Doctors turn to social media to develop Covid-19 treatments in real time | Hacker News Reader

Doctors turn to social media to develop Covid-19 treatments in real time

bloomberg.com

169 pointsJumpCrisscross68 comments

This is awesome. MDs in American and Europe should turn their social media attention to MDs in S. Korea and China... get frontline tips from them. As for PMG, I love it. My wife is an MD and she is on it all the time. Real valuable information there.

As long as you listen to the right people, as in the physical world.

This would be easier if the internet were optimized around enlightenment values (for lack of a better phrase) instead of the values of a tabloid newspaper.

the front line is Europe and America now.

https://promo.guahao.com/en/global/pneumonia/?_cp=yhcbz0315

It seems that a lot of Chinese doctors volunteer to consult on this coronavirus. Not sure whether they are helpful or not.

Perhaps we should coin the term "epidemiological debt" for the compounding costs of ignoring an emergent pandemic early on. The essential definition of such debt is: paying down the debt requires qualitatively greater expense and creativity (as in this case) to solve this problem later than sooner.

Fascinating. First I’ve seen about the low blood pressure and gastric symptoms in old people...makes me wonder. An older friend of mine in the bay area was hospitalized in the last week of January, first week of February. His symptoms were extreme physical weakness, fever, low blood pressure. Enough so that he went to the ICU twice. A few weeks later he was better. Doctors ran all types of tests then, but didn’t know what it was, they told him it was likely a random viral infection. No lung issues that I know of, but that sure sounds like what this article mentions.

I've heard plenty of anecdotes about "a bad virus I had in January/February" (and I even had one myself!), but man, this is the first one I've heard that really sounds like it could be it.

This person might be able to get an antibody test eventually. Probably not any time soon given the impending resource strain. Probably not ever actually, unless infection has long term effects.

I had a sudden gastro episode at the end of january (could have been from stale yogurt, dunno), mild fever and body ache for cca 24 hours. Practically in parallel my sore throat started, coughing a lot of sputum for next 2 weeks. But basically no fever. As I was getting better, my wife got it from me, another 10 days of 'fun'. No running nose, no fever after first day.

I never had anything similar, for last couple of years I don't get this sick since I became much more active and started doing tons of mountain sports. Mostly 2-4 days sore throat/running nose and I am back.

I keep thinking if we caught it (in Switzerland), but probably it was something else.

I used to have this 2-4 days of sore throat (with mild fever and some maybe mild sputum coughing) at max 2-3 times a year and other than nothing else at all.

Since last one and a half years I have this daily thing - in the morning I wake up with slightly thick sputum accumulated in my throat (more if I was sleeping in AC or fan was too fast or it was colder that night) and then throughout the day there's always something that feels sticky around the throat. I never had this.

Talked to 5-6 doctors. They did CT Scan of face (cross-section I guess), chest x rays and put a camera in my noses to look infection and they said there's none inside. So it's just allergy to pollution and pollens (or something else) that finally kicked in or something like that. I live in a polluted city which has a pollen problem since decades. Last summer I backpacked in Europe for two months. The symptoms were gone exactly for that period (showing a little in some colder parts of Eastern Europe when I was there). It's sad. They all basically say I have to live with it now.

PS. They also found out that I have DNS (CT Scan and couldn't inset that camera thing in my left nose) and suggested either surgery or just keep taking saline nasal spray and they said it might not really help with my condition.

I guess at some point something just changes.

Perhaps it will be useful to have an air quality meter and see what it says about the quality of air in your bedroom when you sleep. The one I used is "IQAir AirVisual Pro" and it helped me identify and fix some problems which helped me wake up feeling healthier than before fixing those issues.

That's a good idea. Some friend also suggested a air purifier.

SARS-COV-2 binds to ACE2 receptors which are prevalent in your lungs and your gut. Its possible the virus attacked the gut rather than the lung. Staring at data last night there's about 1/4-1/3 of a chance for "mild symptoms" but the data did not capture gastrointestinal issues. This also goes along with the theory that there are two strains, one more vicious than the other.

FWIW, the Lcov/Scov two-strain theory turned out to be somewhat of a nonsense paper.

Source?

Post criticizing the paper and discussion: http://virological.org/t/response-to-on-the-origin-and-conti...

What I really find worrying is that all this knowledge gets locked up behind the facebook walled garden. Essentially giving them a monopoly on processing this information. I understand why the doctors do it (use something that's available). But as another poster mentioned, we really need something better.

