Leiter Reports: A Philosophy Blog

Lead author of Imperial College London study now more optimstic about UK's prospects

Story here.  Earlier coverage of the ICL report.   Frankly, the about-face in less than ten days seems rather dramatic.  He offers some clarification here.

Useful tips for teachers using Zoom to keep things under control!

Here.

Epidemics in historical perspective

Philosopher Steve Sverdlik (SMU) called my attention to this interesting podcast with a Yale historian, made before the current pandemic.

Trump's Easter announcement

This is the best impersonation of the monster-child I've ever heard; it's also very funny.  I bet SNL snatches him up! 

UPDATE:  For those who can't see it on Twitter, here it is:

(Thanks to Alan White for the pointer.)

Good news or false hope? Regarding the papers circulating that claim infection with the new coronavirus is very widespread, so that actual fatality rate is much lower

MOVING TO FRONT FROM YESTERDAY--UPDATED

There are two papers (neither peer-reviewed or in print) circulating--by legitimate researchers, I should add--speculating based on various assumptions and models that, in fact, huge numbers are already infected with the new coronavirus, but have no symptoms or such mild symptoms as to never get tested.   (Here's a journalistic account of one of them.) The theory, then, is that we are closer to "herd immunity" than we realize, and the fatality rate is much, much lower than previously claimed, maybe even as low as seasonal flu.  Both papers make some dubious assumptions based on my amateur reading, so I am waiting to see some more expert assesments and analyses before posting links (thanks to those who have sent them, I appreciate being kept abreast of these things).  Still, it is plainly true that the "confirmed" cases just about everywhere represent only some fraction of the number of actual cases, but we don't know what that fraction is:   1/10?   1/5?   1/50?  Even if that is true, it's clear that the proportion of confirmed cases requiring hospitalization and ICU treatment is significant (e.g., 10-20% requiring hospitalization, 3-8% requiring ICU), and that's still enough to generate a healthcare crisis.   In any case, I'll keep my eyes open for better-informed assessments and post more when I learn more.

UPDATE:  This Twitter thread (noted by Professor Gressis in the comments) has some illuminating comments from some actual experts.

MARCH 26 UPDATE:  This is a very helpful analysis and explanation of the Oxford study that made (misleading) headlines.  (Thanks to John Dupre for the pointer.)

Why the states trump Trump in most respects when it comes to the coronavirus response

Here's a very good explanation of the state of the law from a well-known public law expert, Dan Farber (Berkeley).  (We touched briefly on this the other day here.)  As I wrote ten days ago, it's "good news" right now that the U.S. is a "federal system" (at least if you're lucky enough to live in a state with competent leadership).  Trump can talk about "opening up the economy" by Easter (which is insane), but he can't actually do it, only the states can.

(Thanks to Dean Rowan for the pointer.)

What the future holds as we learn to live with the new coronavirus

A propos a question raised in the comments here, this new article is informative.  The article is consistent with what I have read in reliable sources, and seems a good summary of the state of current knowledge with regard to what the next year or so will be like.

Another COVID-19 hotspot in the U.S.: New Orleans

The NYT reports.  Some 800 cases in the city, as of yesterday, a bit less than Chicago, but Chicago has nearly three million people, and New Orleans has less than 400,000.   Good luck to readers there; more details or personal reports welcome in the comments.

Washington State positive test results stable or declining?

MOVING TO FRONT FROM MARCH 20--SEE MARCH 26 UPDATE

The University of Washington has led the way in COVID-19 testing, and in the midst of the country's worst initial outbreak.  Their daily tracker of test results (scroll down to see the chart) suggests positive results are not increasing and may even be declining in just the last couple of days.  Perhaps this is due to strict containtment measures in the last few weeks there, or something else.  Thoughts from  knowledgeable readers?

UPDATE:   Statistician Nate Silver on the Washington data.

MARCH 26 UPDATE:   It looks like the rate of new confirmed infections in Washington has indeed stabilized, a good bit of evidence for the value of social distancing and business closures.

A worried senior philosophy major at a state flagship

An undergraduate philosophy major writes:

As somebody with serious intentions to apply to PhD programs in philosophy in the coming year or two, depending on how "gap year" plans pan out, and who will almost certainly be applying to JD programs, I have a question that I suspect many younger readers of the blog share. 

