoam crashes on a brown sand and pepple-filled beach

There is no debate, and never was among serious people, about the need to keep those at high risk for severe coronavirus infection and this very nasty germ – SARS-CoV-2- apart. There is only debate about how. Any suggestion to the contrary is misunderstanding, willful or inadvertent, or the replacement of actual ideas with caricatures of them. …Read more

Coronavirus, Casualties, and Context: Do We Dare Discuss Other Numbers? Headshots of about 500 people all adjacent to each other.

Ordinarily, I work to draw attention away from the crude, bland, anonymizing statistics of public health to the faces they veil, the human stories they obscure.

But as the coronavirus pandemic becomes an ever more proximal menace, affecting more people we all know and love- I see a need to go the other way, and highlight the use and misuse, the lessons and liabilities of numbers, in and out of context. …Read more

Man in heavy coat and face mask walks towards the right of the camera, in front of the Basilica in Rome.

Of the slightly more than 30,000 total, global deaths from coronavirus to date, a third of them all have been in Italy. That sad distinction means Italy is the source of our best potential insights about COVID19 and the risk of severe infection and death.

Colleagues reached me this morning with this March 26 compilation of coronavirus data from the Italian health ministry, when the mortality toll was at around 7000: …Read more

Two medical workers in full protective gear, with blue gowns, blue gloves, masks and hair covers, point a swab towards the driver side window of a car to test for Coronavirus.

Only in a world of ideologues and demagogues, of propagandists and Internet trolls, are our options limited to: “send everyone back to the world by some arbitrary date, and never mind the body count” versus “everybody’s grandparents in coronavirus lockdown until many of them die of other causes before ever again hugging their grandchildren.” Indefinite lockdown and indiscriminate largess are two variants on a common theme of heartless, thoughtless public health carnage. Of course there is another way. …Read more

10' x 12' outdoor pavilion with sign: "Griffin Health Co-Vid-19 Testing by Appointment." Eerily, no people are in the scene.

I am just back from being tested for COVID19- very efficiently and professionally, I might add- at Griffin Hospital in Derby, CT. I can’t commend my Griffin colleagues enough for how beautifully they organized. Below are images of the test facility, and the print guidance I received. That said, I won’t have my test results for 3 to 5 days, which is far too long- not just for me, but for the system that needs those data to understand and best address the pattern of the epidemic. …Read more

2 charts showing age of patients vs days days to COVID infection

As referenced in this New York Times column by Thomas L. Friedman.

A risk-stratified, rather than population-wide, approach to COVID19 interdiction is supported by separate computer models from scientists at MIT and at University of Pittsburgh/Carnegie Mellon.

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Birdseye view of a man walking down a street wearing a black coat, sneakers, headphones, a protective face mask and hospital gloves looking at his cell phone.

Thomas L. Friedman of The New York Times: One of the best ideas I have come across was offered by Dr. David L. Katz, the founding director of Yale University’s C.D.C.-funded Yale-Griffin Prevention Research Center and an expert in public health and preventive medicine. Katz wrote an Op-Ed in The Times on Friday that caught my eye. He argued that we have three goals right now: saving as many lives as we can, making sure that our medical system does not get overwhelmed — but also making sure that in the process of achieving the first two goals we don’t destroy our economy, and as a result of that, even more lives. …Read more

2 medics load a patient on a gurney into an ambulance.

The New York Times: If we were to focus on the especially vulnerable, there would be resources to keep them at home, provide them with needed services and coronavirus testing, and direct our medical system to their early care. I would favor proactive rather than reactive testing in this group, and early use of the most promising anti-viral drugs. This cannot be done under current policies, as we spread our relatively few test kits across the expanse of a whole population, made all the more anxious because society has shut down. …read more

Female lifeguard in red bathing suit with two life buoys enters ocean beach water

The best available global data continue to paint a largely reassuring picture of coronavirus mortality for most of us and our loved ones. I will return to that, COVID-19, and such comfort as I can render amidst this upheaval, momentarily. First, though, this: every death counts. …read more

Map of the world showing where the highest concentrations of Coronavirus are as of 3/13/20.

COVID-19 is not an even-handed scourge. The risk of severe coronavirus infection, and death, are highly concentrated among those over age 80, to a lesser extent among those over 70, and in particular where baseline health is already poor. To maximize the efficiency of our harm reduction efforts- containment, prevention- they should be targeted accordingly. …read more

White hospital face mask on a table.

No one will know for sure the best responses to the COVID-19 pandemic until after it’s all over, and we look back and second guess ourselves. Hindsight will approximate 20/20; foresight almost never does…my view is that we are under-testing, over-reacting, and somewhat misdirecting our efforts. …read more

Table with Coronavirus statistics

How lethal is the coronavirus, compared to, say, the flu? The only way to know a rate- any rate- is to know both the numerator (i.e., those who suffer the outcome), and the denominator (i.e., the population at risk/exposed). …read more

Coronavirus statistics as of 3/8/20: 107,491 cases and 3,652 deaths

There’s no way to watch the COVID-19 drama unfold and not be concerned/anxious (as if we needed another reason for anxiety these days!). My primary point early on- here – was that we exaggerate the ‘new and shiny’ risk relative to more familiar perils. That remains true of COVID-19 almost no matter how bad it gets. …read more

"Paradise Lost: A Poem Written in Ten Books by John Milton" book cover on left, image of naked Adam and Eve under a beautiful tree on right.

Well, there is a credible tip about avoiding serpents bearing apples. But otherwise, almost certainly not. Stick with me, and we’ll get back there in a minute. Food- no, not coronavirus– is the leading cause of premature death in America, and for that matter, much of the world. …read more

Asteroid hitting the Earth's atmosphere and bursting into flames

The ultimate questions- will I get this disease, and will it kill me if I do?– can be broken into component parts. The first is, what is my risk of exposure? Right now, unless you are in one of the rarefied populations around the world where the disease is concentrated, the answer is- probably very, very, very low…read more

Astronaut floating in space with earth below

Perhaps our species will decide before it is entirely too late to stop soiling our nest – although that’s far from clear. Perhaps we will decide to stop ravaging and blighting the only planet we will ever call home while it remains hospitable to our kind. …read more

Devil on fire in front of a US flag

Wouldn’t the Devil you loathe and fear appear disguised, deceive, and evoke your sympathy? Wouldn’t the Devil you believe in and shun, attract rather than repulse you? Wouldn’t he assuage you to his side of every argument? Wouldn’t he make you love him, and hate those who called him out for the hate he sowed, and the evil he did? …read more

Shark coming out of water, mouth open showing teeth

I’ve noticed the inevitable during my travels of the past week: a whole lot of anxious conversations about the coronavirus. This is not entirely unfounded- the pandemic is alarming. For those wanting good, up-to-date, expert intelligence about the virus, its spread, the risks, and suitable responses- they are availableread more

Woman walking across a city street, wearing a protective face mask

Poor overall diet quality is the single leading cause of premature death in the United States today, causing an estimated 500,000 or so deaths each year. That is more than ten times worse than a fairly bad strain of influenza, monumentally worse than coronavirus thus far, and happens every year. ….read more

3 juxtaposed images on a blue background: processed meats back left, microscopic view of a virus back right, Humpty Dumpty sitting on the wall front center.

I happen to be a board-certified specialist in Preventive Medicine and Public Health…it is in my training, if not my DNA, to prevent the preventable calamity. My duty is to perceive vulnerability, peril, and imminent danger to life and limb- and do my utmost about it in advance…read more