Indeed. It seems that Facebook's network effect is at play here. As a platform, it is playing a massive role in communication and information sharing in an epidemic.

Perhaps when this is all over some sort of open-collaboration framework should be devised for medical professionals (assuming one doesn't exist?). Also, someone could quite easily take the information from Facebook and put it somewhere else that's more accessible. Facebook groups are closed, right?

This just makes FB more of a public utility.

It s probably for the best. You dont want twitter crowds shutting down conversations and leading to analysis paralysis because every intervention is risky. I would go even further and say the records of these groups should be deleted after months, so as not to become lawsuit material months down the road

Absolutely. Having the power that comes from network effects should come with matching responsibility.

Least of my concerns. It’s more important that the information be shared now.

That's really one of those theoretical views. Nobody at Facebook is sitting there right now checking for the cure in the comments in order to start production of a vaccine at Facebook. In reality it is as open as it can be.

What's really worrying is that decades after the WWW started as a project for researchers to share their findings, Facebook is the best way to do this.

I wonder if Iran is allowed to take part in this discussion, being under US sanctions and all.

nls/augment was developed in the '60s for precisely this type of thing.

Do you really find it all that worrying, more so than the virus itself? I'm not a FB apologist but the fact that they have this network affect and that doctors can use it for free is outstanding. This would not have happened 20 years ago.

That’s not so much due to Facebook as it is to the internet.

Facebook has, in fairness, made this sort of collaboration far easier than it would have been in the days of the pre-Facebook Internet.

The kicker is that this isn't really news for anyone who works in the realm of open science, information dissemination, digital archiving and so on.

If you think salvaging information from social media is a challenge, consider how much gets lost in e-mail or byzantine folder structures on shared drives, or legacy document management systems, usb drives or personal laptops.

The value of information isn't just determined by it's relevancy or "usefulness" in a particular context, but also by it's level of accessibility and discoverability.

Moreover, let's not forget that a huge amount of that information is noise and only a fraction of that will converge in peer reviewed science down the line. And that's how human communication and sharing of information usually works.

Not everything needs to be kept or archived on the spot "just in case". That's just not feasible.

And that is not the only place knowledge gets locked behind:

https://www.nationalreview.com/the-morning-jolt/chinas-devas...

Is there a publicly available feed/mirror of this?

I have never been there (thefaceship), and would not be just another voyeur of this data set.

Looking at the covid-19 hackathon and wondering if there would be an advantage of a dedicated social network for doctors and labs. Perhaps with possibility of making data publicly readable but not submittable. Thoughts?

This exists and is called ResearchGate. I'm not fond of it personally, but many seem to make good use of it.

> making data publicly readable but not submittable

I'm unclear what you mean by this.

Not the person who wrote that but I think read only feed of the conservation where random folks like myself could hear the conservation but not speak directly == "not submit comments". which would work fine for me. Any hypothesizes I generated should go through a vetting process where the idea generates own momentum so as not to waste their time if it ever showed up. a ... peer review process writ smaller and more distributed.

Yup, I couldn't have said it more eloquently.

My biggest issue with pursuing this is I have next to no breadth of knowledge in the medical or medical research fields. It would be hard for me to understand what would help doctors and research labs to share and distribute information, other than being more filterable and searchable than a facebook group.

tl;dr Kicking out the non-experts won't solve the current problems and is likely to introduce new ones. It's a tooling issue, not a platform one.

This is a difficult problem. In trying to reduce the noise by choosing who gets to speak, you immediately encounter a number of issues related to gatekeeping. Moreover, filtering by source doesn't directly address what I see as the underlying problem of presenting relevant information to the user.

Competent and aggressive moderation seems to work fairly well for setting a standard of discourse without excluding anyone (HN is a good example here) but it's time consuming. And it doesn't do much of anything to address the problem of filtering for relevant information.

I think conversations themselves (ie actual back-and-forth with meaningful input from all sides) ultimately just don't scale well beyond a small group. Topic specific mailing lists seem to be the least-worst solution to date, and a Facebook group or subreddit is essentially the same thing implemented using a proprietary platform.

It seems like we still lack the models and tooling to address these problems on a fundamental level. Plenty of academic research exists surrounding knowledge graphs, ontologies, and relationships, but in practice all the mainstream tooling that "just works" is restricted to hierarchical folders (and tags if you're lucky). Zotero is very much a least-worst reference management solution in my opinion (I detailed my thoughts in an HN comment sometime within the past year if you're curious). On the literature front we have things like Arxiv Sanity Preserver and Semantic Scholar, but we're still proverbially drowning in new publications. Tools like Memex (https://github.com/WorldBrain/Memex) and Contextualise (https://github.com/brettkromkamp/contextualise) look promising, but aren't (yet?) a complete solution.