The transition to online courses will, of course, be disastrous, especially for those disciplines (namely, philosophy) that value and require classroom discussion. All-around, this is going to be a logistical nightmare -- especially for graduating seniors, with thesis defenses and such -- and I, alongside many others, am searching for ways to best streamline the process of finishing degree requirements, while also juggling other exigencies--personal and academic--of the moment. 

In my case, that (potentially) means doing away with courses that are, in relation to degree requirements, entirely supererogatory. I am, for instance, currently enrolled in an advanced course on Early Analytic Philosophy that, while of immense interest, doesn't at this point make much sense to pursue in the digital format, if I don't have to. 

Australian "fair work commission" judge says you can't fire a faculty member for not publishing in enough "A*" journals

A remarkable judicial push-back against the quantification culture that has taken over public university systems in Australia, the UK and elsewhere, in which academic pursuits are hostage to the stupidity of bureaucrats.  See sections 104-109 of the opinion, in particular.

Some advice from Dr. David Price (Cornell Weill Medicine in NYC)

Some useful points from a critical care physician in New York City.   A couple of key takeaways from the first twenty minutes:  (1) his hospital does almost nothing now but care for COVID-19 patients; (2) cases he's seen are overwhelmingly due to "sustained contact" with someone who is sick or one or two days away from getting sick, by which he means 15 to 30 minutes of contact, especially physical contact, with a sick or about-to-be-sick person; and (3) keep your hands clean and don't touch your face (mask are useful to prevent face-touching, but you don't need an N95 mask for that).   Those who listen to more can add additional useful points in the comments.  Point #2 seems to me especially important, and is consistent with points made by the W.H.O. team that visited Wuhan.

 

Anti-malaria drug ineffective in new, small but "controlled" study out of China

Dr. Ozonoff (BU) writes to me about the "[o]nly controlled trial so far of hydroxychloroquine [the anti-malaria drug]," which appears in a paper from Journal of the Zhejiang University...in Chinese...but the Abstract is in English. This is a very small trial (15 subjects per arm) so hard to draw firm conclusions, but there is zero effect of hydroxychloroquine with these endpoints (disappearance of viral nucleic acids in throat swab after a week; time until negative swab; time to become afebrile; 'radiologic progression' in CT [not sure what this means]; clinical improvement)."  Here's the abstract:

[Abstract] Objective: To evaluate the efficacy and safety of hydroxychloroquine (HCQ) in the treatment of patients with common coronavirus disease-19 (COVID-19). Methods: We prospectively enrolled 30 treatment-naïve patients with confirmed COVID-19 after informed consent at Shanghai Public Health Clinical Center. The patients were randomized 1:1 to HCQ group and the control group. Patients in HCQ group were given HCQ 400 mg per day for 5 days plus conventional treatments, while those in the control group were given conventional treatment only. The primary endpoint was negative conversion rate of COVID-19 nucleic acid in respiratory pharyngeal swab on days 7 after randomization. This study has been approved by the ethics committee of Shanghai public health clinical center and registered online (NCT04261517). Results: One patient in HCQ group developed to severe during the treatment. On day 7, COVID-19 nucleic acid of throat swabs was negative in 13 (86.7%) cases in the HCQ group and 14 (93.3%) cases in the control group (P＞0.05). The median duration from hospitalization to virus nucleic acid negative conservation was 4 (1-9) days in HCQ group, which is comparable to that in the control group [2 (1-4) days, (U = 83.5, P ＞ 0.05)]. The median time for body temperature normalization in HCQ group was 1 (0-2) after hospitalization, which was also comparable to that in the control group 1 (0-3). Radiological progression was shown on CT images in 5 cases (33.3%) of the HCQ group and 7 cases (46.7%) of the control group, and all patients showed improvement in follow-up examination. Four cases (26.7%) of the HCQ group and 3 cases (20%) of the control group had transient diarrhea and abnormal liver function (P＞ 0.05). Conclusions: The prognosis of common COVID-19 patients is good. Larger sample size study are needed to investigate the effects of HCQ in the treatment of COVID-19. Subsequent research should determine better endpoint and fully consider the feasibility of experiments such as sample size.

Dr. Ozonoff comments:  "Certainly not conclusive but not exactly encouraging, either."  (Some of the problems with the earlier French study, that got so much attention, are discussed here [thanks to Nathan Ballantyne for the pointer].)

Spain will be the new Italy for a COVID-19 disaster

This is horrifying.  See also.   This will, I fear, also be New York City in about two or three weeks, although Governor Cuomo is leading an impressive effort to avert disaster.

Blood pressure meds and coronavirus, again: conflicting evidence

Following up on an earlier post, there is a new analysis of the evidence so far.  Here is how Dr. David Ozonoff (Boston University), who kindly sent me the paper, usefully summarized it:  

[T]here is evidence in animals that would allow one to infer that: (a) ARBs [one kind of blood pressure medication] via ACE2 could improve lung function; (2) ARBs via ACE2 increase the chances of lung injury. So we have contradictory inferences and which require further work to sort them out. In the meantime, hypertension experts (through their societies, which don’t represent every possible judgment about the persuasiveness of one or another inference) are continuing to say we should default to current recommendations on managing hypertension. It is the conservative (not in the political sense) position, which is not surprising.

Italian mayors are fed up and letting their fellow citizens know

This funny video has been making the rounds--it's indicative, of course, of how serious the situation is.  We need more leaders like this!

Why having an incompetent President is a problem during a national emergency

Yesterday I noted that Governors, not the President, have authority to take public health measures like shutting down businesses and requiring individuals to stay home, but this interview makes very clear why having an imbecile as President is a real problem; an excerpt:

What is supposed to happen is the federal government has to activate the Defense Production Act immediately. Now, what Defense Production Act does is it allows the federal government to step in and aggressively force the private sector to produce what we need. And what is so critical in this is timing. Because you can't simply build factories from scratch; what you can do is identify a supply chain in order to make it work.

For example, if New York needs rubber gloves, New York cannot simply build rubber glove factories overnight. However, there might be a rubber glove factory in Ohio that could produce it, but they might not have the latex. So therefore, the Defense Production Act allows the federal government to go to the condom factory in Missouri and say, "Listen, you have barrels of latex we need. We are requisitioning those. We are giving them to the rubber glove factory in Ohio. And then we are transporting the finished rubber gloves to New York." That's how it is supposed to work.

Richard Marshall interviews Paul Rusnock (Ottawa)...

...at 3:16 AM.

Coronavirus in Chicago (and Illinois): a timeline

MOVING TO FRONT, ORIGINALLY POSTED MARCH 14--VARIOUS UPDATES, BOTH FOR CHICAGO/ILLINOIS AND NEW YORK CITY

Just a snapshot of what's going on in one metropolis, that hasn't (yet!) been hit as bad as NYC or Seattle or parts of Northern California; I'll update this periodically.  Illinois is doing a fair bit of testing, but not nearly enough.  Technically these are the numbers for Illinois, but almost all the cases are in the Chicago metropolitan area (9.5 million people are in the Chicago metro area, Illinois has 12.5 million altogether, Cook County, where Chicago is, has 5.2 million people; the data is broken out starting March 18):

The authority to lockdown business and quarantine people rests with the states, not the federal government...

...so the decision-maker who matters in the U.S. is your Governor not the monster-child.   See the comments on Twitter from law professor Bobby Chesney (Texas).

Timeline for various COVID-19 experimental drugs

Here.  If we're lucky, it looks like we may know more in April or May about some of them, and if we're VERY lucky it will turn out some of them actually work.

Khalidi from York U/Toronto to CUNY Graduate Center

Muhammad Ali Khalidi (philosophy of science and cognitive science, medieval Islamic philosophy), Professor of Philosophy at York University, Toronto, has accepted appointment as Presidential Professor of Philosophy at the City University of New York Graduate Center, effective July 1.    Those of you who have not read his Natural Categories and Human Kinds:  Classification in the Natural and Social Sciences (Cambridge, 2013) should:  it's an important book, one that will be recognized as such quite generally once the current metaphysical fad that has dominated discussion of "natural kinds" for more than a half-century passes, as it should!