May I ask, why are you not fond of research gate? Are there specific pain points? What is your occupation, are you a medical doctor or researcher?

In a past life I was an academic researcher. My objections are nothing specific, I just never had any obvious uses for it and I'm deeply dissatisfied with the centralized Facebook model so to speak.

ResearchGate seems to blend Facebook with LinkedIn and arXiv. That's great for finding and applying to open positions, but not so much for casual discourse. There's an entire conversational continuum, ranging from things I want to openly share with a prospective employer to crazy ideas discussed with one or two coworkers.

For small semi-private conversations, we have email (and dozens of other services and protocols, each with various pros and cons). For large group communications, we have mailing lists and forums of various sorts. For LinkedIn, why wouldn't I just use LinkedIn itself? There's also ORCID, among other things.

A dedicated tool will never reach the level of training and routine that media like Facebook have built up through all that "brightest minds of a generation" dopamine engineering. The participating doctors are basically weaponizing, against the virus, skills and habits acquired on cat pictures and farmville or whatever guilty social media pleasure they usually enjoy.

I'm not saying that dedicated tools should not exist, I'm saying that there's both room and reason to exist for both.

Which hackathon is this?

This one? https://covid-global-hackathon.devpost.com/

George Hotz is also making a valiant attempt. Starting from scratch, he's made a surprising amount of progress in the last 3 days. Armed with just a web browser and python.

https://www.youtube.com/watch?v=8vWaawiUteM&t=43s

Is he going to hack time and go back and prevent it from spreading? Programmers trying to solve a pandemic is so ridiculous to me.

Love how this went nowhere and the people in the comments are lapping it up. Nice to see a live coding session from him, but man..

I don't want to watch it, what is he trying to achieve ? where did it end ?

It ended with him playing Plague Inc.. Reminds me a bit of my early childhood, when I wanted to build a galley with a friend. We already had one piece of wood...

That facebook group they talk about is currently getting over 900 posts per day. Difficult to keep up - definitely a firehose of information. Could ML be used to distill this info?

It's on Facebook so we know for a fact that ML's already being used to refine the posts now - keeping them relatively free of spam, hateful comments, known malware links, etc.

Watch one, Do one, Teach one. Isn't that the MD way?

Send some to China, get some Chinese surgeons and EMT over in the US.

Oh right: we shouted at them because reasons. Hard to be nice, when they have knowledge we need and the posture is shouty.

China has been kicking journalists and other westerns out of the country. I doubt they want to share what they did nor want to disclose what real infection rates are.

We know covid-19 is bad. We had no CDC resources in place in China. A victim of a stupid trade war.

If only the world were so simplistic. 300 Chinese doctors and equipment arrived in Italy last week. They are anxious to share what they know, to help, and heal, as doctors do. That the CCP gets good press out of it is the sort of “soft power” that the US has forgotten.

https://www.wsj.com/articles/chinese-doctors-and-supplies-ar...

All of the Chinese case studies and trial results are ending up on biorxiv and other sites. The CDC is not a business and wouldn't be affected by trade considerations.

I lieu of adequate testing, I wonder if we could use mild proinflammatory immune response as a way for carriers to self-detect - i.e. so that they feel more sick, quicker, rather that just carrying it around for days unknowingly. Perhaps garlic?

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4417560/#sec4ti...

"proinflammatory" ... "perhaps garlic"?

The linked article uses a lot of jargon, but I thought I understood from it that garlic has an anti-inflammatory effect. I'm not a doctor though, and don't understand most of the article, so please elaborate if you think garlic would make more inflammation.

Fine. Not garlic. But that's not my point.

Please don't speculate or spread information like this. When they know what we should do, they'll tell us.

People have already been admitted to hospital for eating too much garlic.

https://www.bbc.co.uk/news/world-51735367

I'm not suggesting trying to cure or prevent the disease, but to promote its symptoms to emerge in asymptomatic carriers so that they can self-isolate.

If this could be shown to work, that might not be such a bad idea provided the effects could be ceased quickly if the reaction becomes a problem in itself. It's been suggested that the antivirals only provide a substantial benefit in the early stages of the infection, and that the complications and deaths in the later stages are not from the presence of the virus per se, but the damage and fluid in the lungs from the immune system's attempt to fight it.

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