How coronavirus progresses, day by day: mild, moderate, severe, critical, fatal

This video is circulating via Tech Insider and is quite informative:

 

Natural selection and coronavirus

A concise primer from philosopher Alex Rosenberg (Duke).

The best anti-Trump joke yet

Donald Trump, Boris Johnson, Angela Merkel, Pope Francis and a ten-year-old schoolboy are on a plane, that is going down.  There are only four parachutes.

Trump declares, "I'm the smartest person in the U.S.A., the country needs me."  He grabs one and jumps.

Johnson declares, "Britain can't survive Brexit without me," as he grabs one and jumps.

The Pope declares, "More than a billion Catholics needs me," as he grabs one and jumps.

Merkel looks at the boy and says, "You take the last one, you have a whole life ahead of you."

The boys replies, "It's OK, there's two parachutes left, the smartest man in the U.S.A. took my backpack."

Italian death toll declining

Let's hope this optimism based on somewhat less life-altering grief in the last couple of days is warranted.

"Respiratory disease" increases the risk of severe illness and death from the coronavirus...

MOVING TO FRONT FROM MARCH 13:  UPDATED

...but what counts as "respitatory disease"?   Clearly something like emphysema or Chronic Obstructive Pulmonary Disease, but what about asthma (or different kinds of asthma)?   On that, I've heard different opinions.   Does anyone know?  Links welcome.

UPDATE:  Some time in the last week, it appears, the CDC added "moderate to severe asthma" as a risk factor for "serious illness" from COVID-19.  That's obviously unhappy news for many people, but all the more reason for those with moderate or severe asthma to take extra precautions.   I note that the CDC also lists extremel obesity (BMI greater than 40) as a risk factor, probably because of the pressure weight places on the lungs, but I don't know if that's the reason.

The chart below the fold explains the meaning of terms like "moderate" and "severe":

A public health message about the coronavirus "shitshow" and dangerous "dumbfuckery"

Courtesy of Australians:

 

Journalistic report: many of those infected with COVID-19 lose their sense of smell and taste

This is curious:

Anosmia, the loss of sense of smell, and ageusia, an accompanying diminished sense of taste, have emerged as peculiar telltale signs of Covid-19, the disease caused by the coronavirus, and possible markers of infection.

On Friday, British ear, nose and throat doctors, citing reports from colleagues around the world, called on adults who lose their senses of smell to isolate themselves for seven days, even if they have no other symptoms, to slow the disease’s spread. The published data is limited, but doctors are concerned enough to raise warnings....

The British physicians cited reports from other countries indicating that significant numbers of coronavirus patients experienced anosmia, saying that in South Korea, where testing has been widespread, 30 percent of 2,000 patients who tested positive experienced anosmia as their major presenting symptom (these were mild cases)....

“Almost everybody who is hospitalized has this same story,” said Dr. Marco Metra, chief of the cardiology department at the main hospital in Brescia, where 700 of 1,200 inpatients have the coronavirus. “You ask about the patient’s wife or husband. And the patient says, ‘My wife has just lost her smell and taste but otherwise she is well.’ So she is likely infected, and she is spreading it with a very mild form.”

Most readers do not yet know anyone with COVID-19

That's one takeaway from the poll tacked on to a post yesterday (Sunday):  68% (of about 350 respondents) report that they know of no friends or acquaintances who have COVID-19, while 22% know 1 or 2 people, 9% know 3 to 7, and 1% know ten or more.   Sadly, these numbers are likely to change dramatically over the next few weeks.

A list and description of treatments and vaccines in development

An informative description of what's being worked on.

Visa problems for foreigners teaching or studying in the U.S.?

A young philosopher writes:

I hope you’re staying safe. I want to thank you for your coverage of the pandemic, which has been immensely helpful to us all.

I also wanted to bring attention to a related issue. The pandemic is creating additional problems for foreign faculty and students on visas. Many visas have residency requirements, and some of these have not been updated or had exceptions made for them in light of the pandemic. Because of this, some are finding that in traveling to safer places, or failing to travel back to more dangerous ones, they are at risk of losing their visas and therefore their employment.

If it helps, let me illustrate this issue with my own example. I am a [non-US] citizen who is (was?) a lecturer in the philosophy department at [U.S. research university] on a J1 visa (for short-term, international scholars). Because of the pandemic, I found it advisable to return to [my home country]. I informed the university and department of my intention to return to [my home country], which I did. A day later the university terminated my employment for ‘voluntarily violating my visa’, in particular the residency requirement. I will no longer be getting paid this term, and my courses and students are now in jeopardy (the university has still not informed them of the change, as evidenced by their continued emails to me, and online lectures are slated to start Monday morning).

In discussing this with other international faculty, at [my former U.S. university] and elsewhere, it has become clear that many are deciding to withhold certain information from both the administration and the department. This so as not to jeopardize their visas and employment. I am hoping that you might be able to bring attention to this issue and prevent others from jeopardizing their own employment or studies.

This the first I've heard of this, but my guess is others are in similar binds or having similar problems.  IF any of my law readers know more about the visa rules, please weigh in.  Links and advice from those with relevant experience are welcome.

Three senior hires for Wash U/St. Louis: Copenhaver, McGrath, Watson

The Department of Philosophy at Washington University, St. Louis has made three senior hires:   Becko Copenhaver (early modern philosophy, philosophy of mind) from Lewis & Clark College; Matthew McGrath (epistemology, metaphysics, philosophy of perception) from Rutgers University, New Brunswick; and Lori Watson (political and legal philosophy, feminist philosophy) from the University of San Diego.   After last year's senior losses (John Doris, Julia Driver, Roy Sorensen), these new hires should preserve Wash U's place in the U.S. overall top 25-30.

(Thanks to Jon Kvanvig for the information.)

I'm falling behind on e-mails, but thanks to all who have written

I am glad so many have found my attempt to sort through the news and information related to the coronavirus useful (traffic has been very high--up 40% since February, and while traffic usually goes up in March, not by this proportion--and thanks especially to all those who have written, I'm trying to acknowledge all those e-mails slowly--one philosopher said I was the only source of "unbiased" news he had found [at best, I'm a source of reasonably objective and sensible news moderation and aggregation, and I'm openign comments a lot for corrections]).  I probably won't be able to keep this up, but will try to share the most helpful items going forward.  Good wishes to you all!

Don't go to the hospital, unless you must: a warning from Italian doctors

Doctors need to read this, but so do possible patients; an excerpt:

“Western health care systems have been built around the concept of patient-centered care,” physicians Mirco Nacoti, Luca Longhi, and their colleagues at Papa Giovanni XXIII Hospital in Bergamo urge in a paper published on Saturday in NEJM Catalyst, a new peer-reviewed journal from the New England Journal of Medicine. But a pandemic requires “community-centered care"....

“We are far beyond the tipping point,” Nacoti and his colleagues write. With 70% of ICU beds reserved for critically ill Covid-19 patients, those beds are being allocated only to those “with a reasonable chance to survive,” as physicians make wrenching triage choices to try to keep alive those who have a chance. “Older patients are not being resuscitated and die alone without appropriate palliative care, while the family is notified over the phone, often by a well-intentioned, exhausted, and emotionally depleted physician with no prior contact,” they report....

To have any hope of avoiding that disaster in the U.S., the health care system needs to decentralize and make the community a focus of interventions on a par with patients, said Cereda, a graduate of the medical school at the University of Milan who has been in touch with colleagues in Italy....

One such step reflects the finding that hospitals might be “the main” source of Covid-19 transmission, the Bergamo doctors warned. The related coronavirus illness MERS also has high transmission rates within hospitals, as did SARS during its 2003 epidemic....

Although doctor house calls seem as prehistoric as rotary phones, home-based care for Covid-19 patients may be necessary in order to protect the community even if, to an individual patient, hospital care might be more effective....

Things "get real" (i.e., personal)--plus get an oximeter if you can

In just the last 24 hours, I've heard from a colleague in Boston whose wife (also an academic) has COVID-19 (he does not have any symptoms yet), and from an academic couple in New York City, both of whom have it.  One of the latter made a good suggestion on Facebook:  it's helpful to have an oximeter at home:  you put your finger in, and it gives you your pulse and, more importantly, the oxygen saturation in your blood.  Normal results are 95 or higher, but you should figure out your own baselines once you get one.  We bought the Zacurate Pro Series 500DL Pulse Oximeter from Amazon a couple of weeks ago for about $27 or $28 dollars.  (My father, who has COPD, has had a Choicemmeter one for a long time, and that has also been fine.)  If one feels short of breath, it's hard to tell how short of breath you really are, and this gives you a useful metric to share with your doctor.   According to the Mayo Clinic, readings under 90 on an oximeter are low, but normal levels can vary depending on one's general pulmonary health.  (Medicare authorizes supplemental oxygen for most patients with blood oxygen consistently below 88 on a pulse oximeter.)  Links to other sources and comments from knowledgeable readers welcome.

UPDATE:  A reader, below, notes that Amazon can't deliver the Zacuarate Oximeter until late May.  There are many others on the market fortunately, google should be able to help you figure out whether they're legitimate.

ADDENDUM:  Here's a poll, to get a sense of how many others now know people with COVID-19.  Maybe I'll run this again in a few weeks for comparison.

The COVID-19 disaster in Italy, in perspective

Italy now has 53,578 confirmed cases (they are not testing everyone), and 4,825 deaths.   China reports 81,397 confirmed cases (they are also not testing everyone), and 3,265 deaths.   But China's population is nearly 1.4 billion people, while Italy's is about 60 million.   If China's statistics were as grim as Italy's, China would have more than 1.2 million confirmed cases, and more than 100,000 deaths.

Daily updates from the head of surgery at Columbia Presbyterian Hospital in New York City...

...are being posted on this Twitter account.  Since this hospital is in the "thick of things" in the hardest hit spot in the U.S., it's a window into what's going on. 

Philosopher of physics Tim Maudlin explains in simple but stark terms why "social distancing" works

 

Spreadsheet of recorded philosophy lectures with links

You can add to it as well.

(Thanks to Tyron Goldschmidt for the pointer.)

Support independent bookshops during the pandemic

A suggestion from philosopher David Velleman:

If people are worried about their local independent bookstores during the crisis — or even under normal conditions — they should consider buying their books from https://bookshop.org. This site enables independent bookstores to set up their own sites within the bookshop.org domain, with all fulfillment functions performed by a third party; and in addition to the returns the bookstores earn from their bookshop.org sites, they share in a pool of returns earned by sales from the central bookstore.org site. If your book its not yet available on bookstore.org, you can become an affiliate and list the book on your own sales site. You will then earn a share of the sales, but if you already link to your books on Amazon from your personal home page, you can switch those links to bookshop.org and format them in such a way that the earnings will go to your local independent bookstore instead, if they are also affiliates. (The format is https://bookshop.org/a/xxxx/yyyyyyyyyyyyy where xxxx is the bookshop.org affiliate number of the store and yyyyyyyyyyyyy is the ISBN-13 number of the book.)

Great moments in obscure rock 'n' roll: Blodwyn Pig, "Dear Jill," 1969

Another nice number from the debut album of ex-Jethro Tull guitarist Mick Abrahams' band:

 

Good speech by Dr. Emily Landon (U of Chicago) explaining why Illinois Governor was correct to require a "lockdown" for at least two weeks

The "lockdown" begins at 5 pm today.   To put this in a bit of context, Cook County, where Chicago is and with 5.2 million people, has 548 confirmed cases as of today (the caseload did not quite double in the last two days); New York City, with 8.5 million people, has about 7500 confirmed cases today.  New York's "lockdown" started just the other day.   New York hospitals are already in crisis, as each day's New York Times reveals.   By starting earlier in Illinois, Governor Pritzker will undoubtedly save lives and alleviate a lot of suffering.  If your locality hasn't acted, send this speech to your local officials.

 

Survey of infectious disease experts

Here; an excerpt (but see the charts in the article for much more detail, including degrees of confidence):

The most recent survey, taken on March 16 and 17, found that, as a group, the experts think that as of March 15, only 12 percent of infections in the U.S. had been reported by the Centers for Disease Control and Prevention. They think there’s a 73 percent chance of a second wave of hospitalizations this fall. And they expect approximately 200,000 deaths in the U.S. by the end of the year....

The expert consensus is to expect about 200,000 deaths in the U.S. from COVID-19 this year, but the uncertainty around that number is also huge: There’s an 80 percent chance the final number will be between 19,000 and 1.2 million, according to these estimates.

According to the CDC, there were a bit more than 2,800,000 deaths in the U.S. in 2017.  So coronavirus, on the average estimate, would increase deaths in the United States by about 7%, but might increase it by as much as 40%!

Twitter threads by Yale's Christakis related to COVID-19...

...collected here.  (We've noted a couple of them previously.)

More on hydroxychloroquine (the anti-malaria drug) as a *possible" treatment for COVID-19

A mixed verdict so far, with skeptics, but also some hopeful assessments.  What might the mechanism be by which it could work?

In the UK, Robin May, Professor of Infectious Disease at the University of Birmingham, explained that there is a scientific rationale for the use of hydroxychloroquine in the treatment of COVID-19, based on its mode of action in malaria.

In a statement through the Science Media Centre, he explained that, as chloroquine is a "weak base" and so helps to neutralise acids, it makes the environment "less suitable" for the malaria parasite to live in when it diffuses into red blood cells.

While the mode of action against COVID-19 is not established, Prof May said, he pointed out that many viruses enter host cells via endocytosis, as a result of which they are initially taken up into an intracellular 'compartment that is "typically fairly acidic”.

Chloroquine would alter the acidity of this compartment, which can interfere with the ability of viruses to escape into the host cell and start replicating.”

He continued: "Another possibility is that chloroquine may alter the ability of the virus to bind to the outside of a host cell in the first place,” adding that the drug "has subtle effects on a wide variety of immune cells…and it may be that one of these effects helps stimulate the body’s ability to fight off COVID-19.”

Crucially, the drug is also "cheap and relatively easy to manufacture" and so could easily be put into clinical trials and, eventually, treatment, May underlined.

(Thanks to Dr. David Ozonoff for the pointer.)

The challenges of fine-tuning a vaccine against the coronavirus

A lucid explanation from a Cambridge scientist.

(Thanks to Joe Hatfield for the pointer.)

Leiter v. Trump

A funny message, from longtime reader Larry Franz:

Thank you for your COVID-19 posts. The public needs reliable information like you've been providing. We also need TV networks to stop giving the president free access to misinform the public. He's a risk to public health.

Alas, I can only address one of these issues!

Tory government to pay up to 80% of wages (up to 2500 GBP per month) of those unable to work due to pandemic

That's a far more serious response than the proposal to send out some $1,000 checks now and then.   Will it inspire the Republicans here?

Is there any bioethical consensus on whose lives to save first in a triage situation? (UPDATED)

Professor Terry Myers (English, William & Mary) writes:

The Johns Hopkins piece notes that "Unless patients can be transferred, we would then enter the uncharted territory of having to ration life-saving care in order to save the most lives—something we have never done before in an organized way.”

Is there a consensus among ethicists as to the best criteria for choosing to save one patient’s life instead of another’s?

I don't know the answer to this.  New York prepared a report in 2015 about criteria for rationing ventilators, but I don't know whether this reflects any kind of "consensus" outside this particular committee, which included philosophers but, thankfully, non-philosophers too.  From page 4 of the Executive Summary:

The primary goal of the Guidelines is to save the most lives in an influenza pandemic where there are a limited number of available ventilators. To accomplish this goal, patients for whom ventilator therapy would most likely be lifesaving are prioritized. The Guidelines define survival by examining a patient’s short-term likelihood of surviving the acute medical episode and not by focusing on whether the patient may survive a given illness or disease in the long-term (e.g., years after the pandemic). Patients with the highest probability of mortality with medical intervention, along with patients with the smallest probability of mortality with medical intervention, have the lowest level of access to ventilator therapy. Thus, patients who are most likely to survive without the ventilator, together with patients who will most likely survive with ventilator therapy, increase the overall number of survivors.

This article suggests a similar kind of consensus among the bioethicists consulted (those with best chance of surviving get priority for treatment).   Links and comments from more knowledgeable readers welcome.

UPDATE:   Thomas Cunnigham, the Bioethics Director at KP West Los Angeles and a faculty member at the Loyola Marymount Bioethics Institute, writes: